文献类型：期刊文献

中文题名：骨伤复元汤结合外固定支架术对创伤性胫腓骨骨折疗效观察

英文题名：Effect Observation on Gushang Fuyuan Decoction(骨伤复元汤)Combined with External Fixation and Stenting in Treatment of Traumatic Tibiofibular Fracture

作者：许宏斌[1];徐克武[1];贾永龙[1];黄凯[1];蒋宜伟[1];强胜林[1];杨学锋[1];王玉娟[1]

第一作者：许宏斌

机构：[1]甘肃中医药大学附属医院,甘肃兰州730020

第一机构：甘肃中医药大学第二附属医院

年份：2022

卷号：40

期号：4

起止页码：215

中文期刊名：中华中医药学刊

外文期刊名：Chinese Archives of Traditional Chinese Medicine

收录：CSTPCD;;北大核心:【北大核心2020】；

基金：甘肃省中医药管理局科研立项项目(GZK-2018-19)。

语种：中文

中文关键词：创伤性胫腓骨骨折;骨伤复元汤;外固定支架术;疗效;并发症;骨折愈合情况

外文关键词：traumatic tibiofibular fractures;Gushang Fuyuan Decoction(骨伤复元汤);external fixation stenting;curative effect;complications;fracture healing condition

摘要：目的探究骨伤复元汤结合外固定支架术对创伤性胫腓骨骨折患者疗效、血清炎症因子及骨折愈合情况。方法研究合计纳入116例创伤性胫腓骨骨折患者,均由医院2018年6月—2020年12月收治,将纳入患者以随机数字表法分成两组,分别为对照组与观察组,各组病例58例,对照组患者均实行外固定支架术治疗,予以观察组患者外固定支架术联合骨伤复元汤治疗,比较各组患者临床治疗效果、手术后1 d及术后3 d、术后7 d两组患者疼痛情况评分(视觉模拟疼痛评分法,VAS)、患者手术切口愈合情况、胫骨骨折愈合时间及腓骨骨折愈合时间、疼痛消失时间及肿胀消失时间、瘀斑消失时间、治疗前后患者中医证候(骨折筋伤、肿痛、瘀斑、肌紧张、活动受限等)积分变化及骨痂影像学指标(骨痂密度、骨痂量、骨痂边缘及断端边缘)变化、术前及术后7 d两组患者血清白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、治疗前后血管内皮生长因子(VEGF)及骨形态发生蛋白(BMP-2)指标水平变化、患者术后并发症情况。结果较观察组(96.55%,56/58),对照组患者效果(86.21%,50/58)较差(P<0.05);术后1 d及术后3 d、术后7 d,观察组患者VAS评分均低于对照组患者,P<0.05;观察组患者手术切口愈合情况(98.28%,57/58)优于对照组(87.93%,51/58)(P<0.05);较对照组,观察组患者胫骨骨折愈合时间及腓骨骨折愈合时间、疼痛消失时间及肿胀消失时间、瘀斑消失时间均更短(P<0.05);治疗前,两组患者中医证候(骨折筋伤、肿痛、瘀斑、肌紧张、活动受限等)积分、骨痂影像学指标(骨痂密度、骨痂量、骨痂边缘及断端边缘)、IL-6及TNF-α、VEGF及BMP-2水平比较(P>0.05),治疗后各组患者中医证候(骨折筋伤、肿痛、瘀斑、肌紧张、活动受限等)积分、骨痂影像学指标(骨痂密度、骨痂量、骨痂边缘及断端边缘)、IL-6及TNF-α、VEGF及BMP-2水平均改善,观察组患者治疗后中医证候(骨折筋伤、肿痛、瘀斑、肌紧张、活动受限等)积分、骨痂影像学指标(骨痂密度、骨痂量、骨痂边缘及断端边缘)、IL-6及TNF-α、VEGF及BMP-2水平均优于对照组(P<0.05);观察组患者术后并发症率发生率(1.72%,1/58)低于对照组(12.07%,17/58)(P<0.05)。结论骨伤复元汤结合外固定支架术治疗创伤性胫腓骨骨折临床效果显著,患者术后症状恢复好,骨功能恢复快,疼痛轻,并发症率少,安全可靠,值得应用及深入探究。
Objective To investigate the therapeutic effect,serum inflammatory factors and fracture healing of patients with traumatic tibiofibular fracture treated by Gushang Fuyuan Decoction(骨伤复元汤)combined with external fixation and stenting.Methods The combined study included 116 patients with traumatic tibiofibula fracture in our hospital from June 2018 to December 2020.According to the random number table method,the patients were divided into control group and observation group,58 cases in each group.The control group's patients were treated with external fixation stent treatment and the observation group was treated with external fixation stent combined with Gushang Fuyuan Decoction.The clinical treatment effect and pain scores of patients in each group were compared 1 d,3d and 7d after surgery(visual analogue pain score,VAS).The incision healing of patients,tibial and fibular fracture healing time,fracture healing time pain disappeared time and swelling bruises,disappear time disappear time before and after treatment,TCM syndromes(fracture muscle injury,bruises,swelling,muscle tension,restricted movement,etc.)change and callus integral imaging indexes(callus density,amount of callus,callus edges and the broken end)changes,serum levels of interleukin-6(IL-6),tumor necrosis factorα(TNF-α),vascular endothelial growth factor(VEGF)and bone morphogenetic protein(BMP-2)before and after treatment and postoperative complications in two groups were compared.Results Compared with that of the observation group(96.55%,56/58),the effect of the control group(86.21%,50/58)was lower(P<0.05).The VAS score of the observation group was significantly lower than that of the control group at 1 d,3 d and 7 d after surgery(P<0.05).The wound healing of the observation group(98.28%,57/58)was significantly better than that of the control group(87.93%,51/58)(P<0.05).Compared with those of the control group,the healing time of tibia fracture,the healing time of fibula fracture,the disappearance time of pain,the disappearance time of swelling and the disappearance time of petechiae in the observation group were shorter(P<0.05).Before treatment,scores of TCM syndromes(fracture and tendon injury,swelling and pain,ecchymoechiae,muscle tension,limited activity,etc.),callus imaging indexes(callus density,callus volume,callus edge and broken end edge),levels of IL-6,TNF-α,VEGF and BMP-2 in two groups were not significant(P>0.05).After treatment,TCM syndromes scores,callus imaging indexes,levels of IL-6,TNF-α,VEGF and BMP-2 were improved in both groups.After treatment,those in the observation group were better than those in the control group(P<0.05).The incidence of postoperative complications in the observation group(1.72%,1/58)was significantly lower than that in the control group(12.07%,7/58)(P<0.05).Conclusion Gushang Fuyuan Decoction combined with external fixation and stenting in the treatment of traumatic tibiofibular fracture has significant clinical effects,with good postoperative symptom recovery,rapid bone function recovery,less pain and lower complication rate.It is safe and reliable,worthy of application and in-depth exploration.