手法复位杉树皮夹板固定联合补肾活血汤口服治疗老年肱骨近端骨折肾虚血瘀证的临床研究  

A clinical study of manipulative reduction and fir-bark splint external fixation combined with oral application of Bushen Huoxue Tang(补肾活血汤) for treatment of kidney-deficiency-blood-stasis-type proximal humeral fractures in the aged

作　　者：刘丹琼 LIU Danqiong(Benxi Hospital of Traditional Chinese Medicine,Benxi 117000,Liaoning,China)

机构地区：[1]辽宁省本溪市中医院,辽宁本溪117000

出　　处：《中医正骨》2018年第8期16-20,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:观察手法复位杉树皮夹板固定联合补肾活血汤口服治疗老年肱骨近端骨折肾虚血瘀证的临床疗效。方法:将60例老年肱骨近端骨折肾虚血瘀证患者按其意愿分为手法复位外固定组和切开复位内固定组,每组30例。手法复位外固定组采用手法复位杉树皮夹板固定联合补肾活血汤口服治疗,补肾活血汤每日1剂,每次100 m L,每日3次,连续服用3周;切开复位内固定组采用切开复位钢板内固定治疗。比较2组患者的骨折愈合情况及末次随访时的Constant-Murley肩关节功能评分。结果:所有患者均获随访,随访时间8~30个月,中位数12个月。骨折均愈合。手法复位外固定组的骨折愈合时间短于切开复位内固定组[(8.90±1.63)周,(10.47±1.89)周,t=-3.443,P=0.001]。末次随访时,2组患者的Constant-Murley肩关节疼痛评分、日常活动能力评分、肩关节活动度评分、肌力评分及总分比较,组间差异均无统计学意义[(15.40±1.63)分,(16.10±1.79)分,t=-1.584,P=0.119;(17.80±1.63)分,(16.77±3.47)分,t=1.476,P=0.145;(34.37±4.38)分,(35.50±5.85)分,t=-0.849,P=0.399;(17.73±3.27)分,(18.23±3.36)分,t=-0.584,P=0.561;(83.33±6.64)分,(85.70±6.24)分,t=-1.423,P=0.160]。结论:手法复位杉树皮夹板固定联合补肾活血汤口服治疗老年肱骨近端骨折肾虚血瘀证,与切开复位钢板内固定的临床疗效相当,但骨折愈合比后者快,值得临床推广应用。Objective： To observe the clinical curative effects of manipulative reduction and fir-bark splint external fixation combined with oral application of Bushen Huoxue Tang（ 补肾活血汤,BSHXT） for treatment of kidney-deficiency-blood-stasis-type proximal humeral fractures in the aged. Methods： Sixty aged patients with kidney-deficiency-blood-stasis-type proximal humeral fractures enrolled in the study were divided into manipulative reduction external fixation group and open reduction internal fixation group according to their wishes,30 cases in each group. The patients in manipulative reduction external fixation group were treated with manipulative reduction and fir-bark splint external fixation combined with oral application of BSHXT,while the patients in open reduction internal fixation group were treated with open reduction and steel plate internal fixation. The BSHXT was taken for 3 weeks,one dose a day by 3 times,100 m L at a time. The fracture healing and the Constant-Murley shoulder function score at last follow-up were compared between the 2 groups.Results： All patients in the 2 groups were followed up for 8-30 months with a median of 12 months,and all fractures healed in the 2 groups. The fracture healing time was shorter in manipulative reduction external fixation group compared to open reduction internal fixation group（ 8. 90 ＋/-1. 63 vs 10. 47 ＋/-1. 89 weeks,t =-3. 443,P = 0. 001）. There was no statistical difference in Constant-Murley shoulder pain scores,activity of daily living（ ADL） scores,shoulder range of motion（ ROM） scores,muscle strength scores and total scores between the2 groups at last follow-up（ 15. 40 ＋/-1. 63 vs 16. 10 ＋/-1. 79 points,t =-1. 584,P = 0. 119; 17. 80 ＋/-1. 63 vs 16. 77 ＋/-3. 47 points,t = 1. 476,P = 0. 145; 34. 37 ＋/-4. 38 vs 35. 50 ＋/-5. 85 points,t =-0. 849,P = 0. 399; 17. 73 ＋/-3. 27 vs 18. 23 ＋/-3. 36 points,t =-0. 584,P = 0. 561; 83. 33 ＋/-6. 64 vs 85. 70 ＋/-6. 24 points,t =-1. 423,P = 0. 160）. Conclusion： Therapy of

关 键 词：肩骨折 肱骨骨折 肾虚 血瘀 正骨手法 小夹板固定 补肾活血汤 骨折固定术 内 临床试验 

分 类 号：R683.41[医药卫生—骨科学]