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243.7 陽和湯化裁治跟骨粉碎性骨折經疤痕切除手術併慢性傷口之病例報告

TJ TCM.24(3) : 93-104, 2021

DOI : 10.6516/TJTCM.202109_24(3).0007

陽和湯化裁治跟骨粉碎性骨折經疤痕切除手術併慢性傷口之病例報告

A Case Report of Yanghe Decoction for Treatment of Comminuted Calcaneal

Fracture after Scar Reconstructive Plastic Surgery Combined with Chronic Wound

莊凱雯1　林廉証1*

1 財團法人彰化基督教醫院中醫部，彰化，台灣

【摘要】

此病患於106 年7 月10 日右腳跟骨粉碎性骨折，由於骨折後的疤痕組織妨礙足踝活動，於109 年3 月進行疤痕切除手術，現今右腳外踝傷口恢復速度緩慢，傷口大小6 公分乘以0.5 公分，傷口底偏黃偏淡，流有紅黃色的滲出液，按壓傷口周圍麻木微痛感，VAS 2 分，右腳外踝腫脹悶痛嚴重阻礙右腳踝活動角度，右腳小腿肚到末端右腳腳趾處畏冷感，以手背觸摸膚冷不溫，溫度明顯低於健側。因右腳外踝慢性傷口，且右腳腳踝活動功能仍不佳，病患於109 年5 月15 日就診中醫，經中醫辨證為陽虛寒凝，給予陽和湯化裁服用，搭配針灸。治療將近兩個月，右腳溫度和健側相比已無明顯區別，慢性傷口已完全痊癒，上下坡度或跑跳時足踝關節活動範圍增加，疼痛不適感減輕。

【關鍵詞】跟骨粉碎性骨折、慢性傷口、中醫、陽和湯

Kai-Wen Chuang1　Lien-Cheng Lin1*

1Department of Traditional Chinese Medicine, Changhua Christian Hospital, Changhua, Taiwan

【Summary】

Due to the right comminuted calcaneal fracture on 10 July, 2017, our patient had gone for scar removing operation later on March 2020 to try to alleviate the ankle incapability from right wound sutured adhesions. However, the lesion of 6cm by 0.5cm area on right lateral ankle was still light yellowish look with some reddish discharge, and numbness with slightly pain by pressed, VAS 2. The everlasting swelling and aches around right lateral ankle limited the range of motion; also the chillness may extend from right calf to the distal digits, and apparently lower lesion temperature from the other calf and felt by hand. The patient turned to our TCM Traumatology on 15 May, 2020 for his incapable right ankle and unrecovered wound. The present individual was then prescribed with Yanghe decoction by yang insufficient and cold stasis diagnosis. With 2 months period, the chronic lesion was healing with no significant temperature differences, lesion closure, and improved motion range of exercise with lesser pain scale.

【Keywords】Ankle Comminuted Fracture; Chronic Injury; Chinese Medicine; Yanghe Decoction

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