骨伤复原汤配合PFNA治疗股骨粗隆间骨折的临床价值及对患者血清骨折愈合因子表达的影响  

Clinical Value of Gushang Fuyuan Decoction Combined with PFNA in Treatment of Intertrochanteric Fracture and Effects on Expression of Fracture Healing-Associated Factors in Serum

作　　者：李芳兰 胡学昱 王倩 李岩 LI Fang-lan;HU Xue-yu;WANG Qian;LI Yan(Operating Room of Orthopedics Department,First Affiliated Hospital of Air Force Medical University,Xi'an Shaanxi 710032;Orthopedics Department,First Affliated Hospital of Air Force Medical University,Xi'an Shaanxi 710032)

机构地区：[1]中国人民解放军空军军医大学第一附属医院骨科手术室,陕西西安710032 [2]中国人民解放军空军军医大学第一附属医院骨科,陕西西安710032

出　　处：《世界中西医结合杂志》2022年第4期816-820,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金面上项目(81572151)。

摘　　要：目的探究骨伤复原汤配合股骨近端防旋髓内钉(Proximal Femoral Nail Anti-rotation,PFNA)治疗股骨粗隆间骨折的临床价值。方法选取2018年10月—2020年4月期间中国人民解放军空军军医大学第一附属医院收治的104例股骨粗隆间骨折患者,采用随机数字表法分为对照组和治疗组,每组各52例。两组患者均行PFNA治疗,对照组给予常规术后处理,治疗组在上述基础上,配合骨伤复原汤治疗,共治疗4周。观察比较两组患者手术基本情况、中医证候疗效、血清骨折愈合因子[转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、成纤维细胞生长因子-2(Fibroblast growth factor-2,FGF-2)]水平、骨折愈合情况及安全性。结果(1)手术基本情况:两组患者手术操作时间、手术出血量及手术切口长度比较,差异无统计学意义(P>0.05);(2)中医证候疗效:治疗组中医证候疗效总有效率88.24%(45/51)高于对照组64%(32/50),差异有统计学意义(P<0.05);(3)血清骨折愈合因子:术后4周,两组患者血清TGF-β1、FGF-2均较术后第1天增高,差异有统计学意义(P<0.05),且治疗组高于对照组(P<0.05);(4)骨折愈合情况:治疗组骨折愈合时间短于对照组(P<0.05);两组患者骨折延迟愈合发生率比较,差异无统计学意义(P>0.05);(5)安全性:PFNA术后,对照组并发症发生率为4.0%(2/50),治疗组无并发症发生,且骨伤复原汤服用期间未见明显不良反应发生。结论骨伤复原汤配合PFNA治疗股骨粗隆间骨折安全、有效,值得推广应用于临床。Objective To explore the clinical value of Gushang Fuyuan Decoction combined with proximal femoral nail antirotation(PFNA)in the treatment of intertrochanteric fracture.Methods A total of 104 patients with intertrochanteric fracture in the First Affiliated Hospital of Air Force Medical University from October 2018 to April 2020 were randomly divided into a control group(n=52)and a treatment group(n=52)by a random number table.After PFNA,the patients in the control group only received routine postoperative treatment,and those in thetreatment group were orally administered with Gushang Fuyuan Decoction on the basis of postoperative treatment.All patients were treated for four weeks.The operation conditions,efficacies of traditional Chinese medicine(TCM)syndromes,levels of fracture healing-associated factors in the serum[transforming growth factor-β1(TGF-β1)and fibroblast growth factor-2(FGF-2)],fracture healing,and safety of the two groups were compared.Results In terms of operation conditions,no significant differences in operation time,blood loss,and incision length were observed between the two groups(P>0.05).The total effective rate of TCM syndrome in the treatment group was 88.24%(45/51),higher than 64%(32/50)in the control group(P<0.05).The serum levels of TGF-β1 and FGF-2 in the two groups increased compared with those on the first day after the operation(P<0.05),and the treatment group was higher than the control group(P<0.05).The fracture healing time in thetreatment group was shorter than that in the control group(P<0.05),and no significant difference in the incidence of delayed fracture healing was observed between the two groups(P>0.05).After PFNA,the incidence of complications in the control group was 4.0%(2/50),while no complicationoccurred in the treatment group.There was no obvious adverse event during the oral administration of Gushang FuyuanDecoction.Conclusion Gushang Fuyuan Decoction combined with PFNA is safe and effective in the treatment of intertrochanteric fracture,which is worthy of cli

关 键 词：股骨粗隆间骨折 PFNA 骨伤复原汤 骨折愈合因子 骨折愈合时间 

分 类 号：R274.1[医药卫生—中医骨伤科学]