Effects Of Guyi Decoction On The Inflammatory Reaction After Tibial And Fibular Fractures

ObjectiveTo explore the effects of Guyi decoction on the inflammatory reaction after tibial and fibular fractures by applying the decoction to the patients with closed tibial and fibular fractures at the early period.Methods60 patients with tibial and fibular fractures were selected,who were hospitalized at the department of traumatic orthopedics in Foshan hospital of TCM and met the inclusion criterias between April 2017 and January 2018.The patients were randomly divided into three groups(Chinese medicine group,western medicine group and control group),each group had 20 patients.All groups were given the same basic treatment after admission,including apply the splintage,take the Qushang pills and notoginseng compound oral liquid.All the patients would get a blood test to evaluate the white blood cell count,IL-6,TNF-? and CRP 24 hours after injury,and also evaluate the pain score and swelling degree.After the first time of evaluation,the Chinese medicine group added the Guyi decoction,the western medicine group added Celecoxib,the control group kept the same treatment.Then we took the second and third evaluation of the same indexs above at the 4th and 7th day after injury for the three groups.At last,We collected and analysed the data to find whether there is a difference among the three groups.ResultsThere were 58 patients who finished the research in the end.One in control group got the osteofascial compartment syndrome,another patient in western medicine group,whose ultrasonic examination report indicated a high risk of deep venous thrombosis,all these two patients were excluded from the research.There was no significant difference in the baseline data(like sex,age,the reason of injury,et al)and the indexs of the first time evaluation among the three groups(P>0.05).The WBC count among 3 groups had no statistical differences at the 4th and 7th day after injury(P>0.05).There was a significant difference in the level of IL-6 among the three groups at the 4th and 7th day after injury(P<0.01),the western medicine group and the Chinese medicine group all had a significant difference compared with the control group at the 4th and 7th day after injury(P<0.05),and there was also a significant difference in IL-6 between the Chinese medicine group and the western medicine group at the 4th day after injury(P<0.05),but no significant difference between the two groups at the 7th day after injury.There was no significant difference in the level of TNF-? and CRP among the three groups at the 4th day after injury(P>0.05),but had a significant difference at the 7th day after injury(P<0.05).The western medicine group and the Chinese medicine group all had a significant difference in TNF-? and CRP compared with the control group at the 7th day after injury(P<0.01),but no significant difference between the western medicine group and the Chinese medicine group(P>0.05).In the pain score and swelling degree,there was a significant difference among the three groups at the 4th and 7th day after injury(P<0.01).But there was no significant difference in the pain score between the western medicine group and the Chinese medicine group at the 4th and 7th day after injury(P>0.05),even though the two groups all had a detecable difference with the control group(P<0.01).The Chinese medicine group had a significant difference in swelling degree compared with either western medicine group or control group(P<0.01),but there was no significant difference between the western medicine group and control group(P>0.05).ConclusionThe Guyi decoction and Celecoxib all are able to inhibit and reduce the level of IL-6,TNF-? and CRP,which also can relieve the local pain.But the Guyi decoction is better than Celecoxib in the reduction of IL-6 and also has the detumescence effect which Celecoxib does not contain.So the results indicate that the Guyi decoction can effectively allieviate the inflammatory reaction's development and reduce the level of inflammatory cytokine in early treatment of tibial and fibular fractures,which also has the effects to relieve the pain and swelling during the inflammatory reaction.The Guyi decoction's effects is comprehensive and safety,which is worthy being widely used and popularized.