云克静脉滴注联合活血通络方口服治疗距骨骨软骨损伤的临床研究  

Clinical study on intravenous drip of Yunke( 云克) combined with oral application of Huoxue Tongluo Fang( 活血通络方) for treatment of talar osteochondral injury

作　　者：郭会利[1] 叶艳君[1] 李盼盼[1] 郭树农[1] 王军辉[1] 郭水洁 

机构地区：[1]河南省洛阳正骨医院河南省骨科医院,河南洛阳471002

出　　处：《中医正骨》2016年第3期9-13,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：河南省中医药科学研究专项课题(2013ZY02046)

摘　　要：目的：观察云克静脉滴注联合自拟活血通络方口服治疗距骨骨软骨损伤的临床疗效。方法：将75例距骨骨软骨损伤患者随机分为3组,每组25例,分别采用单纯静脉滴注云克、单纯口服自拟活血通络方及云克静脉滴注联合自拟活血通络方口服治疗。云克注射液静脉滴注每日1次,每分钟40滴,连续治疗30 d;自拟活血通络方口服每日1剂,连续口服30 d。治疗结束后6个月采用自拟影像学评价标准、美国足与踝关节外科协会（American orthopaedic foot and ankle society,AOFAS）踝与后足功能评分标准及疼痛数字评价量表（numerical rating scale,NRS）评分法评定3组患者的临床疗效。结果：1踝关节NRS疼痛评分结果。治疗前3组患者踝关节NRS疼痛评分比较,差异无统计学意义[（3.000±0.577）分,（3.160±0.624）分,（3.080±0.759）分,F=0.369,P=0.693]。治疗结束后6个月,3组患者踝关节NRS疼痛评分比较,差异有统计学意义[（1.120±0.332）分,（1.640±0.757）分,（1.680±0.690）分,F=6.310,P=0.003];云克联合活血通络方组踝关节NRS疼痛评分低于云克组和活血通络方组（P=0.004,P=0.002）;云克组与活血通络方组比较,差异无统计学意义（P=0.821）。2踝关节AOFAS功能评分结果。云克联合活血通络方组1例患者自行退出试验。治疗结束后6个月,活血通络方组显效7例,有效10例,无效8例;云克组显效9例,有效10例,无效6例;云克联合活血通络方组显效15例,有效6例,无效3例。3组患者踝关节AOFAS功能评分比较,差异有统计学意义（χ^2=6.316,P=0.043）;进一步两两比较（校正α＇=0.025）,云克联合活血通络方组优于活血通络方组（u=162.000,P=0.003）;云克组与云克联合活血通络方组、活血通络方组比较,差异均无统计学意义（u=218.000,P=0.045;u=251.000,P=0.232）。3影像学评价结果。3组均有患者拒绝影像学检查,其中活血通络方组2例、云克组2例、云克联合�Objective： To observe the clinical curative effects of intravenous drip of Yunke（ 云克） combined with oral application of Huoxue Tongluo Fang（ 活血通络方,HXTLF） in the treatment of talar osteochondral injury. Methods： Seventy-five patients with talar osteochondral injury were randomly divided into 3 groups,25 cases in each group. The patients were treated with intravenous drip of Yunke（ Yunke group,once a day for consecutive 30 days）,oral application of self-made HXTLF（ HXTLF group,one dose a day for consecutive 30days） and combination therapy of intravenous drip of Yunke and oral application of self-made HXTLF（ combination therapy group） respectively. The clinical curative effects were evaluated and compared between the 3 groups at 6 months after the end of the treatment by using self-designed radiographic evaluation criterion,ankle-hindfoot scale made by American orthopaedic foot and ankle society（ AOFAS） and pain numerical rating scale（ NRS）. Results： There was no statistical difference in ankle NRS pain scores between the 3 groups before treatment（ 3. 000 ＋/- 0. 577,3. 160 ＋/- 0. 624,3. 080 ＋/- 0. 759 points,F = 0. 369,P = 0. 693）. There was statistical difference in ankle NRS pain scores between the 3 groups at 6 months after the end of the treatment（ 1. 120 ＋ /- 0. 332,1. 640 ＋ /- 0. 757,1. 680 ＋ /- 0. 690 points,F =6. 310,P = 0. 003）. The ankle NRS pain scores were lower in combination therapy group compared to Yunke group and HXTLF group（ P =0. 004,P = 0. 0020）. There was no statistical difference in ankle NRS pain scores between Yunke group and HXTLF group（ P = 0. 821）.One patient dropped out in combination therapy group. Seven patients got a good result,10 fair and 8 poor in HXTLF group; 9 patients got a good result,10 fair and 6 poor in Yunke group; while 15 patients got a good result,6 fair and 3 poor in combination therapy group at 6months after the end of the treatment. There was statistical difference in AOFAS ankle function score

关 键 词：距骨 踝关节 锝 亚甲基二膦酸盐 中药疗法 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 图像融合 治疗 临床研究性 

分 类 号：R259[医药卫生—中西医结合]