成骨因子保留结合补肾凉血化瘀方促进踝部骨折快速愈合的临床研究  

Clinical Study of Bushen Liangxue Huayu Decoction Combined with Osteogenic Factor Replantation for Promoting Rapid Healing of Ankle Fracture

作　　者：林晓光[1] 邓蕴源 陈元荣 傅强[1] LIN Xiaoguang;DENG Yunyuan;CHEN Yuanrong(Foshan Hospital of Traditional Chinese Medicine,Foshan Guangdong 528100,China)

机构地区：[1]佛山市中医院,广东佛山528000

出　　处：《四川中医》2021年第2期139-143,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：2018年佛山市科技创新项目(编号:2018AB001691)。

摘　　要：目的:观察成骨因子保留结合补肾凉血化瘀中药对踝部骨折术后快速愈合的影响。方法:将120例均符合纳入排除标准的踝部骨折患者随机分成3组,分别为成骨因子保留组、中药组和成骨因子保留+中药组,每组40例。成骨因子保留组术中在骨折线处回植含有成骨因子的血肿块,中药组采用常规切开复位内固定术,术后次日开始口服补肾凉血化瘀中药,疗程为4周;成骨因子保留+中药是在保留血块的基础上同时口服补肾凉血化瘀中药4周。分别于术后1周、2周和4周时测量患肢踝后足评分系统量表(AOFAS)评分;术前、术后2周和4周时检测患者血清中骨碱性磷酸酶(BALP)、骨钙素(BGP)、Ⅰ型前胶原羧基端肽(PICP)等骨生化指标的含量;在术后第4、5、6、7、8周对患肢行X射线检查,确定骨折愈合时间。结果:三组患者术后1周时的AOFAS评分比较无明显统计学差异(P>0.05),而术后2周和4周时,联合组和中药组患肢踝部AOFAS评分均明显高于单纯成骨因子保留组,差异均有显著统计学意义(P<0.01);术后2周和4周时中药组的患肢踝部AOFAS评分均稍微高于联合组,但差异无统计学意义(P>0.05)。三组患者术前的骨代谢指标BGP、BALP和PICP比较差异均无统计学意义(P>0.05);术后2周和4周时,单纯成骨因子保留组和联合组的BGP、BALP和PICP值均高于中药组(P<0.01),而且联合组的相关指标也高于单纯成骨因子保留组(P<0.01)。成骨因子保留组和联合组的骨折愈合时间均短于中药组(P<0.01),而且联合组的愈合时间也较单纯成骨因子保留组缩短(P<0.01)。结论:补肾凉血化瘀中药能协同成骨因子保留促进踝部骨折愈合,并能快速恢复成骨因子保留的踝部骨折内固定术后的踝关节活动功能,表明成骨因子保留结合补肾凉血化瘀法能有效促进踝部骨折快速愈合,加快踝关节功能恢复。Objective:To explore the effect of Bushen Liangxue Huayu Decoction(BSLXHY)combined with osteogenic factor replantation on healing after ankle fracture surgery.Methods:120patients with ankle fracture were randomly divided into three groups:osteogenic factor replantation group,Chinese herbs group and osteogenic factor replantation combined with Chinese herbs group,40cases in each group.In the osteogenic factor replantation group,the osteogenic factor was replanted at the fracture area.The Chinese herbs group was treated with open reduction and internal fixation,and the Chinese medicine for BSLXHY Decoction was given orally for 4weeks on the first day after operation.The combination group was given the Chinese herbal medicine of BSLXHY Decoction orally for 4weeks on the basis of osteogenic factor replantation.The AOFAS score was detected and recorded on the 1w,2w and 4w after operation.The serum levels of bone alkaline phosphatase(BALP),bone gla-protein(BGP)and carboxyterminal peptide of type I procollagen(PICP)were detected before operation,2weeks and 4weeks after operation,and then X-ray examination was performed at 4,5,6,7,8weeks after operation to determine the healing time of fracture.Results:There was no significant difference in AOFAS scores among the three groups at 1week after operation(P>0.05),but at 2weeks and 4weeks after operation,AOFAS scores of affected limb in the combination group and the Chinese herbs group were significantly higher than those in the simple osteogenic factor replantation group(P<0.01).2and 4weeks after operation,AOFAS score of affected limb in the Chinese herbs group was slightly higher than that in the combination group,but the difference was not statistically significant(P>0.05).There was no significant difference in the preoperative BGP,BALP and PICP among the three groups(P>0.05),at 2and 4weeks after operation,the BGP,BALP and PICP levels of the simple osteogenic factor replantation group and the combined group were higher than those of the Chinese herbs group(P<0.01),and the r

关 键 词：成骨因子 补肾凉血化瘀法 踝部骨折 快速愈合 

分 类 号：R274.12[医药卫生—中医骨伤科学]