小柴胡汤是《伤寒杂病论》中的一首经典方剂，是和解法的基础方，后世将其广泛用于治疗妇科疾病。本研究旨在通过文献检索，探讨小柴胡汤在治疗妇科疾病方面的有效性及其应用的最新进展。文章综述了小柴胡汤在治疗妇科痛证、血证、带下证、块证等相关疾病方面的临床研究和实践经验。小柴胡汤通过其疏肝利胆、健运脾胃、和解枢机的作用，有效改善了女性痛经、盆腔炎性疾病、月经不调、妇科肿瘤、围绝经期综合征等妇科疾病症状。作为临床常用的妇科学方剂，小柴胡汤亟需进一步的发扬与创新，以期更有效地应用于未来的临床实践。

    Xiaochaihu Decoction，as a classic prescription in the Treatise on Cold Pathogenic and Miscellaneous Diseases，laid the foundation for reconciliation．It has a wide range of applications in the treatment of gynecological diseases．Through a literature search，this study aimed to explore the effectiveness of Xiaochaihu Decoction in the treatment of gynecological diseases and the latest progress of its application．This article reviews the clinical research and practical experience of Xiaochaihu Decoction in the treatment of gynecological pain，bleeding，leucorrhea disease，tumors and other related diseases．Xiaochaihu Decoction has effectively improved the symptoms of gynecological diseases such as dysmenorrhea，pelvic inflammatory disease，menstrual irregularities，gynecological tumors，and perimenopausal syndrome through its role of soothing the liver and promoting bile flow，strengthening the spleen and stomach，and harmonizing and releasing the pivot．As a commonly used gynecological prescription in clinical practice，Xiaochaihu Decoction urgently needs to be further developed and innovated to be more effectively applied to clinical practice in the future．

      目的 系统比较小针刀、局部浸润麻醉及两者联合疗法治疗腰椎间盘突出症（LDH）的临床疗效。方法 采用前瞻性随机对照设计，选取2023年1月—2025年1月收治的120例保守治疗无效的LDH患者，随机分为小针刀组（A组，n=40）、局部浸润麻醉组（B组，n=40）和联合治疗组（C组，n=40）。A组实施标准化小针刀松解术，采用“三点九刀”布点法松解粘连组织；B组采用超声引导下椎间孔外口及关节突关节囊周围利多卡因联合曲安奈德浸润麻醉；C组实施“麻醉-松解序贯疗法”（即先B组方案，后A组方案）。比较三组治疗前后视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、腰椎活动度（ROM）、表面肌电图（sEMG）、疼痛压力阈值（PPT）及改良Macnab优良率。结果 治疗后，三组VAS、ODI评分均较治疗前下降（P＜0.001）。组间比较显示，C组VAS（2.08±0.90分）、ODI（14.65±3.70分）改善显著优于A组（3.80±1.20分，21.00±4.25分）和B组（3.93±1.15分，22.10±4.65分）（均P＜0.05），A、B两组间无统计学差异（P＞0.05）。C组在腰椎前屈ROM（67.78±9.18°）、竖脊肌静息sEMG比值（0.19±0.05）、腰椎旁PPT（4.60±0.91 kg/cm²）上亦显著优于A、B两组（均P＜0.05）。改良Macnab评价显示C组优良率达85.00%（34/40），高于A组的52.50%（21/40）和B组的55.00%（22/40）（P＜0.05）。结论 小针刀与局部浸润麻醉单一疗法对LDH均有效，但联合应用可产生多模式协同效应，通过阻断疼痛传导、调节炎性微环境和改善生物力学失衡，在缓解疼痛、促进功能恢复及改善客观生理指标方面均展现出显著优势，为中西医结合治疗LDH提供了更优化的创新性方案，具有重要临床推广价值。

