CAJ | 학술논문

背景:作者自制的清热活血消肿Ⅰ.Ⅱ合剂治疗骨折并软组织损伤取得了良好疗效,但其机制尚不明确.目的:观察清热活血消肿合剂对闭合性骨伤所致软组织损伤患者血清白细胞介素1β、白细胞介素6的影响.设计:随机对照观察.单位:解放军第四○一医院中医科病房.对象:选择2000-02/2002-02在解放军第四○一医院中医科住院的骨折早、中期合并软组织损伤患者88例,均自愿参加观察.按随机数字表法分为2组,清热活血消肿Ⅰ+Ⅱ合剂组45例,清热活血消肿Ⅱ合剂组43例.清热活血消肿Ⅰ合剂为内服剂,Ⅱ合剂为外熏洗剂.方法:①治疗骨伤:两组均给予钙尔奇D片及壮骨关节丸口服.②治疗软组织损伤:清热活血消肿Ⅰ+Ⅱ合剂组口服自制清热活血消肿Ⅰ合剂,每付药水煎450 mL,分装成3袋,150 mL/袋,3次/d;外用清热活血消肿Ⅱ合剂熏洗患部,每付药水煎600 mL,分装4袋,150 mL/袋,每次取4袋药加水2 000 mL加热熏洗患处,2次/d,每次熏洗20～30 min(4袋药可连续熏洗2 d).清热活血消肿Ⅱ合剂组仅外用清热活血消肿Ⅱ合剂熏洗患部,具体用法与清热活血消肿Ⅰ+Ⅱ合剂组相同.两组患者均以10 d为1个疗程,共治疗2个疗程,分别于治疗前、1个疗程、2个疗程后应用酶联免疫吸附试剂盒检测患者血清白细胞介素1β、白细胞介素6含量并进行比较.主要观察指标:两组患者治疗前、治疗1,2个疗程后的血清白细胞介素1β、白细胞介素6含量.结果:清热活血消肿Ⅰ+Ⅱ合剂组治疗2个疗程后白细胞介素1Ⅰ和白细胞介素6水平均较治疗前、治疗1个疗程后显著降低(P＜0.05～0.01).亦较同时间点清热活血消肿Ⅱ合剂组显著降低(P＜0.05).此外,清热活血消肿Ⅰ+Ⅱ合剂组治疗1个疗程后白细胞介素1β和白细胞介素6水平亦较治疗前显著降低(P＜0.05).清热活血消肿Ⅱ合剂组治疗2个疗程后白细胞介素1β水平较治疗前显著降低(P＜0.05),白细胞介素6水平较治疗前和1个疗程后显著降低(P＜0.05).结论:清热活血消肿Ⅰ,Ⅱ合剂通过抑制血清白细胞介素1β、白细胞介素6水平治疗骨折并软组织损伤,两药合用的治疗效果优于单独用药. 揹景:作者自製的清熱活血消腫Ⅰ.Ⅱ閤劑治療骨摺併軟組織損傷取得瞭良好療效,但其機製尚不明確.目的:觀察清熱活血消腫閤劑對閉閤性骨傷所緻軟組織損傷患者血清白細胞介素1β、白細胞介素6的影響.設計:隨機對照觀察.單位:解放軍第四○一醫院中醫科病房.對象:選擇2000-02/2002-02在解放軍第四○一醫院中醫科住院的骨摺早、中期閤併軟組織損傷患者88例,均自願參加觀察.按隨機數字錶法分為2組,清熱活血消腫Ⅰ+Ⅱ閤劑組45例,清熱活血消腫Ⅱ閤劑組43例.清熱活血消腫Ⅰ閤劑為內服劑,Ⅱ閤劑為外熏洗劑.方法:①治療骨傷:兩組均給予鈣爾奇D片及壯骨關節汍口服.②治療軟組織損傷:清熱活血消腫Ⅰ+Ⅱ閤劑組口服自製清熱活血消腫Ⅰ閤劑,每付藥水煎450 mL,分裝成3袋,150 mL/袋,3次/d;外用清熱活血消腫Ⅱ閤劑熏洗患部,每付藥水煎600 mL,分裝4袋,150 mL/袋,每次取4袋藥加水2 000 mL加熱熏洗患處,2次/d,每次熏洗20～30 min(4袋藥可連續熏洗2 d).