植骨后外固定支架固定联合健骨促愈中药治疗胫骨骨折不愈合的临床研究  

Clinical Study on Treatment of Nonunion of Tibial Fracture by Bone Graft Combined With Jianggu Cuyu Decoction

作　　者：连霄[1] 顾晓民[1] 孙洪军 曾云记[1] 

机构地区：[1]杭州师范大学附属医院骨科,浙江杭州310015

出　　处：《中华中医药学刊》2017年第10期2643-2645,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划项目(2016ZA166)

摘　　要：目的:探讨植骨后外固定支架固定联合健骨促愈中药对胫骨骨折不愈合关节功能改善、骨痂评分及愈合时间的影响。方法:研究对象选取医院2013年4月—2015年7月收治胫骨骨折不愈合患者共130例,以随机数字表法分为对照组(65例)和观察组(65例),分别采用植骨后外固定支架固定单用和在此基础上加用健骨促愈中药辅助治疗;比较两组患者近期疗效,骨折愈合时间,治疗后骨痂评分,治疗前后Lysholm评分,HSS评分及实验室指标水平等。结果:观察组患者近期疗效显著优于对照组(P<0.05);观察组患者骨折愈合时间显著短于对照组(P<0.05);观察组患者治疗后Lysholm评分和HSS评分均显著高于对照组、治疗前(P<0.05);观察组患者治疗后骨痂评分显著高于对照组(P<0.05);同时观察组患者治疗后实验室指标水平均显著高于对照组、治疗前(P<0.05)。结论:植骨后外固定支架固定联合健骨促愈中药治疗胫骨骨折不愈合可有效缩短骨折愈合时间,改善膝关节功能,并有助于上调BMP-2,IGF-1,IGF-2及VEGF水平。Objective：To investigate the effect of external fixation after bone graft combined with Jianggu Cuyu Decoction on joint function improving stuation, callus score and healing time of nonunion of tibial fractures. Methods ： A total of 130 patients with nonunion of tibial fractures were chosen in the period from April 2013 to July 2015 in our hospital and randomly divided into control group （65 patients） with external fixation after bone graft alone and observation group （65 patients） with Jianggu Cuyu Decoction on the basis of control group. And the clinical efficacy for short -term, the fracture healing time, the callus score after treatment, the Lysholm score, the HSS score and the levels of laboratory index of both groups were compared. Results ： The clinical efficacy for short - term of observation group was significantly better than that of the control group（P 〈 0.05 ）. The fracture healing time of observation group was significantly shorter than that of the control group（P 〈 0. 05）. The callus scores after treatment of observation group were significantly higher than that of the control group（ P 〈 0.05 ）. The Lysholm score and the HSS score after treatment of observation group were significantly higher than that of the control group and before treatment（ P 〈 0. 05 ）. The levels of laboratory index after treatment of observation group were significantly higher than that of the control group and before treatment（ P 〈0. 05 ）. Conclusion：External fixation after bone graft combined with Jianggu Cuyu Decoction in the treatment of nonunion of tibial fractures can efficiently shorten the healing time of fracture, improve the function of knee joint and up - regulate the levels of BMP - 2, IGF - 1, IGF - 2 and VEGF.

关 键 词：中医药 外固定 胫骨骨折 骨折不愈合 疗效 

分 类 号：R274.1[医药卫生—中医骨伤科学]