      Objective To systematically evaluate and compare the clinical effectiveness and mechanistic actions of acupotomy，local infiltration anesthesia，and their combination in treating lumbar disc herniation（LDH）．Methods This prospective，randomized controlled trial included 120 LDH patients unresponsive to conservative management，admitted between January 2023 and January 2025．Participants were randomly allocated to three groups：the Acupotomy Group（Group A，n=40）receiving standardized acupotomy release with a “three-point nine-needle” technique to address adhesions；the Local Infiltration Anesthesia Group（Group B，n=40）receiving ultrasound-guided infiltration of lidocaine combined with triamcinolone acetonide around the extraforaminal outlet and facet joint capsule；and the Combined Therapy Group（Group C，n=40）undergoing a sequential “anesthesia-release” protocol（first applied Group B therapy then Group A therapy）．Assessments conducted before and after treatment included the Visual Analog Scale（VAS），Oswestry Disability Index（ODI），lumbar range of motion（ROM），surface electromyography（sEMG），pain pressure threshold（PPT），and the modified Macnab criteria．Results Following treatment，significant reductions from baseline were observed in VAS and ODI scores across all three groups（P＜0.001）．Between-group comparisons indicated that Group C achieved significantly greater improvement in VAS（2.08±0.90）and ODI scores（14.65±3.70）compared to Group A（3.80±1.20；21.00±4.25）and Group B（3.93±1.15；22.10±4.65）（all P＜0.05），with no significant difference between Groups A and B（P＞0.05）．Group C also showed superior outcomes in lumbar flexion ROM（67.78±9.18°），the resting sEMG amplitude ratio of the erector spinae muscles（0.19±0.05），and paravertebral PPT（4.60±0.91 kg/cm²）compared to the other two groups（all P＜0.05）．Based on the modified Macnab criteria，the excellent-good rate was 85.00%（34/40）in Group C，significantly higher than the rates of 52.50%（21/40）in Group A and 55.00%（22/40）in Group B（P＜0.05）．Conclusions While both acupotomy and local infiltration anesthesia as standalone treatments are effective for LDH，their combined application produces a multimodal synergistic effect．This integrated strategy，which concurrently interrupts pain signaling，modulates the local inflammatory milieu，and ameliorates biomechanical dysfunction，demonstrates significant advantages in pain relief，functional recovery，and normalization of objective physiological measures．The findings present an optimized and novel integrative approach for LDH management，highlighting its considerable potential for broader clinical adoption．

       目的 验证尿沉渣评分（USS）对肾前性急性肾损伤（AKI）与急性肾小管坏死（ATN）的鉴别价值，评估USS与AKI严重程度及预后的相关性，为优化AKI分层管理提供依据。方法 回顾性分析2021年3月至2022年2月在郑州市中医院治疗的120 AKI患者，根据肾组织活检及改良FENa-UA诊断标准分为肾前性AKI组（n=68）与ATN组（n=52），于入院日检测USS、血清胱抑素C（Cys-C）及尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL），分析USS诊断效能。结果 ATN组USS高于肾前性组（P＜0.001），且评分随AKI分期升高而增加（P＜0.001）。USS诊断肾前性AKI的ROC曲线下面积（AUC）为0.892，联合Cys-C与NGAL后AUC提升至0.941，灵敏度与特异度分别达90.12%和88.51%。结论 USS通过量化肾小管结构性损伤，可早期鉴别肾前性AKI与ATN，其与Cys-C、NGAL的联合应用提高诊断准确性，且对AKI预后具有重要价值，为临床分层管理提供客观依据。

       Objective To validate the discriminative value of urinary sediment score（USS）in differentiating prerenal acute kidney injury（AKI）from acute tubular necrosis（ATN），and to evaluate the correlation between USS and AKI severity/prognosis，providing evidence for optimizing stratified AKI management．Methods A retrospective analysis was conducted on 120 AKI patients treated at Zhengzhou Traditional Chinese Medicine Hospital from March 2021 to February 2022．According to renal tissue biopsy and modified FENa-UA diagnostic criteria，patients were divided into a prerenal AKI group（n=68）and an ATN group（n=52）．On the day of admission，USS，serum cystatin C（Cys-C），and urinary neutrophil gelatinase-associated lipocalin（NGAL）were measured to analyze the diagnostic performance of USS．Results USS was significantly higher in ATN group than prerenal group（P＜0.001），and increased with advancing AKI stages（P＜0.001）．The area under the ROC curve（AUC）of USS for diagnosing prerenal AKI was 0.892，which improved to 0.941 when combined with Cys-C and NGAL，yielding sensitivity and specificity of 90.12% and 88.51%，respectively．Conclusions USS quantifies structural damage to the renal tubules，allowing for early differentiation between prerenal AKI and ATN．Its combined use with Cys-C and NGAL improves diagnostic accuracy and is of significant value in predicting AKI prognosis，providing an objective basis for clinical stratified management．