清熱活血消腫Ⅱ閤劑組僅外用清熱活血消腫Ⅱ閤劑熏洗患部,具體用法與清熱活血消腫Ⅰ+Ⅱ閤劑組相同.兩組患者均以10 d為1箇療程,共治療2箇療程,分彆于治療前、1箇療程、2箇療程後應用酶聯免疫吸附試劑盒檢測患者血清白細胞介素1β、白細胞介素6含量併進行比較.主要觀察指標:兩組患者治療前、治療1,2箇療程後的血清白細胞介素1β、白細胞介素6含量.結果:清熱活血消腫Ⅰ+Ⅱ閤劑組治療2箇療程後白細胞介素1Ⅰ和白細胞介素6水平均較治療前、治療1箇療程後顯著降低(P＜0.05～0.01).亦較同時間點清熱活血消腫Ⅱ閤劑組顯著降低(P＜0.05).此外,清熱活血消腫Ⅰ+Ⅱ閤劑組治療1箇療程後白細胞介素1β和白細胞介素6水平亦較治療前顯著降低(P＜0.05).清熱活血消腫Ⅱ閤劑組治療2箇療程後白細胞介素1β水平較治療前顯著降低(P＜0.05),白細胞介素6水平較治療前和1箇療程後顯著降低(P＜0.05).結論:清熱活血消腫Ⅰ,Ⅱ閤劑通過抑製血清白細胞介素1β、白細胞介素6水平治療骨摺併軟組織損傷,兩藥閤用的治療效果優于單獨用藥.
배경:작자자제적청열활혈소종Ⅰ.Ⅱ합제치료골절병연조직손상취득료량호료효,단기궤제상불명학.목적:관찰청열활혈소종합제대폐합성골상소치연조직손상환자혈청백세포개소1β、백세포개소6적영향.설계:수궤대조관찰.단위:해방군제사○일의원중의과병방.대상:선택2000-02/2002-02재해방군제사○일의원중의과주원적골절조、중기합병연조직손상환자88례,균자원삼가관찰.안수궤수자표법분위2조,청열활혈소종Ⅰ+Ⅱ합제조45례,청열활혈소종Ⅱ합제조43례.청열활혈소종Ⅰ합제위내복제,Ⅱ합제위외훈세제.방법:①치료골상:량조균급여개이기D편급장골관절환구복.②치료연조직손상:청열활혈소종Ⅰ+Ⅱ합제조구복자제청열활혈소종Ⅰ합제,매부약수전450 mL,분장성3대,150 mL/대,3차/d;외용청열활혈소종Ⅱ합제훈세환부,매부약수전600 mL,분장4대,150 mL/대,매차취4대약가수2 000 mL가열훈세환처,2차/d,매차훈세20～30 min(4대약가련속훈세2 d).청열활혈소종Ⅱ합제조부외용청열활혈소종Ⅱ합제훈세환부,구체용법여청열활혈소종Ⅰ+Ⅱ합제조상동.량조환자균이10 d위1개료정,공치료2개료정,분별우치료전、1개료정、2개료정후응용매련면역흡부시제합검측환자혈청백세포개소1β、백세포개소6함량병진행비교.주요관찰지표:량조환자치료전、치료1,2개료정후적혈청백세포개소1β、백세포개소6함량.결과:청열활혈소종Ⅰ+Ⅱ합제조치료2개료정후백세포개소1Ⅰ화백세포개소6수평균교치료전、치료1개료정후현저강저(P＜0.05～0.01).역교동시간점청열활혈소종Ⅱ합제조현저강저(P＜0.05).차외,청열활혈소종Ⅰ+Ⅱ합제조치료1개료정후백세포개소1β화백세포개소6수평역교치료전현저강저(P＜0.05).청열활혈소종Ⅱ합제조치료2개료정후백세포개소1β수평교치료전현저강저(P＜0.05),백세포개소6수평교치료전화1개료정후현저강저(P＜0.05).결론:청열활혈소종Ⅰ,Ⅱ합제통과억제혈청백세포개소1β、백세포개소6수평치료골절병연조직손상,량약합용적치료효과우우단독용약.
