| Objective:The purpose of this study is to observe and compare therapeutic effects in soft tissue swelling and aching in middle closed fracture of tibia and fibula before the operation by using Xiaoyu Zhitong Gao, ice compress and the above combined treatment respectively on the basis of Mannitol treatment.Methods:117 patients with middle closed fracture of tibia and fibula are involved in this study. They stayed in our hospital from March 2014 to August 2015 and all met the diagnostic criteria of such disease, among whom 93 cases were male patients and 24 were female patients with their average age is 38.34±9.41. They were randomly divided into four groups by SPSS software according to the admission sequence:group 1 (Mannitol combined with ice compress), group 2 (Mannitol combined with Xiaoyu Zhitong Gao), group 3 (Mannitol combined with Xiaoyu Zhitong Gao and ice compress) and control group (Mannitol). Group 1 were treated with mannitol and ice compress on both sides of the limb. Group 2 were treated with mannitol and covered with Xiaoyu Zhitong Gao on affected parts and bandage it appropriately. Group 3 were treated with combination treatment of basic mannitol, Xiaoyu Zhitong Gao and ice compress. The control group wrere treated with mannitol treatment immediately after admission. Their treatment period last for 7 days. Observational index includes blood Hemorheology before and after treatment respectively:whole blood viscosity, hematocrit, fibrinogen; serum inflammatory cytokines:TNF-α, IL-6; limb swelling rate of patients, pain relief, time for the first dermatoglyph, tension blisters, allergic dermatitis, occurrence of compartment syndrome (OCS).Results:There were no significant differences between the four groups before the treatment (p>0.05). During therapy period, allergic dermatitis of group 1 and group 2 are 2 cases and one case respectively. Only one case of Osteofascial compartment syndrome was found in group 1, which means it is of no statistic significance. The analysis of hemorheology: whole blood viscosity, hematocrit, fibrinogen index in blood rheology of four groups are statistically significant before and after treatment. Inter-group comparison:experimental groups (1,2,3) are lower than control group, group 2 and group 3 are lower than group 1, which means they are all statistically significant. Serum inflammatory factors:before treatment, TNF-a and IL-6 index values of the 4 groups were increased, and experimental indexes were decreased after 7 days of treatment. They were all of statistic significance during Pre-treatment and post-treatment in intra-group comparison. Intra-group comparison: experimental groups are lower than control group, group 2 and group 3 are lower than group 1, which indicates they all have statistical significance. Swelling rate:the swelling of each group showed an upward trend during the treatment period from day 1 to day 3. The rising range of swelling of experimental groups is lower than the control group, and the rising range of group 1 and group 3 is lower than group 2, which shows they all statistically significant. From the 5th day to the 7th day, the falling range of swelling rate of experimental groups was higher than control group, while that of group 2 and group 3 was higher than group 1, which means the differences are all statistically significant. Pain relief rate:The difference between experimental groups and the control group was statistically significant. On the 3rd day of treatment, group 3 was higher than group 1 and group 2. From the 5th day to the 7th day, group 2 and group 3 was higher than groupl, which indicates they all have statistical significance. Time for the first dermatoglyph:the difference between experimental groups and the control group was statistically significant, while the difference between each two groups among experimental groups showed no statistic significance.Conclusion:Both Xiaoyu Zhitong Gao and ice compress can effectively relieve the soft tissue swelling and aching of Tibiofibula closed fracture and can obviously improve the early blood rheology and inflammatory response. Results shows that treatment with combination of Xiaoyu Zhitong Gao and ice compress has better therapeutic effect than single treatment. Therefore. Xiaoyu Zhitong Gao combined with ice compress is an effective method in treating soft tissue swelling and aching in middle closed fracture of tibia and fibula before operation. |
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