      目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料，根据随机数字表法将患者分为两组：对照组40例，术前5 min予5 mL生理盐水；观察组40例，术前5 min予以0.25 mg/kg艾司氯胺酮（以生理盐水配置成5 mL）。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为（213.54±64.22）min、（240.67±81.26）min、（141.31±45.03）mL，与对照组的（210.43±65.71）min、（244.25±81.33）min、（137.64±42.75）mL比较，差异均无统计学意义（t=0.214、0.197、0.374，P均＞0.05），而观察组丙泊酚、瑞芬太尼用量分别为（1 075.52±134.37）mg、（1 267.18±242.26）μg，虽然低于对照组的（1?126.64±150.21）mg、（1 352.50±295.14）μg，但差异也无统计学意义（t=1.604、1.413，P均＞0.05）；观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为（54.52±9.64）pg/mL、（40.08±7.75）pg/mL、（30.38±6.93）mg/L，均低于对照组的（77.31±10.86）pg/mL、（56.35±9.47）pg/mL、（43.73±7.61）mg/L（t=9.926、8.409、8.203，P均＜0.05）；术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为（51.92±4.41）分、（53.96±4.47）分、（3.59±1.14）分、（3.06±1.01）分、（2.89±0.91）分、（2.57±0.76）分，均低于对照组的（55.06±5.12）分、（57.21±5.19）分、（4.27±1.36）分、（3.68±1.18）分、（3.41±1.06）分、（2.96±0.92）分（t=2.939、3.001、2.423、2.525、2.329、2.067，P均＜0.05），但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义（P＞0.05）；两组术后不良反应发生率也无显著差异（P＜0.05）。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平，减轻术后疼痛，缓解术后负性情绪，且不会增加患者术后不良反应发生率。

Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer．Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed．The patients were divided into two groups according to the random number table method：40 cases in the control group were given 5 mL saline，five minutes before operation，40 cases in the observation group were treated with 0.25 mg / kg esketamine（in 5 mL saline）five minutes before operation．The perioperative indicators，inflammatory factors，negative emotions，pain and adverse reactions were compared between two groups．Results The operation time，anesthesia time and intraoperative blood loss of the observation group were（213.54±64.22）min，（240.67±81.26）min and（141.31±45.03）mL，respectively，which were not significantly different from those of the control group（210.43±65.71）min，（244.25±81.33）min and（137.64±42.75）mL（t=0.214，0.197，0.374，all P＞0.05）．The dosage of propofol and remifentanil in the observation group were（1 075.52±134.37）mg and（1 267.18±242.26）μg，respectively，which were lower than those in the control group of （1126.64±150.21）mg and（1352.50±295.14）μg，but the difference was not statistically significant（t=1.604，1.413，P＞0.05）．The levels of tumor necrosis factor-α，interleukin-6 and C-reactive protein in the observation group at 24 h after operation were（54.52±9.64）pg / mL，（40.08±7.75）pg / mL and（30.38±6.93）mg / L，respectively，which were lower than those in the control group of （77.31±10.86）pg / ml，（56.35±9.47）pg / mL and 43.73±7.61）mg / L（t=9.926，8.409，8.203，all P＜0.05）．The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h，6 h，12 h and 24 h after operation were（51.92±4.41），（53.96±4.47），（3.59±1.14），（3.06±1.01），（2.89±0.91） and（2.57±0.76），respectively，which were lower than those of the control group（55.06±5.12），（57.21±5.19），（4.27±1.36），（3.68±1.18），（3.41±1.06） and（2.96±0.92）（t=2.939，3.001，2.423，2.525，2.329，2.067，P＜0.05）．However，no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively（P＞0.05）．Adverse event rates showed no significance in two groups（P＞0.05）．Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation，decrease pain，mitigate negative emotions，without increasing the incidence of postoperative adverse reactions．

       目的 在体外诊断试剂（IVDR）临床试验中，准确快速地完成EP09c的统计分析工作。方法 利用MedCalc软件对差异图（Difference Plot）执行偏倚量化；利用SPSS或MedCalc软件的回归模型对散点图（Scatter Plot）执行偏倚量化；差异图和散点图被用于确认偏倚量化结果的正确性。结果 MedCalc的差异图确定工作样本的低浓度数据符合恒定标准差分布，偏倚为0.10（0.09，0.28）；高浓度数据符合恒定变异系数分布，偏倚为-5.0%（中位数：-7.2%，1.5%）或-3.2%（Hodges-Lehmann中位数：-5.5%，-0.8%）。散点图确认Passing&Bablok回归和加权线性回归（权重1/x_i ^1.4）适用于工作样本的数据，回归方程分别为y=0.122+0.952x（R²=0.983）和y=0.269+0.977^x（R²=0.981）。结论 偏倚量化结果必须得到差异图和散点图的确认，否则结果的正确性无法保证。

