有限内固定和外固定架术联合桃红四物汤促进胫骨平台骨折愈合的影像学及生化指标评估  

Effect of limited internal fixation+ external fixation combined with Taohong Siwu decoction on imaging and biochemical indexes assessment in patients of tibial plateau fracture

作　　者：祝勇刚[1] 张大伟[1] 赵广跃[1] 漆伟 孙强[1] 邹继伟[1] 

机构地区：[1]解放军第四军医大学西京医院骨二科,陕西西安710032 [2]解放军第520医院外二科,四川绵阳621000

出　　处：《海南医学院学报》2016年第15期1680-1683,共4页Journal of Hainan Medical University

基　　金：陕西省自然科学基金项目(2014JM4201)~~

摘　　要：目的：研究有限内固定和外固定架术联合桃红四物汤对胫骨平台骨折患者影像学愈合情况及生化指标的影响。方法：选择2010年3月~2014年10月期间我院收治的34例Schatzker V型和VI型胫骨平台骨折患者作为研究对象,随机分为联合治疗组和手术治疗组,手术前后行膝关节正侧位片检查以明确影像学愈合情况,采集血清测定骨碱性磷酸酶（BALP）、血清I型胶原交联C端肽（β-CTX）、血栓素B2（TXB-2）、6-酮前列腺素F1α（6-Keto-PGF1α）的含量。结果：术后1个月时,两组患者的膝关节正侧位片均可见内固定和外固定在位,联合治疗组的骨折断端愈合情况优于手术治疗组。联合治疗组患者手术后14d时的血清β-CTX、TXB2含量及TXB2/6-Keto-PGF1α比例显著低于手术后当天,BALP、6-Keto-PGF1α含量显著高于手术后当天（P〈0.05）;手术治疗组患者手术后14d时的血清BALP含量高于手术后当天、β-CTX含量均低于手术后当天（P〈0.05）,血清TXB2、6-Keto-PGF1α含量及TXB2/6-Keto-PGF1α比例与手术后当天比较无显著性差异（P〉0.05）。联合治疗组术后14d时的血清BALP、6-Keto-PGF1α含量高于手术治疗组、β-CTX、TXB2含量及TXB2/6-Keto-PGF1α比例含量低于手术治疗组（P〈0.05）。结论：有限内固定＋外固定架术联合桃红四物汤能够促进胫骨平台骨折的愈合,调节成骨/破骨细胞活性以及TXA2/PGF1α平衡是桃红四物汤发挥作用的分子靶点。Objective：To study the effect of limited internal fixation ＋ external fixation combined with Taohong Siwu decoction on imaging healing and biochemical indicators in patients with tibial plateau fracture.Methods：A total of 34 patients with Schatzker type V and VI tibial plateau fracture who were treated in our hospital from March 2010 to October 2014 werenbsp;selected as the research subj ects and randomly divided into combined treatment group and surgical treatment group,anteropos-terior and lateral film examination of the knee joint was performed before and after surgery in order to make clear the imaging healing,serum was collected to determine bone alkaline phosphatase （BALP）,serum C-terminal telopeptide of collagen type 1 （β-CTX）,thromboxane B2 （TXB-2）and 6-ketone prostaglandin F1α（6-Keto-PGF1α）content.Results：One month after sur-gery,anteroposterior and lateral film of the knee joint of both groups showed internal fixation and external fixation in-place, and the healing of fracture end of combined treatment group was better than that of the surgical treatment group.Serumβ-CTX and TXB2 content as well as TXB2/6-Keto-PGF1αratio of combined treatment group 14 days after surgery were significantly lower than those on the very day after surgery while BALP and 6-Keto-PGF1αcontent were significantly higher than those on the very day after surgery （P〈0.05）;serum BALP content of surgical treatment group 14 days after surgery was higher than that on the very day after surgery whileβ-CTX content was lower than that on the very day after surgery （P〈0.05）,and ser-um TXB2 and 6-Keto-PGF1αcontent as well as TXB2/6-Keto-PGF1αratio were not significantly different from those on the very day after surgery （P〉0.05）.Serum BALP and 6-Keto-PGF1αcontent of combined treatment group 14 days after surgery were higher than those of surgical treatment group whileβ-CTX and TXB2 content as well as TXB2/6-Keto-PGF1αratio were lower than those of surgical treatment group （P〈0.05）.

关 键 词：胫骨平台骨折 内固定术 外固定术 桃红四物汤 骨代谢 血栓素A2 前列腺素F1Α 

分 类 号：R687.3[医药卫生—骨科学]