| Objective:By observing the clinical effect of Dangui Sihuang Powder on calcaneal fracture in early stage,the mechanism of reducing swelling,pain and skin temperature was studied,and the significance of stagnation-heat syndrome in the early development of calcaneal fracture was discussed,and the advantages of cooling blood and removing blood stasis method in early treatment of calcaneal fracture were promoted METHODS:From November 2017 to November 2018,64 patients with calcaneal fracture were randomly divided into treatment group and control group with 32 cases in each group.During the treatment period,the treatment group lost 1 case and the control group lost 2 cases.The final effective cases were 61 cases,including 31 cases in the treatment group and 30 cases in the control group.Two groups of patients were treated with the same basic treatment,the control group was given 20% mannitol injection 125 ml,intravenous drip,once a day for seven days,celecoxib capsule 250 mg,oral,once a day,for 11 days,with RICE principle as the basic treatment;the treatment group was treated with basic treatment combined with Dangui Sihuang powder for external application,twice a day,for 11 days.The changes of pain,swelling and skin temperature on the first day,the third day,the fifth day,the seventh day,the ninth day and the eleventh day after admission were observed.The peak swelling and the time of skin wrinkles were recorded.The scores of TCM syndromes before and after treatment were compared.The treatment results were evaluated by SPSS21.0 statistical software.1.Baseline data:The 64 patients included in this study lost 3 cases during the treatment period,and 61 patients actually completed the treatment.There were no significant differences in gender,age,emergency time,fracture type and soft tissue injury type between the two groups(P > 0.05).2.Relaxation of swelling:Inter-group comparison: The two groups of patients on the first,third,fifth,seventh,ninth and eleventh day of admission using repeated measurement variance analysis,the difference was statistically significant(P < 0.05),and the degree of swelling in the treatment group was lower than that in the control group,indicating that the level of swelling in the treatment group was better than that in the control group.Intra-group comparison: The swelling degree of two groups of patients after the first,third,fifth,seventh,ninth and eleventh days of admission was compared before and after,the difference was statistically significant(P < 0.05),indicating that the swelling of two groups of patients had been alleviated after treatment.Comparing the final effect of the two groups of patients,the treatment group healed 5 cases,markedly effective 21 cases,effective 5 cases;the control group healed 2 cases,markedly effective 16 cases,effective 12 cases,there was no significant difference between the two groups(P > 0.05).3.The time of skin wrinkles:During the treatment period,dermatoglyphic signs were found in both groups,with an average of 6.03 days in the treatment group and 6.62 days in the control group.There was a significant difference between the two groups in the time of dermatoglyphic signs(P < 0.05).4.Changes of skin temperature in affected area:Inter-group comparison: The skin temperature changes of the two groups on the1 st,3rd,5th,7th,9th and 11 th day of admission were analyzed by repeated measurement variance analysis,the difference was statistically significant(P < 0.05),and the difference of skin temperature in the treatment group was lower than that in the control group,indicating that the skin temperature level in the treatment groupwas better than that in the control group.The difference was statistically significant(P< 0.05),indicating that the skin temperature of affected part of both groups decreased after treatment.5.VAS pain scoreInter-group comparison: There was no significant difference in VAS pain score between the two groups on the first day of admission(P > 0.05).There was significant difference in VAS pain score between the two groups on the 11 th day of admission(P< 0.05).Intra-group comparison: VAS scores of the two groups before and after treatment were compared,the difference was statistically significant(P < 0.05).The improvement of VAS pain score: in the treatment group,8 cases were excellent,21 cases were good,2 cases were good,0 cases were poor,the excellent and good rate was 93.54%.In the control group,4 cases were excellent,22 cases were good,4 cases were middle,0 cases were poor,the excellent and good rate was 86.66%.There was no significant difference between the two groups(P > 0.05).6.Integral of TCM syndromes:Inter-group comparison: There was no significant difference in TCM syndrome scores between the two groups on the first day of admission(P > 0.05).There was significant difference in TCM syndrome scores between the two groups on the 11 th day(P < 0.05);there was significant difference in TCM syndrome scores between the two groups before and after treatment(P < 0.05).The total effective rate was 100%.In the control group,0 cases were cured,4 cases were markedly effective,23 cases were effective and 3 cases were ineffective.The total effective rate was 3%.The total effective rate was 90%.There was significant difference between the two groups(P <0.05).Conclusion:1.For the early treatment of calcaneal fracture,routine basic treatment can achieve better effect of detumescence and pain relief,but combined with external application of Dangui Sihuang Powder has better effect.2.In the early stage of calcaneal fracture,the special physiological structure of the heel is easy to accumulate heat and stasis.Combined with the symptoms and signsof patients,according to the syndrome differentiation of stagnation and heat,guided by the method of cooling blood and removing blood stasis,external application of Dangui Sihuang Powder can obviously reduce the skin temperature of the affected part and alleviate the symptoms of swelling,pain,thirst and urinary red,which is worthy of clinical application. |
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