      Objective To perform accurate and efficient statistical analysis of EP09c in clinical studies of in vitro diagnostic reagents（IVDR）．Methods Bias quantification was performed on the difference plot using MedCalc．Bias quantification was conducted on the scatter plot using regression modeling in SPSS and MedCalc．The difference plot and scatter plot were employed to corroborate the accuracy of the bias quantification results．Results Difference plots demonstrated that the low-concentration data of the working sample exhibited a constant standard deviation distribution with a bias of 0.10（0.09，0.28），while the high-concentration data conformed to a constant coefficient of variation distribution with a bias of -5.0%（median：-7.2%，1.5%） or -3.2%（Hodges-Lehmann median：-5.5%，-0.8%）．Scatter plots confirmed that Passing & Bablok（P-B） regression and weighted least square（WLS） regression（weight 1/x_i ^1.4） were applicable to the data from the working sample，with the resulting regression equations being y=0.122+0.952x（R²=0.983） and y=0.269+0.977x（R²=0.981），respectively．Conclusions The results of bias quantification must be confirmed by difference plot and scatter plot，otherwise the correctness of the results cannot be assured．

       乳腺癌（BC）发病率持续上升，已成为严重威胁公共健康的重大挑战，转移仍是导致患者死亡的主要原因。目前，切除肿瘤并辅以放化疗后仍有较大几率发生转移。此外，早期转移隐匿性强，干预措施不完善及耐药发生迅速均是预后不良的重要因素。细胞外囊泡（EVs）是由细胞释放的、具有膜结构的纳米级颗粒，是细胞间通讯的重要介质。EVs通过转运膜性组分、胞质蛋白及核酸等，调控乳腺癌的发生、进展及转移定植，其来源异质性决定了其在乳腺癌转移中发挥独特作用。本文重点总结了不同来源EVs作为液体活检标志物在转移预警中的价值，以及靶向EVs分泌或阻断其通讯网络在克服免疫治疗耐药中的潜在临床应用，以期为临床医生提供有价值的诊疗参考。

     The incidence of breast cancer（BC） continues to rise and has become a major public health challenge．Metastasis remains the principal cause of BC-related mortality．Currently，there remains a high probability of metastasis even after surgical tumor resection followed by radiotherapy and chemotherapy．The insidious nature of early metastasis，inadequate intervention strategies，and rapid development of drug resistance are all critical factors contributing to poor prognosis．Extracellular vesicles（EVs） are membrane-enclosed，nanoscale particles released by cells．As mediators of intercellular communication，EVs transfer membrane components，cytosolic proteins，and nucleic acids to recipient cells，thereby modulating BC initiation，progression，and metastatic dissemination．The heterogeneity of EV origins determines their distinct roles in breast cancer metastasis．This review focuses on summarizing the value of EVs from different sources as liquid biopsy biomarkers for metastasis warning，as well as their potential clinical applications in targeting EV secretion or blocking their communication networks to overcome immunotherapy resistance，aiming to provide valuable diagnostic and therapeutic references for clinicians．

      目的 探讨不同体质指数（BMI）分组成年1型糖尿病（T1DM）患者的临床特征以及超重/肥胖与心血管代谢危险因素之间的关系。方法 纳入2015年6月至2022年6月在广州市第一人民医院内分泌代谢科住院的268例成人T1DM患者。分为超重肥胖组（BMI≥24.0 kg/m²，41例）、体质量正常组（18.5≤BMI＜24.0 kg/m²，155例）和体质量过低组（BMI＜18.5 kg/m²，72例）。比较三组人口学、人体测量及代谢指标的差异，采用多元线性回归分析BMI与估算肾小球滤过率（eGFR）的关联。结果 超重肥胖组患者的特征表现为年龄更大、病程更长、体脂肪量更高、腹部皮下脂肪面积更大、腰围、臀围更大、合并高血压比例更高、收缩压更高、高密度脂蛋白胆固醇更低、eGFR更低、糖化血红蛋白（HbA1c）更低。多元线性回归分析显示，校正年龄、性别、病程后，BMI与eGFR呈负相关（β=-2.050，P=0.012）；进一步校正HbA1c、血压、血脂后，该关联不再显著。结论 超重/肥胖成人T1DM患者存在多重代谢异常聚集，BMI与eGFR的负向关联可能主要与血糖、血压、血脂等代谢因素有关。

