【目的】 探讨消瘀膏（由酒大黄、蒲公英、金银花、赤芍、姜黄、醋香附、栀子、白芷、当归、薄荷、羌活等组成）局 部外敷配合水穴消肿手法（选取阴陵泉、尺泽、曲池及损伤部位周围的阿是穴等穴位进行点穴治疗）治疗急性软组织损伤 的临床疗效。【方法】 将136例急性软组织损伤患者随机分为治疗组和对照组，每组各68例。对照组给予洛索洛芬钠凝胶外 敷治疗，治疗组给予消瘀膏局部外敷配合水穴消肿手法治疗，5 d为1个疗程，共治疗2个疗程。观察2组患者治疗前后疼痛 程度视觉模拟量表（visual analogue scale，VAS）评分以及中医证候的各项主症评分（肿胀程度、活动受限程度、疼痛持续时 间）和总积分的变化情况，并评价 2组患者的临床疗效和安全性。【结果】（1）治疗 2个疗程后，治疗组的总有效率为 94.12% （64/68），对照组为91.18%（62/68），2组患者的总有效率比较（χ2检验），差异无统计学意义（P＞0.05），但治疗组的总体疗效 （秩和检验）明显优于对照组，差异有统计学意义（P＜0.05）。（2）治疗后，2组患者的疼痛程度 VAS评分均较治疗前明显降低 （P＜0.01），且治疗组的降低幅度明显优于对照组，差异有统计学意义（P＜0.01）。（3）治疗后，2组患者的肿胀程度、活动受 限程度及疼痛持续时间评分均较治疗前明显降低（P＜0.01），且治疗组的降低幅度均明显优于对照组，差异均有统计学意义 （P＜0.05或P＜0.01）。（4）治疗后，2组患者的中医证候积分均较治疗前明显降低（P＜0.01），但治疗后组间比较，差异无统计 学意义（P＞0.05）。（5）治疗期间，治疗组无明显不良反应发生，对照组有2例患者在药物接触范围出现皮肤潮红、瘙痒，但 停药后消失。【结论】 消瘀膏局部外敷配合水穴消肿手法治疗急性软组织损伤在消肿、止痛、改善关节活动度方面疗效显著。

Objective To explore the clinical efficacy of focal external application of Xiaoyu Ointment（mainly composed of wine-processed Rhei Radix et Rhizoma， Taraxaci Herba， Lonicerae Japonicae Flos， Paeoniae Radix Rubra，Curcumae Longae Rhizoma，vinegar-processed Cyperi Rhizoma，Gardeniae Fructus，Angelicae Dahuricae Radix，Angelicae Sinensis Radix，Menthae Haplocalycis Herba，and Notopterygii Rhizoma et Radix） combined with manipulations for relieving swelling on hydro-acupoints of Yinlingquan（SP9）， Chize（LU5）， Quchi（LI11）and Ashi points around the injury site for the treatment of acute soft tissue injury. Methods A total of 136 patients with acute soft tissue injury were randomly divided into treatment group and control group， with 68 cases in each group. The control group was treated with topical application of Loxoprofen Sodium Gel，and the treatment group was treated with topical application of Xiaoyu Ointment combined with manipulations for relieving swelling on hydro-acupoints. Five days constituted a course of treatment，and the treatment lasted for 2 courses.The changes of visual analogue scale（VAS）score of pain degree， scores of primary symptoms of degree of swelling，degree of activity limitation and pain duration，and the overall scores of traditional Chinese medicine （TCM）syndromes in the two groups were observed before and after treatment. After treatment，the clinical efficacy and safety of the two groups were evaluated. Results（1）After 2 courses of treatment，the total effective rate of the treatment group was 94.12%（64/68）and that of the control group was 91.18%（62/68）. There was no significant difference of the total effective rate（by chi-square test）between the two groups（P＞0.05）， but the overall efficacy of the treatment group（tested by rank sum test）was significantly superior to that of the control group（P＜ 0.05）.（2）After treatment，the VAS scores of pain degree in the two groups were significantly lower than those before treatment（P＜0.01）， and the decrease in the treatment group was significantly superior to that in the control group，the difference being significant（P＜0.01）.（3）After treatment，the scores of degree of swelling， degree of activity limitation and pain duration in the two groups were significantly decreased when compared with those before treatment （P＜0.01），and the decrease in the treatment group was superior to that in the control group， the differences being significant（P＜0.05 or P＜0.01）.（4）After treatment，the overall scores of TCM syndromes in the two groups were significantly decreased when compared with those before treatment（P＜0.01），but there was no significant difference between the two groups after treatment（P＞0.05）.（5）During the treatment period， there was no obvious adverse reaction occurring in the treatment group. In the control group，2 patients had skin flushing and itching in the medicated region， which disappeared after drug withdrawal. Conclusion Topical application of Xiaoyu Ointment combined with manipulations for relieving swelling on hydro-acupoints is effective on alleviating swelling，relieving pain and improving joint motion of range during the treatment of acute soft tissue injury.

R274.3

国家自然科学基金青年科学基金项目（编号：82205301）