摘要
目的:观察化瘀消肿止痛汤治疗SeinsheimerⅢ~Ⅴ型股骨粗隆下骨折的临床疗效。方法:将70例SeinsheimerⅢ~Ⅴ型股骨粗隆下骨折患者按照随机数字表法分为观察组和对照组,每组各35例。两组患者均接受小切口环扎钢丝联合长股骨近端髓内钉内固定术治疗,对照组术后给予常规对症治疗,观察组在对照组治疗的基础上加服化瘀消肿止痛汤。比较两组患者骨折愈合情况、血液流变学指标[红细胞压积(hematocrit, Ht)、血沉(erythrocyte sedimentation rate, ESR)、血浆比黏度和全血比黏度]、骨代谢指标[骨钙素(bone-γ-carboxyglutamic acid-containing protein, BGP)、全段甲状旁腺素(intact parathyroid hormone, iPTH)、骨碱性磷酸酶(bone alkalinephos phatase, BLAP)、Ⅰ型胶原羧基端前肽(typeⅠcollagen carboxy-terminal propeptide, CICP)]及炎症因子水平[白细胞介素-6(interleukin-6,IL-6)、白细胞介素-10(interleukin-10,IL-10)及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]变化情况。结果:观察组骨折愈合时间短于对照组,差异有统计学意义(P<0.05)。观察组Harris评分均低于对照组,差异有统计学意义(P<0.05)。术后3个月两组Ht、ESR、血浆比黏度和全血比黏度水平低于术后1 d,且术后3个月组间比较,差异具有统计学意义(P<0.05)。术后3个月两组BGP、BLAP水平高于术后1 d, iPTH、CICP水平低于术后1 d,且术后3个月组间比较,差异具有统计学意义(P<0.05)。术后7 d两组IL-6、IL-10及TNF-α水平低于术后1 d,且术后7 d组间比较,差异具有统计学意义(P<0.05)。结论:化瘀消肿止痛汤可改善SeinsheimerⅢ~Ⅴ型股骨粗隆下骨折患者术后血液流变学指标及炎症因子水平,促进骨代谢,缩短骨折愈合时间。
Objective: To observe the clinical efficacy of Decoction for Resolving Stasis and Relieving Swelling and Stopping Pain on Seinsheimer Ⅲ-Ⅴ subtrochanteric fracture of femur.Methods: A total of 70 patients with Seinsheimer Ⅲ-Ⅴ subtrochanteric fracture of the femur were randomly divided into the observation group and the control group, with 35 cases in each group.The patients in both groups were first treated with small incision cerclage wire and internal fixation with long proximal femoral nail.Then the ones in the control group were treated with conventional symptomatic treatment after surgery.The ones in the observation group were additionally treated with Decoction for Resolving Stasis and Relieving Swelling and Stopping Pain on the basis of the treatment in the control group.The changes of the fracture healing, hemorheology indexes [including hematocrit(Ht),erythrocyte sedimentation rate(ESR),plasma specific viscosity and whole blood specific viscosity],bone metabolism indexes [including osteocalcin(BGP),whole parathyroid hormone(iPTH),bone alkaline phosphatase(BLAP),C-terminal propeptide(CICP) of type I collagen],and the levels of inflammatory factors [including interleukin-6(IL-6),interleukin-10(IL-10),and tumor necrosis factor-α(TNF-α)] were compared between the two groups.Results: The fracture healing time of the observation group was shorter than that of the control group, with a statistically significant difference(P<0.05).Harris score in the observation group was lower than that in the control group, with a statistically significant difference(P<0.05).Three months after operation, the levels of Ht, ESR,plasma specific viscosity and whole blood specific viscosity in the observation group were lower than those in the first day after operation, and the differences between groups were statistically significant(P<0.05).Three months after operation, the levels of BGP and BLAP in the observation group were higher than those in the first day after operation, while the levels of iPTH and CICP in the control group were lower than those in the first day after operation.There were statistically significant differences among the groups three months after operation(P<0.05).The levels of IL-6,IL-10 and TNF-α in the observation group 7 days after operation were lower than those in the first day after operation, and all the differences were statistically significant(P<0.05).Conclusion: Decoction for Resolving Stasis and Relieving Swelling and Stopping Pain can improve the levels of hemorheology and inflammatory factors in patients with Seinsheimer Ⅲ-Ⅴ subtrochanteric fracture of fur after surgery, promote bone metabolism, and shorten the time of fracture healing.
作者
邱林
QIU Lin(Dayu County People's Hospital,Dayu,Jiangxi,China,341500)
出处
《河南中医》
2023年第1期92-96,共5页
Henan Traditional Chinese Medicine
关键词
股骨粗隆下骨折
长股骨近端髓内钉内固定术
化瘀消肿止痛汤
subtrochanteric fracture of femur
internal fixation of proximal femur with intramedullary nail
Decoction for Resolving Stasis and Relieving Swelling and Stopping Pain