Objective To investigate the clinical characteristics of adult patients with type 1 diabetes mellitus（T1DM）in different body mass index（BMI）categories and the associations of overweight and obesity with cardiometabolic risk factors．Methods A total of 268 adult T1DM inpatients from Guangzhou First People’s Hospital were enrolled．Patients were divided into three groups：overweight/obese（BMI≥24.0 kg/m²，n=41），normal-weight（18.5≤BMI＜24.0 kg/m²，n=155），and underweight（BMI＜18.5 kg/m²，n=72）．Demographic characteristics，anthropometric measurements，and metabolic parameters were compared among the three groups．Multivariable linear regression analyses were performed to evaluate the association between BMI and estimated glomerular filtration rate（eGFR）．Results Patients in the overweight/obesity group were characterized by older age，longer diabetes duration，higher body fat mass，larger abdominal subcutaneous fat area，greater waist and hip circumferences，a higher prevalence of hypertension，higher systolic blood pressure，lower high-density lipoprotein cholesterol levels，lower eGFR，and lower glycated hemoglobin（HbA1c）levels．Multivariable linear regression analysis demonstrated that BMI was inversely associated with eGFR after adjustment for age，sex，and diabetes duration（β=-2.050，P=0.012）．However，this association was no longer significant after further adjustment for HbA1c，blood pressure，and lipid parameters．Conclusions Overweight/obese adult T1DM patients exhibit clustering of metabolic abnormalities．The negative association between BMI and eGFR may be primarily mediated by metabolic factors such as hyperglycemia，hypertension，and dyslipidemia．

       目的  观察补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床疗效。方法  收集2023年6月—2024年6月结直肠癌康复期的80例住院及门诊患者，随机平均分为两组。行常规对症支持治疗的为对照组；在常规对症支持治疗上加用补肾益气方肾俞膏摩的为干预组；两组均连续治疗14天。于开始治疗前1天和治疗结束后1天分别进行疗效评估相关指标检测。于治疗前1天、治疗第7天和第14天进行不良反应检测。结果 干预组治疗后Piper评分、中医证候总积分、PSQI评分、KPS评分及免疫功能指标（CD₃⁺  、CD₄⁺、CD₈⁺  、CD₄⁺ /CD₈⁺ ）较治疗前均有明显改善；干预组发生不良反应少于对照组。结论  补肾益气方肾俞膏摩治疗能够有效改善结直肠癌患者的癌因性疲乏的治疗效果，提高生活质量和免疫功能，减少不良反应。

       Objective  To observe the clinical observation of Shenshu Tuina combined with Bushen Yiqi herbal ointment in the treatment of cancer-induced fatigue in the convalescent stage of colorectal cancer and evaluate the efficacy．Methods  From June 2023 to June 2025，80 inpatients and outpatients of colorectal cancer in the  recovery period were collected and  randomly divided into two groups．The patients who received routine symptomatic supportive treatment were enrolled as the control group．The intervention group was given Shenshu Tuina combined with Bushen Yiqi herbal ointment on the basis of control group．The relevant indicators for efficacy evaluation were tested one day before treatment and one day after the end of treatment．Adverse reactions were detected on the day before treatment，theseventh day and 14th day during treatment．Results  The efficacy evaluation indexes of the intervention group after treatment were obviously improved compared with those before treatment．Adverse  reactions occurred less in the intervention group than in the control group．Conclusions  Shenshu Tuina combined with Bushen Yiqi herbal ointment can effectively improve the treatment effect of cancer-induced fatigue in patients with colorectal cancer，improve the quality of life and immune function，reduce adverse reactions．

