【摘要】 目的:观察自拟骨伤复元汤对胸腰椎骨折术后早期白介素-2、纤维蛋白原表达及患者疼痛的影响。方法:将符合要求的80例胸腰椎骨折患者随机分为2组。对照组40例,术后给予补充血容量、抗感染等常规治疗;观察组40例,术后给予常规治疗联合口服自拟骨伤复原汤治疗。分别于术后第1天、第7天及第14天,比较2组患者血浆中白介素-2、纤维蛋白原含量的变化情况及疼痛视觉模拟评分变化情况。结果:1血浆白介素-2含量。不同时间点间血浆白介素-2的差异有统计学意义(F=98.792,P=0.000)。2组血浆白介素-2的组间差异总体上有统计学意义(F=18.916,P=0.000)。进一步比较显示,术后第1天2组患者血浆白介素-2含量的差异无统计学意义[(6.20±1.03)ng·L-1,(6.50±0.85)ng·L-1,t=-0.714,P=0.475];术后第7天、第14天2组患者血浆白介素-2含量比较,组间差异有统计学意义[(8.30±0.95)ng·L-1,(9.70±0.67)ng·L-1,t=-2.950,P=0.030;(10.20±1.32)ng·L-1,(11.90±1.29)ng·L-1,t=-2.431,P=0.015];时间因素与分组因素存在交互效应(F=12.417,P=0.011)。2血浆纤维蛋白原含量。不同时间点间血浆纤维蛋白原含量的差异有统计学意义(F=118.439,P=0.000)。2组患者血浆纤维蛋白原含量的组间差异总体上有统计学意义(F=0.896,P=0.049)。进一步比较显示,术后第1天2组血浆纤维蛋白原含量比较,差异无统计学意义[(3.29±0.31)mg·dL-1,(3.34±0.23)mg·dL-1,t=0.277,P=0.741)];术后第7天、术后第14天,2组血浆纤维蛋白原含量比较,组间差异有统计学意义[(2.98±0.16)mg·dL-1,(2.39±0.18)mg·dL-1,t=1.487,P=0.042;(2.77±0.13)mg·dL-1,(2.11±0.12)mg·dL-1,t=8.952,P=0.039];时间因素与分组因素存在交互效应(F=22.248,P=0.000)。3术后疼痛视觉模拟评分。不同时间点间术后疼痛视觉模拟评分的差异有统计学意义(F=264.972,P=0.000)。2组术后疼痛视觉模拟评分的组间差异总体上有统计学意义(F=6.399,P=0.039)。进一步比较显示,术后第1天2组术后疼痛视觉模拟评分的差异无统计学意义[(6.20±1.03)分,(6.10±0.99)分,t=0.221,P=0.828)];术后第7天、第14天,2组术后疼痛视觉模拟评分比较,组间差异有统计学意义[(3.70±1.06)分,(2.70±0.82)分,t=2.333,P=0.031;(2.00±0.82)分,(1.30±0.48)分,t=2.357,P=0.030];时间因素与分组因素存在交互效应(F=12.662,P=0.024)。结论:在胸腰椎骨折患者术后早期应用自拟骨伤复元汤,能够提高血浆白介素-2的含量,降低纤维蛋白原的含量,有效缓解患者的疼痛。更多还原

【Abstract】 Objective: To observe the effect of self-made GUSHANG FUYUAN DECOCTION on the early postoperative expression of interleukin-2 and fibrinogen and the pain in patients with thoracolumbar vertebral fracture. Methods: Eighty patients with thoracolumbar vertebral fracture enrolled in the study were randomly divided into 2 groups. The patients in control group( 40 cases) were treated with postoperative conventional therapy including blood volume supplement and anti-infection drug after the surgery,while the others in observation group( 40 cases) were treated with the conventional therapy combined with oral application of self-made GUSHANG FUYUAN DECOCTION. The plasma contents of interleukin-2 and fibrinogen and the visual analogue score( VAS) of pain were observed and compared between the 2 groups at the 1st,7th and 14 th day after the operation respectively. Results: There was statistical difference in plasma interleukin-2 contents between different time points( F = 98. 792,P = 0. 000). There was statistical difference in the plasma interleukin-2 contents between the 2 groups( F = 18. 916,P = 0. 000). Further comparison indicated that there was no statistical difference in the plasma interleukin-2 contents between the 2 groups at the 1st day after the operation( 6. 20 +/- 1. 03 vs 6. 50 +/- 0. 85 ng /L,t =- 0. 714,P = 0. 475).There was statistical difference in the plasma interleukin-2 contents between the 2 groups at the 7th and 14 th day after the operation respectively( 8. 30 +/- 0. 95 vs 9. 70 +/- 0. 67 ng /L,t =- 2. 950,P = 0. 030; 10. 20 +/- 1. 32 vs 11. 90 +/- 1. 29 ng /L,t =- 2. 431,P =0. 015). There was interaction effect between time factor and grouping factor( F = 12. 417,P = 0. 011). There was statistical difference in plasma fibrinogen contents between different time points( F = 118. 439,P = 0. 000). There was statistical difference in the plasma fibrinogen content between the 2 groups( F = 0. 896,P = 0. 049). Further comparison indicated that there was no statistical difference in the plasma fibrinogen content between the 2 groups at the 1st day after the operation( 3. 29 +/- 0. 31 vs 3. 34 +/- 0. 23 mg /dL,t = 0. 277,P = 0. 741).There was statistical difference in the plasma fibrinogen content between the 2 groups at the 7th and 14 th day after the operation respectively( 2.98 +/-0.16 vs 2.39 +/-0.18 mg/dL,t =1.487,P =0.042;2.77 +/-0.13 vs 2.11 +/-0.12 mg/dL,t =8.952,P =0.039). There was interaction effect between time factor and grouping factor( F = 22. 248,P = 0. 000). There was statistical difference in the postoperative VAS between different time points( F = 264. 972,P = 0. 000). There was statistical difference in the postoperative VAS between the 2groups( F = 6. 399,P = 0. 039). Further comparison indicated that there was no statistical difference in the postoperative VAS between the 2groups at the 1st day after the operation( 6. 20 +/- 1. 03 vs 6. 10 +/- 0. 99 points,t = 0. 221,P = 0. 828). There was statistical difference in the postoperative VAS between the 2 groups at the 7th and 14 th day after the operation respectively( 3. 70 +/- 1. 06 vs 2. 70 +/- 0. 82 points,t = 2. 333,P = 0. 031; 2. 00 +/- 0. 82 vs 1. 30 +/- 0. 48 points,t = 2. 357,P = 0. 030). There was interaction effect between time factor and grouping factor( F = 12. 662,P = 0. 024). Conclusion: The application of self-made GUSHANG FUYUAN DECOCTION can imcrease the plasma interleukin-2 contents and decrease the plasma fibrinogen contents and relieve the pain effectively in the early period after the surgery for patients with thoracolumbar vertebral fracture.更多还原