Abstract: Objective　To discuss the effect of self-made Mangpeng powders cold compress in the treatment of early pain and swelling among patients with fracture of lower leg.Methods　90 cases with fracture of lower leg who underwent surgery in the Fifth Department of Orthopedics，Jinhua Hospital of Traditional Chinese Medicine form June 2014 to October 2015,were divided into 3 groups equally according to their hospital admission sequence:control group,10% Mangpeng powders group and 40% Mangpeng powders group.All cases received conventional treatment,cases in control group received Xiaoyanzhitong cream cold compress,cases in 10% Mangpeng powders group and 40% Mangpeng powders group received 10% Mangpeng powders cold compress and 40% Mangpeng powders cold compress respectively.The visual analog scale（VAS） score of pain and swelling degree of affected limb were assessed before and 1 hours,24 hours,48 hours and 72 hours after cold compress respectively.The swelling score before and 1 days,2 days,3 days,5 days and 7 days after cold compress and complications were also recorded respectively.Results　For treatment method and time,there were significant interaction among the VAS score of pain,swellingdegree and swelling score（P<0.05）.For treatment method and time,there were significant main effect in the VAS score of pain,swelling degree and swelling score respectively（P<0.05）.24 hours and 48 hours after cold compress,the VAS score of pain in 10% and 40% Mangpeng powders group was significantly lower than that in the control group respectively（both P<0.05）.48 hours after cold compress,the VAS score of pain in 40% Mangpeng powders group was significantly lower than that in 10% Mangpeng powders group（P<0.05）.24 hours and 48 hours after cold compress,the swelling degree in 10% Mangpeng powders group was significantly lower than that in control group（P<0.05）.24 hours,48 hours and 72 hours after cold compress,the swelling degree in 40% Mangpeng powders group was significantly lower than that in control group and 10% Mangpeng powders group（P<0.05）.3 days after cold compress,the swelling score in 40% Mangpeng powders group was significantly lower than that in control group（P<0.05）.5 days and 7 days after cold compress,the swelling score in 40% Mangpeng powders group was significantly lower than that in control group and 10% Mangpeng powders group（P<0.05）.Three groups of patients had no complications such as deep vein thrombosis and osteofascial compartment syndrome.Conclusion　The effect of self-made Mangpeng powders cold compress in the treatment of early pain and swelling among patients with fracture of lower leg is good，and the effect of 40% Mangpeng powders is better than that of 10% Mangpeng powders.

Key words: Fractures,bone, External applications（TCD）, Natrii sulfas, Borax, Pain

摘要： 目的　探讨自制芒硼散冷敷对小腿骨折早期疼痛和肿胀度的影响。方法　选取2014年6月—2015年10月金华市中医医院骨伤五科收治的行手术治疗的小腿骨折患者90例，按入院顺序分为对照组、10%芒硼散组、40%芒硼散组，每组30例。均给予常规处理，对照组予消炎止痛膏外敷；10%芒硼散组、40%芒硼散组患者入院后72 h内分别予10%、40%芒硼散软膏剂冷敷。观察记录3组患者治疗前及治疗1、24、48、72 h患肢疼痛视觉模拟评分（VAS评分）、肿胀度，治疗前及治疗1、2、3、5、7 d肿胀值，并发症发生情况。结果　治疗方法与时间在疼痛VAS评分、肿胀度、肿胀值上存在交互作用（P<0.05）；治疗方法在VAS评分、肿胀度、肿胀值上主效应显著（P<0.05）；时间在VAS评分、肿胀度、肿胀值上主效应显著（P<0.05）。其中治疗24、48 h 10%芒硼散组和40%芒硼散组患者疼痛VAS评分较对照组降低，治疗48 h 40%芒硼散组患者疼痛VAS评分较10%芒硼散组降低（P<0.05）；治疗48、72 h 10%芒硼散组患者肿胀度较对照组降低，治疗24、48、72 h 40%芒硼散组患者肿胀度较对照组和10%芒硼散组降低（P<0.05）；治疗3 d 40%芒硼散组患者肿胀值较对照组降低，治疗5、7 d 40%芒硼散组患者肿胀值较对照组和10%芒硼散组降低（P<0.05）。3组患者均未发生患肢深静脉血栓及骨筋膜室综合征等并发症。结论　自制芒硼散冷敷对小腿骨折早期疼痛和肿胀度有较好临床疗效，且40%芒硼散的疗效优于10%芒硼散。

关键词: 骨折, 中药外敷, 芒硝, 硼砂, 疼痛