Effect Of Modified Fuyuan Huoxue Decoction On Limb Swelling Before Operation Of AO 42-B Type And 42-C Type Tibiofibular Fracture

Objective: The purpose of this study is to explore the curative effect of modified Fuyuan Huoxue Decoction in the treatment of preoperative limb swelling in patients with AO 42-B type and 42-C type tibiofibular fracture,and to analyze its clinical application prospect.Methods: From February 2020 to February 2021,60 patients with AO 42-B type and 42-C type tibiofibular fractures and TCM Syndrome Differentiation belong to stagnation of qi and blood stasis who met the standard were randomly divided into a control gro up and a test group.After admission,the two groups of patients were treated with conventional treatment programs including traction and immobilization of the calcaneal bone on the affected side,elevation of the affected limb,ice compress,medication to reduce swelling and pain relief.The test group was treated with modified Fuyuan Huoxue Decoction orally on the basis of conventional treatment for 5 consecutive days.We record the difference in calf circumference,swelling grade,erythrocyte sedimentation rate,C-reactive protein and other indicators before treatment、on the first day after treatment、on the third day after treatment and on the fifth day after treatment for each patient.Meanwhile,we aslo record TCM syndrome score before treatment 、TCM syndrome score on the fifth days after treatmentthe,and occurrence of tension blisters、deep vein thrombosis and the time of skin wrinkles.Finally,we through the data and analysis to draw a conclusion.Results: There are 4 cases were removed in study.One case in the control group and one case in the experimental group asked to return to the local hospital for treatment,one case in the control group refused the treatment due to poor compliance,and one case in the experimental group could not accept the bitter taste of traditional Chinese medicine.Finally,56 eligible patients were included,and 4 cases were removed in study.There are 28 cases each in the test group and the control group.There were no significant differences in gender,age,height,weight,BMIindex,fracture classification,the difference in calf circumference,swelling ratio of leg circumference before treatment,swelling grade before treatment,TCM syndrome integral before treatment erythrocyte sedimentation rate before treatment and C-reactive protein before treatment between the two groups(P>0.05).On the first day after treatment : There was no significant difference in calf circumference,swelling grade,erythrocyte sedimentation rate,C-reactive protein between two groups.The third day after treatment: There was no significant difference in swelling grade between the two groups(P >0.05);the Erythrocyte sedimentation rate in the experimental group was lower than that of the control group,and the difference was statistically significant(P < 0.05);the difference in calf circumference of the experimental group was smaller than that of the control Group,and the difference was statistically significant(P<0.01);the C-reactive protein in the test gro up was lower than the control group,and the difference was statistically significant(P<0.01).The fifth day of treatment: The swelling grade of the test group was lower than that of the control group and the difference was statistically significant(P<0.05);Erythrocyte sedimentation rate of the test group was lower than the control group and the difference was statistically significant(P<0.01);The difference in calf circumference of the test group was lower than that of the control group and the differ ence was statistically significant(P<0.01);the C-reactive protein in the test group was lower than that of the control group,and the difference was statistically significant(P<0.01).The incidence of tension blisters in the test group were 14.29% and that in the control group was 21.43%,and the difference of those groups was not statistically significant(P>0.05);The incidence of DVT in the experimental group was 10.71% and that in control group was 17.86%,and the difference was not statistically significant(P>0.05).the appearance time of skin wrinkles in the test group was lower than that in the control group,and the difference was statistically significant(P<0.01).The TCM symptom score of the experimental group was lower than that in the contro l group,and the difference was statistically significant(P<0.01);the total effective rate of TCM symptom in the experimental group(85.71%)was higher than that in the control group(57.14%),and the difference was statistically significant(P < 0.05).Conclusion: The modified Fuyuan Huoxue Decoction can reduce the swelling degree of limbs,inflammatory reaction and TCM syndrome integral before operation of AO 42-B and42-C type tibiofibular fractures,and shorten the appearance time of skin wrinkles.