补肾活血汤联合骨搬移治疗胫骨骨折后感染性骨不连的临床疗效观察  

Clinical Observation of Bushen-Huoxue Decoction Combined with Bone Mobilization in Treating Infectious Nonunion of Patellar Fracture

作　　者：王德 刘森 李阳 曹泽宾 陈泷烨 王强 Wang De;Liu Sen;Li Yang;Cao Zebin;Chen Longye;Wang Qiang(Dingzhou Traditional Chinese Medicine Hospital,Dingzhou,073000,China)

机构地区：[1]定州市中医医院,河北定州073000

出　　处：《成都中医药大学学报》2018年第3期62-66,80,共6页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：河北省中医药管理局项目(2018191);政府资助临床医学优秀人才培养项目(2015054965)

摘　　要：目的:观察补肾活血汤联合骨搬移治疗胫骨骨折后感染性骨不连的临床疗效。方法:将80例胫骨骨折后感染性骨不连患者按照随机数字表分为观察组和对照组,每组40例,对照组给予骨搬移技术治疗,术后给予常规处理,观察组在对照组基础上给予给予补肾活血汤熏蒸+内服治疗,疗程3个月。记录2组疼痛、骨折端骨痂形成、下肢运动功能、日常生活活动能力的变化,检测2组治疗前后血液流变学、炎性反应指标并统计2组临床预后情况。结果:2组治疗后疼痛视觉模拟评分(Visual Analogue Scale,VAS)分级和平均分值均有显著改善,观察组的改善情况优于对照组,结果有显著差异(P <0. 05);观察组在治疗结束时、治疗结束后3个月时的骨痂评分分级和分值均显著优于对照组,结果有显著差异(P <0. 05); 2组治疗后下肢Fugl-Meyer运动功能评分、Barthel指数评分分级及平均分均优于对照组,结果有显著差异(P <0. 05); 2组全血粘度(高、中、低切)、血浆粘度、红细胞聚集指数、血清ICAM-1、IL-6、TNF-α水平均显著降低,观察组以上指标均低于对照组,结果有显著差异(P <0. 05);观察组临床预后情况:骨折愈合时间、日常步行速度、术后并发症均优于对照组,结果有显著差异(P <0. 05)。结论:在骨搬移技术治疗胫骨骨折后感染性骨不连的基础上,采用补肾活血汤治疗能够显著缓解疼痛、促进骨折愈合,并改善局部血液流变学,抑制炎性反应,有利于下肢运动功能和日常生活活动能力的改善。Objective： To observe the clinical effect of Bushen huoxue decoction combined with bone removal in the treatment of infectious nonunion after tibial fracture. Methods ： Eighty patients w,ith infective nonunion after tibial fracture w,ere divided into observation group and control group according to the random number table. There w,ere 40 cases in each group. The control group w,as treated with bone movement technique, and routine treatment w,as given after operation. The observation group w,as in the control group. Based on the treatment given to Bushen huoxue decoction fumigation and internal treatment, treatment for 3 months. The changes of pain, fracture osteoporosis, low-er extremity motor function, and activities of daily living w,ere recorded. The blood rheology and inflammatory response indexes of the two groups before and after treatment were recorded and the clinical outcomes of the two groups were recorded. Results ： The pain visual analogue scale （VAS） grade and mean score were significantly improved in the two groups after treatment. The improvement in the obser^^ation group was better than that in the control group. The results were significantly different （P 〈0. 05） ; the observation group w,as at the end of the treatment. The grade and score of osteophyte score at 3 months after the end of treatment were significantly better than that of the control group （ P 〈 0. 05 ） ; the Fugl-Meyer motor function score, Barthel index score and classification of the lower limbs of the 2 groups after treatment were significantly different. The scores were better than the control group and the results were significantly different （P 〈0. 05） ; the whole blood viscosity （high, middle, low cut） , plasma viscosity, erythrocyte aggregation index, serum ICAM-1, IL-6, TNF-a The average level of blood decreased significantly. The above indicators in the observation group wee low,er than those in the control group. The results w,ere significantly different （P 〈0. 05） .

关 键 词：补肾活血汤 骨搬移 胫骨骨折 感染性骨不连 血液流变学 炎性反应 

分 类 号：R274[医药卫生—中医骨伤科学] R289[医药卫生—中医学]