【摘要】 目的:观察冰酥肿痛酊外用治疗踝关节闭合性骨折早期肿痛的临床疗效。方法:将90例符合要求的闭合性踝关节骨折患者随机分为3组，每组30例。冰敷组予以肿胀处冰敷、患肢石膏固定制动、患肢抬高、功能锻炼等处理；雪上花搽剂组在冰敷组处理的基础上，在肿胀处外敷雪上花搽剂，每次5 mL,每天3次；冰酥肿痛酊组在冰敷组处理的基础上，在肿胀处外敷冰酥肿痛酊，每次3～5 mL,每天3次。3组均治疗至肿胀消退。比较3组患者的肿胀持续时间、消肿速度、踝关节疼痛视觉模拟量表（visual analogue scale, VAS）评分。结果:（1）肿胀持续时间。3组患者的肿胀持续时间比较，差异有统计学意义[（10.13±0.96）d,（8.03±0.91）d,（9.70±0.66）d,F=61.967,P=0.000];冰敷组的肿胀持续时间比雪上花搽剂组和冰酥肿痛酊组长（P=0.000;P=0.000）;雪上花搽剂组和冰酥肿痛酊组的肿胀持续时间比较，差异无统计学意义（P=0.067）。（2）消肿速度。3组患者的消肿速度比较，差异有统计学意义[（0.35±0.09）cm·d^-1,（0.44±0.08）cm·d^-1,（0.50±0.10）cm·d^-1,F=17.816,P=0.000];冰敷组的消肿速度比雪上花搽剂组和冰酥肿痛酊组慢（P=0.000;P=0.000）;雪上花搽剂组和冰酥肿痛酊组的消肿速度比较，差异无统计学意义（P=0.625）。（3）踝关节疼痛VAS评分。治疗前3组患者的踝关节疼痛VAS评分比较，差异无统计学意义[（8.07±0.57）分，（8.10±0.54）分，（8.17±0.58）分，F=7.630,P=0.120]。治疗结束后3组患者的踝关节疼痛VAS评分均较治疗前减小（t=1.256,P=0.000;t=2.575,P=0.000;t=1.360,P=0.000）。治疗结束后3组患者的踝关节疼痛VAS评分比较，差异有统计学意义[（1.93±0.63）分，（1.90±0.47）分，（1.80±0.48）分，F=18.714,P=0.045];冰敷组与雪上花搽剂组比较，差异无统计学意义（P=0.240）;冰敷组和雪上花搽剂组的踝关节疼痛VAS评分均高于冰酥肿痛酊组（P=0.001;P=0.000）。结论:在冰敷的基础上采用冰酥肿痛酊外用治疗踝关节闭合性骨折早期肿痛，疗效确切，其疗效优于单纯冰敷和冰敷联合雪上花搽剂外用。更多还原

【Abstract】 Objective:To observe the clinical outcome of external application of Bingsu Zhongtong(冰酥肿痛,BSZT)tincture in treatment of early swelling and pain resulting from closed ankle fractures.Methods:Ninety patients with closed ankle fractures were enrolled in the study and were randomly divided into ice compress group, Xueshanghua(雪上花,XSH)liniment group and BSZT tincture group, 30 cases in each group.All patients in the 3 groups were treated with the conventional treatments such as ice compress at the swelling parts, plaster fixing, braking and raising the injured limbs and functional exercises.Moreover, the patients in XSH liniment group were further treated with external application of XSH liniment at the swelling parts, 3 times a day, 5 mL at a time; and the ones in BSZT tincture group with external application of BSZT tincture at the swelling parts, 3 times a day, 3-5 mL at a time.All patients in the 3 groups were treated till the swelling was subsided and skin folds appeared in ankle.The ankle swelling duration, detumescence speed and ankle pain visual analogue scale(VAS)score were compared between the 3 groups.Results:(1)There was statistical difference in ankle swelling duration between the 3 groups(10.13±0.96,8.03±0.91,9.70±0.66 days, F=61.967,P=0.000).The ankle swelling duration was longer in ice compress group compared to XSH liniment group and BSZT tincture group(P=0.000,P=0.000),while there was no statistical difference between XSH liniment group and BSZT tincture group(P=0.067).(2)There was statistical difference in detumescence speed between the 3 groups(0.35±0.09,0.44±0.08,0.50±0.10 cm/d, F=17.816,P=0.000).The detumescence speed was slower in ice compress group compared to XSH liniment group and BSZT tincture group( P = 0. 000; P = 0. 000),while there was no statistical difference between XSH liniment group and BSZT tincture group( P = 0. 625).(3)There was no statistical difference in ankle pain VAS score between the 3 groups before the treatment( 8. 07 ± 0. 57,8. 10 ± 0. 54,8. 17 ± 0. 58 points,F = 7. 630,P = 0. 120). The ankle pain VAS scores decreased in the 3 groups after the end of the treatment compared to pre-treatment( t = 1. 256,P = 0. 000; t = 2. 575,P = 0. 000; t = 1. 360,P = 0. 000).There was statistical difference in ankle pain VAS score between the 3 groups after the end of the treatment( 1. 93 ± 0. 63,1. 90 ± 0. 47,1. 80 ± 0. 48 points,F = 18. 714,P = 0. 045). The ankle pain VAS scores were not significantly different from each other between ice compress group and XSH liniment group( P = 0. 240),whereas it was lower in BSZT tincture group compared to compress group and XSH liniment group( P = 0. 001; P = 0. 000). Conclusion: Combination of ice compress with external application of BSZT tincture has reliable curative effects in treatment of early swelling and pain resulting from closed ankle fractures,and it surpasses the monotherapy of ice compress and the combination therapy of ice compress and external application of XSH liniment in curative effects.更多还原