桃红四物汤加味佐治创伤性小腿皮肤严重缺损疗效观察OA
Observation on the Efficacy of Modified Taohong Siwu Decoction as Adjuvant Therapy for Severe Traumatic Skin Defects of the Lower Leg
目的 观察桃红四物汤加味联合游离皮瓣修复术治疗创伤性小腿皮肤严重缺损的临床疗效.方法 回顾性研究2022年11月—2025年5月焦作市第二人民医院收治的创伤性小腿皮肤严重缺损68例患者的病案资料,按照治疗方案不同分为治疗组和对照组各34例.对照组给予游离皮瓣修复术治疗,治疗组在对照组基础上给予桃红四物汤加味治疗.经治4周后,比较两组患者皮瓣成活率和皮瓣血管危象发生率,视觉模拟量表(VAS)评分、健康调查简表(SF-36)评分、美国足踝外科协会(AOFAS)小腿-足功能评分,炎症指标[白细胞(WBC)、C反应蛋白(CRP)、降钙素原(PCT)]水平,创面愈合时间及术后住院时间.结果 治疗后,治疗组皮瓣成活率为97.06％(32/34),高于对照组的82.35％(28/34)(P＜0.05),治疗组皮瓣血管危象发生率5.88％(2/34),低于对照组的23.53％(8/34)(P＜0.05);两组VAS评分较治疗前均降低(P＜0.05),SF-36、AOFAS评分较治疗前均升高(P＜0.05),且治疗组改善程度均优于对照组(P＜0.05);两组WBC、CRP、PCT降低,且治疗组低于对照组(P＜0.05);治疗组创面愈合时间、术后住院时间均短于对照组(P＜0.05).结论 桃红四物汤加味联合游离皮瓣修复术治疗创伤性小腿皮肤严重缺损,可通过提高皮瓣成活率,降低血管危象发生率,抑制炎症反应,缓解疼痛,缩短创面愈合时间,从而改善患者肢体功能和生活质量.
Objective To observe the clinical efficacy of modified Taohong Siwu Decoction combined with free flap repair in the treatment of severe traumatic skin defects in the lower leg.Methods Sixty-eight patients with severe traumatic skin defects in the lower leg admitted to Jiaozuo Second People's Hospital from November 2022 to May 2025 were selected as study subjects and divided into a treatment group and a control group,with 34 pa-tients in each group,according to a random number table method.The control group was treated with free flap repair,while the treatment group received modified Taohong Siwu Decoction on top of the control group's treat-ment.After 4 weeks of treatment,the survival rate of the skin flaps,incidence of flap vascular crisis,visual ana-log scale(VAS)scores,Short Form-36 Health Survey(SF-36)scores,American Orthopedic Foot and Ankle Society(AOFAS)lower leg-foot function scores,levels of inflammatory markers(WBC,CRP,PCT),wound healing time,and postoperative hospital stay were compared between the two groups.Results After treatment,the survival rate of the skin flaps in the treatment group was 97.06％(32/34),which was higher than that in the control group[82.35％(28/34)(P＜0.05)].The incidence of flap vascular crisis in the treatment group was 5.88％(2/34),which was lower than that in the control group[23.53％(8/34))(P＜0.05)].Both VAS scores decreased after treatment compared to before treatment(P＜0.05),and both SF-36 and AOFAS scores increased after treatment compared to before treatment(P＜0.05),with the improvement being more pro-nounced in the treatment group than in the control group(P＜0.05).WBC,CRP,and PCT levels decreased in both groups,with lower levels in the treatment group than in the control group(P＜0.05).The wound healing time and postoperative hospital stay were shorter in the treatment group than in the control group(P＜0.05).Conclusion Modified Taohong Siwu Decoction combined with free flap repair can improve patient limb function and quality of life by increasing the survival rate of skin flaps,reducing the incidence of vascular crisis,inhibi-ting inflammatory reactions,alleviating pain,and shortening wound healing time in the treatment of severe trau-matic skin defects in the lower leg.
石战军;白传光;张豪
焦作市第二人民医院,河南焦作 454001焦作市第二人民医院,河南焦作 454001焦作市第二人民医院,河南焦作 454001
医药卫生
桃红四物汤游离皮瓣修复术创伤性小腿皮肤严重缺损中西医结合疗法
Taohong siwu decoctionFree flap repairSevere traumatic skin defect of the lower legIntegrated chinese and western medicine therapy
《国医论坛》 2026 (2)
31-35,5
河南省中医药科学研究专项课题(2024ZY3070).
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