逐瘀通络法配合腕关节镜下锁定加压钢板内固定治疗桡骨远端骨折患者腕关节活动功能及疼痛介质的影响  

Effect of Zhuyu Tongluo Method Combined with LCP Internal Fixation Under Wrist Arthroscopy on Wrist Function,Activity and Pain Mediators in Patients with Distal Radius Fractures

作　　者：曹哲铭 李志刚[2] 曾祥悦[3] 宋锡国 周立民 CAO Zhe-ming;LI Zhi-gang;ZENG Xiang-yue;SONG Xi-guo;ZHOU Li-min(Department of Surgery,Tangshan Haigang Economic Development Zone Hospital,Tangshan Hebei 063611;Fourth Department of Hand,Tangshan Second Hospital,Tangshan Hebei 063600;Department of Otolaryngology,Department of Clinical Medicine,Tangshan Vocational and Technical College,Tangshan Hebei 063600)

机构地区：[1]唐山市海港经济开发区医院外科,河北唐山063611 [2]唐山市第二医院手四科,河北唐山063600 [3]唐山职业技术学院临床医学系耳鼻喉教研室,河北唐山063600

出　　处：《世界中西医结合杂志》2022年第1期151-156,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2021414)。

摘　　要：目的探讨逐瘀通络法配合腕关节镜下锁定加压钢板(LCP)内固定治疗桡骨远端骨折患者腕关节功能活动功能及疼痛介质的影响。方法选取2019年8月—2020年8月期间唐山市海港经济开发区医院外科收治的130例桡骨远端骨折患者,按随机数字表法分为观察组和对照组,每组各65例。对照组给予关节镜下LCP内固定治疗,观察组给予逐瘀通络法配合关节镜下LCP内固定治疗。观察比较两组患者治疗前后中医证候积分、腕关节功能活动功能、疼痛介质[P物质(Substance P,SP)、β-内啡肽(Human Beta-Endorphin,β-EP)、5羟色胺(5-hydroxytryptamine,5-HT)、前列腺素E;(Prostaglandin Receptor-2,PGE;)、神经肽Y(Neuropeptide Y,NPY)],以及治疗后两组患者临床疗效、骨折愈合时间、疼痛消失时间及肿胀消失时间。结果治疗后两组患者骨连未坚、瘀斑、局部疼痛、肿胀、腰膝酸软、活动受限、神疲乏力评分均较治疗前降低(P<0.05);且观察组骨较对照组明显降低(P<0.05)。治疗后观察组总有效率96.92%(63/65)明显高于对照组84.62%(55/65)(P<0.05)。治疗后观察组患者骨折愈合时间、疼痛消失时间及肿胀消失时间均较对照组明显缩短(P<0.05)。治疗后两组患者腕关节功能活动功能评分均较治疗前升高(P<0.05);且观察组较对照组明显升高(P<0.05)。治疗后两组患者SP、β-EP、5-HT、PGE;、NPY水平均较治疗前降低(P<0.05);且观察组较对照组明显降低(P<0.05)。结论逐瘀通络法配合腕关节镜下LCP内固定治疗能够有效改善桡骨远端骨折患者腕关节功能活动功能、降低疼痛介质,效果显著,可在临床推广应用。Objective To investigate the effect of removing blood stasis and dredging collaterals combined with locking compression plate(LCP)internal fixation under wrist arthroscopy in the treatment of wrist joint function and activity and pain mediators in patients with distal radius fractures.Methods From August 2019 to August 2020,130 patients with distal radius fractures who were admitted to surgery in Tangshan Haigang Economic Development Zone Hospital were selected and divided into an observation group and a control group according to the random number table method,with 65 cases in each group.The control group was given arthroscopic LCP internal fixation,and the observation group was given the Zhuyu dredging method combined with arthroscopic LCP internal fixation.Observation and comparison of TCM syndrome scores,wrist joint function and mobility,pain mediator[Substance P(SP),β-endorphin(β-EP),serotonin(5-hydroxytryptamine,5-HT),prostaglandin E;(Prostaglandin Receptor-2,PGE;),neuropeptide Y(Neuropeptide Y,NPY)],as well as the clinical efficacy,fracture healing time,pain disappearance time and swelling disappearance in thetwo groups after treatment time.Results After treatment,the scores of weak bone union,ecchymosis,local pain,swelling,soreness and weakness of waist and knee,limited activity,and Shenpi fatigue in the two groups were all lower than those before treatment(P<0.05).decreased(P<0.05).After treatment,the total effective rate of the observation group was 96.92%(63/65),which was significantly higher than that of the control group,84.62%(55/65)(P<0.05).After treatment,the fracture healing time,pain disappearance time and swelling disappearance time in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,the wrist joint functional activity scores of the two groups were increased compared with those before treatment(P<0.05).And the observation group was significantly increased compared with the control group(P<0.05).After treatment,the levels of SP,β-EP,5-HT

关 键 词：桡骨远端骨折 腕关节功能活动 逐瘀通络法 腕关节镜下LCP内固定 疼痛介质 

分 类 号：R683[医药卫生—骨科学]