BACKGROUND:Qingre Huoxue Xiaozhong composition Ⅰ and Ⅱ made by ourselves are effective in treating bone fracture complicated by soft tissue injury.However,its mechanism is still unclear.OBJECTIVE:To observe the effect of Qingre Huoxue Xiaozhong composition on the levels of intedeukin 1β(IL-1β) and interleukin 6(IL-6) in serum of patients with closed bone injury-induced soft tissue injury.DESIGN:Randomized controlled observation.SETTING:Wards of the Department of Traditional Chinese Medicine,the 401 Hospital of Chinese PLA.PARTICIPANTS: Eighty-eight inpatients with bone fracture at early and moderate stages accompanied by soft tissue injury were chosen as volunteers to be studied in the Department of Traditional Chinese Medicine,the 401 Hospital of Chinese PLA between February 2000 and February 2002.The involved inpatients were assigned into 2 groups according to the table of random digit:Oingre Huoxue Xiaozhong composition Ⅰ + Ⅱ group (n=45) and Qingre Huoxue Xiaozhong composition Ⅱ group (n=43).Oingre Huoxue Xiaozhong composition Ⅰ was for internal administration,and Qingre Huoxue Xiaozhong composition Ⅱ was for external fumigation.METHODS:①Treatment of bone injury:Both caltrate D pellets and pills for strengthening bone joints were used in two groups.②Treatment of soft tissue injury: In the Qingre Huoxue Xiaozhong composition Ⅰ+ Ⅱ group,Qingre Huoxue Xiaozhong composition Ⅰ was decocted.Each decoction was 450 mL,and was packed into 3 pouches, 150 mL/pouch,three times a day;Qingre Huoxue Xiaozhong composition Ⅱ was decocted.Each decoction was 600 mL,and was packedinto 4 Douches,150 mL/pouch.Four pouches of Qingre Huoxue Xiaozhong composition Ⅱ was diluted by 2 000 mL water,then heated and used for fume-washing, twice a day, 20 to 30 minutes once. Four pouches could be used for fume-washing for 2 days successively. In the Oingre Huoxue Xiaozhong compositionⅡgroup, only Oingre Huoxue Xiaozhong composition Ⅱ was used to fume-wash the lesioned region.The concrete method was the same as that in the Qingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group.In each group, ten days were set as one course of treatment,and totally, there are 2 courses of treatment.IL-1β and IL-6 levels in serum of patients were detected by with ELISA kit before.one and two courses after treatment, and compared separately.MAIN OUTCOME MEASURES: Levels of IL-1β and IL-6 in serum of patients in two groups before, one and two courses after treatment.RESULTS: In the eingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group,the level of IL-1β and IL-6 was respectively significantly lower after 2 courses of treatment as compared with the previous one and one course after treatment (P＜0.05-0.01), also at the same time point in compared with the Qingre Huoxue Xiaozhong composition Ⅱ group (P＜0.05).In addition, in the Oingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group,the level of IL-1β and IL-6 was respectively significantly decreased after one course of treatment as compared with before treatment (P＜0.05). In the Oingre Huoxue Xiaozhong composition Ⅱ group,after 2 courses of treatment,the level of IL-1β was significantly decreased as compared with before treatment, and the level of IL-β was also significantly decreased as compared with before treatment and after one course of treatment (P＜0.05).CONCLUSION: Qingre Huoxue Xiaozhong composition Ⅰ+Ⅱ can be used to treat bone fracture accompanied by soft tissue injury by inhibiting the levels of IL-1β and IL-6. The effect of the combination of Oingre Huoxue Xiaozhong composition Ⅰ and Ⅱ is superior to that of each alone.