       目的  探讨胸部肿瘤患者手术后早期排痰的效果，降低肺部并发症的发生率。方法  选择2024年6月—2025年7月在本院进行胸部肿瘤切除的60例术后患者作为研究对象。采用非同期回顾对照设计，以不同时间段病例分组，分为对照组（n＝30）和观察组（n＝30）。两组胸部手术后患者均给予常规围术期护理，观察组胸部手术后患者增加早期排痰护理。统计两组排痰效果［咳痰难度、血氧饱和度（SPO₂）］变化、疼痛评分，并统计两组肺部相关并发症及住院时间进行比较。结果  观察组患者术后的SPO₂水平高于对照组（P＜0.05），咳痰难度评分低于对照组患者（P＜0.05）。干预后第B、C时间点观察组患者的疼痛评分均低于对照组（P＜0.05）。观察组住院时间短于对照组（P＜0.05），胸部并发症总发生率低于对照组（P＜0.05），满意度高于对照组（P＜0.05）。结论  胸部肿瘤术后早期排痰有助于促进术后患者排痰，减少肺部相关发症，缩短住院时间。

       Objective  To investigate the efficacy of early expectoration management in reducing pulmonary complications for patients following thoracic tumor surgery．Methods  Sixty patients undergoing thoracic tumor  resection at our hospital between 2024 and 2025 were enrolled．A non-concurrent retrospective control design was adopted．Cases were grouped according to different time periods，divided into a control group（n=30）and an observation group（n=30）．The control group  received  standard perioperative care，while the observation group received additional early expectoration nursing interventions．Outcome measures included expectoration efficacy（assessed by cough difficulty score and oxygen saturation［SpO₂］），pain scores，incidence of pulmonary complications，and hospital stay duration．Results  Postoperative SpO₂ levels were higher in the observation group than in the control group （P＜0.05），while cough difficulty scores were significantly lower（P＜0.05）．At time points B and C after the intervention，the pain scores of patients in the observation group were lower than those in the control group（P＜0.05）．The observation group demonstrated a significantly shorter hospital stay（P＜0.05），a lower overall incidence of thoracic complications（P＜0.05），and higher patient satisfaction  than the control group（P＜0.05）．Conclusions  Implementing early expectoration protocols after thoracic tumor surgery facilitates sputum clearance can reduce pulmonary complications，and shorten hospitalization time．

        目的 探究四子散中药封包药熨在股骨骨折术后疼痛及肿胀中的临床疗效及安全性。方法 选取2024年6月—2025年5月婺源县人民医院骨科收治的60例股骨骨折术后患者, 随机分为观察组（30例,常规治疗+四子散中药封包药熨）与对照组（30例,常规治疗）。比较两组治疗前后疼痛评分（NRS-11）、肿胀程度评分、C反应蛋白（CRP）、白细胞介素-6（IL-6）水平及不良事件发生率。结果 治疗前两组患者疼痛、肿胀评分、CRP、IL-6水平比较差异无统计学意义（P>0.05）; 治疗1周后,观察组疼痛评分为（2.11±0.48）分、肿胀程度为（0.35±0.43）度、CRP为（12.23±3.12）mg/L、IL-6为（16.03±4.01）ng/L,均低于对照组的（3.54±0.56）分、（1.04±0.58）度、（24.31±4.51）mg/L、（23.19±6.75）ng/L,差异有统计学意义（P<0.001）。观察组与对照组均无发生不良事件。结论 四子散中药封包药熨可缓解股骨骨折术后疼痛及肿胀,安全性良好。

       Objective To explore the clinical efficacy and safety of Sizi powder pack hot compress in the treatment of pain and swelling after femoral fracture surgery．Methods From June 2024 to May 2025, 60 patients after femoral fracture surgery were admitted to the Orthopedics Department of Wuyuan County People's Hospital and randomly divided into observation group（30 cases, conventional treatment+Sizi power pack hot compress）and control group（30 cases, conventional treatment）． The pain score（NRS-11）, swelling score, CRP,IL-6 levels and incidence of adverse events before and after treatment were compared between the two groups．Results There was no significant difference in pain and swelling scores between the two groups before treatment（P>0.05）．After 1 week of treatment, the pain score（2.11±0.48）, swelling score（0.35±0.43）, CRP（12.23±3.12 mg/L）, IL-6（16.03±4.01 ng/L）levels in the observation group were significantly lower than those in the control group（3.54±0.56, 1.04±0.58, 24.31±4.51 mg/L, 16.03+4.01 ng/L）, and the difference was statistically significant（P<0.001）．There were no adverse events in the observation group or the control group．Conclusions Sizi power pack hot compress can significantly alleviate the pain and swelling after femoral fracture surgery,and with good safety．