外敷藥是傷科常用方法之一,尤其對軟組織挫傷的治療,更具有特色。如意金黃散組方始於明代陳實功<外科正宗>,迄今近四百年了,由於組方合理,適用性廣,故沿用至今,歷久不衰。然同一種外敷藥因使用不同基質就可能有不同療效。臨床上在臺灣地區常用水或是米酒(含酒精濃度20﹪)為其基質,但此兩種方法對軟組織急性挫傷的療效有何差異呢?為此我們建立兔子軟組織挫傷模型對其藥膏進行研究。 健康雄性家兔38隻,隨機分成五組,正常組8隻、控制組8隻(挫傷後,不外敷任何藥膏)、水調組8隻(挫傷後,外敷80-90公克藥膏為粉劑重與水重1比1.5之比例)、酒調組7隻(挫傷後,外敷80-90公克藥膏為粉劑重與米酒重(含酒精濃度20﹪)1比1.5之比例)、噴劑組7隻(挫傷後,噴灑市面上某S品牌噴劑)。外傷的定量化是以物理學的勢能來定量:勢能 = 重物的質量 ×當時重力 ×重物至物體的垂直高度(E=M×G×H),本模型採用重物1500克,70公分高,擊傷兔子右後肢小腿肌肉豐厚處。各組動物每天測量局部腫脹周徑,以ANOVA統計方法分析結果。 結果表明,(1)本模型採用重物1500克,70公分高,擊傷兔子右後肢小腿肌肉豐厚處,來建立兔子軟組織挫傷後局部腫脹模型是可行的。(2)就每天局部腫脹消腫程度而論,水調組、酒調組及噴劑組,三組之間無明顯差異。但三組對局部腫脹都有減少的趨勢,其中以噴劑組對局部消腫趨勢最強。尤其噴劑組於第1天、第7天時,與控制組相比較有明顯療效,其他天數無明顯差異。(3)就軟組織挫傷後局部腫脹欲恢復接近正常組腫脹所需天數而論,噴劑組比控制組提早6天、比水調組提早4天、比酒調組提早3天(就本實驗共連續觀察11天而言)。; The purpose of this study was to observe the effects of ru-yih-jin-huang-sann (RYJHS) with water base or wine base on contusion of right cuff in rabbits. Thirty-eight rabbits were divided randomly into (1) normal group; (2) control group - without any treatment after contusion; (3) water group - topical RYJHS with water; (4) wine group - topical RYJHS with wine; (5) spray group — commercially available spray. We measured the circumference of right leg at eleven days period. The results demonstrated that (1) the model of contusion of rabbits was successful. Spray group was six, four and three days earlier than the group of control, water and wine for muscle recovery, respectively. (2) No significant differences were noted between the water group, the wine group and spray group for their ability to decrease the muscle swelling. However, all the three groups could decrease the muscle swelling among which the spray group had the best effect, especially at 1 and 7 days after treatment.