分期辨证联合切开复位内固定术治疗新鲜闭合性跟骨关节内骨折60例临床观察  

Syndrome Differentiation Combined with Open Reduction and Internal Fixation for the Treatment of Clinical Observation of 60 Cases of Fresh Closed Intra-articular Fracture of Calcaneus

作　　者：隋晓辉[1] 金成辉[1] 张丽[2] 

机构地区：[1]沈阳市骨科医院运动医学科,沈阳110044 [2]沈阳体育学院门诊部,沈阳110102

出　　处：《实用中医内科杂志》2014年第3期61-63,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察分期辨证联合切开复位内固定术治疗新鲜闭合性跟骨关节内骨折疗效。[方法]使用前瞻性设计方法,对60例住院患者使用①切开复位内固定术,术后2周拆线并进行常规预防感染,消除肿胀。②分期辨证：术后初期宜活血化瘀、消肿止痛,桃红四物汤,熟地、当归各15g,白芍10g,川芎8g,桃仁9g,红花6g,加牛膝、泽泻等;中期宜和荣止痛、续筋接骨、舒筋通络,续骨活血汤,落得打、骨碎补、川续断肉、煅自然铜、全当归、杭白芍各9g,鲜生地12g,乳香、没药各9g,地鳖虫制6g;后期宜补气养血、滋补肝肾、温经通络,补血复元汤,玄胡1.5g,当归6g,甘草1.8g,山甲2.1g,熟庄黄9g,桃仁研5~7粒,红花0.9g,花粉1.5g。连续治疗30d为1疗程。观测临床症状、Bohler角、Gissane角、不良反应。治疗1疗程,随访6-18个月,判定疗效。[结果]优40例,良15例,可5例,差0例,优良率91.67%。Bohler角及Gissane角均有改善（P〈0.01）。[结论]分期辨证分型联合切开复位内固定术治疗新鲜闭合性跟骨关节内骨折,疗效满意,无副作用,值得推广。[Objective] To observe the differentiation of symptoms and signs combined with open reduction and internal fixation for treatment of fresh closed intra-articular calcaneal fractures. [Method] Using a prospective design method,the use of open reduction and internal fixation in 60 cases of hospitalized patients, after 2 weeks in stitches and routine to prevent infection,eliminate swelling. The syndrome differentiation：in the early stage after operation should be promoting blood circulation and removing blood stasis,detumescence and acesodyne,Taohong Siwu Decoction,prepared rhizome of rehmannia,angelica 15g,10g of white peony root, Chuanxiong 8g,peach 9g,safflower 6G,plus Achyranthes root,Alisma;interim should and Rong pain, bone reunion,Shujin Tongluo,Xuguhuoxuetang,Centella asiatica Drynaria,Dipsacus,meat,calcined pyrite,Angelica sinensis,white peony root 9g,fresh 12g,frankincense,myrrh 9g,Eupolyphaga sinensis 6G;late Yi Qi Nourishing,nourishing the liver and kidney,warming meridians,blood decoction for recovery, Xuan Hu 1.5g,angelica 6G,licorice 1.8g,pangolin scales 2.1g,ripe Zhuang Huang 9g,peach kernel 5 ~ 7 seed,safflower 0.9g,pollen,1.5g. Continuous treatment with 30d for 1 courses. Observation of clinical symptoms,Bohler angle,Gissane angle,adverse reaction. 1 courses of treatment,patients were followed up for 6 - 18 months,the curative effect.[Results] Were excellent in 40 cases,good in 15 cases,5 cases, poor in 0 cases,the excellent and good rate was 91.67%.[Conclusion] Syndrome differentiation combined with open reduction and internal fixation for the treatment of fresh closed calcaneal intra-articular fracture,curative effect,no side effect,is worth promoting.

关 键 词：新鲜闭合性跟骨关节内骨折 分期辨证 切开复位内固定术 Bohler角 Gissane角 中西医结合治疗 前瞻性设计 

分 类 号：R274.12[医药卫生—中医骨伤科学] R241.4[医药卫生—中医学]