| 摘要: |
| 目的:探讨自拟活血止痛方应用于胫骨平台骨折患者术后治疗的效果及对患者康复效果的影响。方法:选取2018 年4 月—2019 年8 月在本院接受手术治疗的70 例胫骨平台骨折患者，随机分为两组，对照组(35 例)给予甘露醇治疗，观察组(35 例)在对照组的基础上再加用自拟活血止痛方治疗，观察两组患者术后疼痛、骨代谢指标变化、关节功能恢复等情况。结果:观察组术后10 d 的肿胀程度为(1.30±0.10) cm，小于对照组的(1.98±0.42) cm，VAS 评分为(1.48±0.22)分，低于对照组的(1.97±0.38)分，差异有统计学意义(P ＜ 0.05)；观察组术后消肿、止痛平均时间为(8.10±1.63)d、(5.30±1.03)d，均短于对照组的(9.86±2.13)d、(6.87±1.08)d，骨折愈合、完全负重平均时间分别为(90.10±13.74)d、(94.53±14.88)d，均显著短于对照组的(116.63±16.32)d、(112.45±14.45)d，差异有统计学意义(P ＜ 0.05)；观察组术后6个月Lysholm 膝关节评分为(53.48±3.28)分，Merchant 量表总评分为(92.63±10.53)分，均高于对照组的(46.85±3.74)分、(80.84±11.62)分，差异有统计学意义(P ＜ 0.05)；观察组术后6 个月的基质金属蛋白酶-2(MMP-2)、骨形态发生蛋白-2(BMP-2)、胰岛素样生长因子-1(IGF-1)水平分别为(679.03±60.73) ng/mL、(677.05±65.28) ng/mL、(204.84±24.74)ng/mL，均高于对照组的(580.84±58.74)ng/mL、(580.88±58.94)ng/mL、(184.72±26.62)ng/mL，差异均有统计学意义(P ＜ 0.05)；观察组术后6 个月的并发症总发生率为5.71%，显著低于对照组的22.86%，差异有统计学意义(P ＜ 0.05)。结论:胫骨平台骨折患者术后加用自拟活血止痛方治疗，可有效减轻患者术后患肢肿痛及疼痛，改善骨代谢，提高关节功能，改善治疗效果。 |
| 关键词: 胫骨平台骨折 活血止痛 疼痛 骨代谢 关节功能 |
| DOI：10.3969/j.issn.1007-6948.2020.06.020 |
| 投稿时间：2020-03-26 |
| 基金项目: |
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| The Effect of Self-made Huoxue Zhitong Recipe on Bone Metabolism and Joint Recovery of Patients with Tibial Plateau Fracture |
| TIAN Zhong-qing |
| Department of orthopedic, Heze Traditional Chinese Medicine Hospital of Shandong Province, Heze 274000,China |
| Abstract: |
| Objective To evaluate the effect of self-made Huoxue Zhitong Recipe(HXZT) on postoperative treatment and rehabilitation of patients with tibial plateau fracture. Methods Seventy patients with tibial plateau fractures who received surgical treatment in our hospital from April 2018 to August 2019 were divided into two groups according to random number table. The control group(35 cases)was treated with mannitol, and the observation group(35 cases) was treated with Huoxue Zhitong recipe.The postoperative pain, changes of bone metabolic index and recovery of joint function were observed.Results The degree of swelling ten days after operation was (1.30±0.10) cm in the observation group,which was significantly lower than that in the control group(1.98 ±0.42)cm, and the VAS score was(1.48±0.22),which was significantly lower than that in the control group(1.97±0.38)(P <0.05). The average time of detumescence and analgesia in the observation group was(8.10±1.63) d and(5.30±1.03)d, which were shorter than those in the control group(9.86±2.13) d and(6.87±1.08) d respectively, The average time of fracture healing and complete weight-bearing were(90.10±13.74) d and(94.53±14.88) drespectively, which were significantly shorter than those in the control group(116.63±16.32) d and(112.45±14.45) d respectively(P <0.05). Six months after operation, the scores of Lysholm and Merchant were(53.48±3.28) and (92.63±10.53), which were higher than those of the control group (46.85±3.74) and (80.84±11.62) respectively(P<0.05). The levels of MMP-2,BMP-2 and IGF-1 in the observation group were(679.03±60.73) ng/mL, (677.05±65.28) ng/mL, (204.84±24.74) ng/mL respectively, which were higher than those in the control group (580.84 ±58.74) ng/mL, (580.88±58.94) ng/mL and (184.72±26.62) ng/mL respectively(P<0.05). The total incidence of postoperative complications was 5.71% in the observation group, which was signi?cantly lower than that of the control group(22.86%)(P<0.05). Conclusion Patients with tibial plateau fractures were treated with self-made prescription for promoting blood circulation and stopping pain after operation. It can effectively relieve the pain and swelling of the affected limb and improve bone metabolism and the effect of joint function. |
| Key words: Fracture of tibial plateau promoting blood circulation to relieve pain pain bone metabolism joint function |
