目的 探讨五苓散联合徒手淋巴引流术治疗下肢创伤后急性肿胀的临床疗效。方法 选取2014年6月—2017年6月广东省工伤康复中心收治的下肢创伤后急性肿胀患者100例，随机分为对照组和治疗组，每组各50例。对照组给予徒手淋巴引流，治疗组在对照组治疗基础上口服五苓散，150 mL/次，午晚饭后1 h各服1次。两组均连续治疗1周。观察两组的临床疗效，比较两组治疗前后血浆黏度（ηb）、血小板聚集率（PAR）、健患肢周径差、疼痛视觉模拟评分法（VAS）评分的变化情况。结果 治疗后，对照组和治疗组患者的总有效率分别为82%、98%，两组比较差异有统计学意义（P<0.05）。治疗后，两组ηb、PAR、健患肢周径差、VAS评分均明显低于治疗前，同组治疗前后差异有统计学意义（P<0.05）；治疗后，治疗组ηb、PAR、健患肢周径差、VAS评分低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 五苓散联合徒手淋巴引流术治疗下肢创伤后急性肿胀具有较好的临床疗效，有利于缓解患者疼痛及肿胀症状，具有一定的临床推广应用价值。

Objective To investigate the therapeutic effect of Wuling Powder combined with manual lymphatic drainage in treatment of acute swelling after lower limb trauma. Methods Patients (100 cases) with acute swelling after lower limb trauma in Guangdong Work Injury Rehabilitation Hospital from June 2014 to June 2017 were randomly divided into control (50 cases) and treatment (50 cases) groups. Patients in the control group were given manual lymphatic drainage treatment. Patients in the treatment group were po administered with Wuling Powder, 150 mL/time, 1 h after lunch and dinner. Patients in two groups were treated for 1 week. After treatment, the clinical efficacy was evaluated, and the changes of ηb, PAR, circumference difference of healthy and sick limb, and VAS score in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 82% and 98%, respectively, and there was difference between two groups (P < 0.05). After treatment, ηb, PAR, circumference difference of healthy and sick limb, and VAS score in two groups were decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, ηb, PAR, circumference difference of healthy and sick limb, and VAS score in the treatment group were lower than those in the control group, and there was difference between two groups (P < 0.05). Conclusion Wuling Powder combined with manual lymphatic drainage has clinical curative effect in treatment of acute swelling after lower limb trauma, and can relieve the pain and swelling of the patients, which has a certain clinical application value.

广东省中医药局管理局科研项目（20172025）