加味桃红四物汤治疗气滞血瘀型胫骨平台骨折切开复位内固定患者临床研究  

Clinical Study on Modified Taohong Siwu Decoction for Patients Undergoing Open Reduction and Internal Fixation After Tibial Plateau Fracture of Qi Stagnation and Blood Stasis Type

作　　者：沈良 单方军 徐学方 吴天泉 SHEN Liang;SHAN Fangjun;XU Xuefang;WU Tianquan

机构地区：[1]绍兴市中西医结合医院,浙江绍兴312030

出　　处：《新中医》2023年第7期75-79,共5页New Chinese Medicine

基　　金：浙江省中医药科技计划项目(2021ZT006)。

摘　　要：目的:观察加味桃红四物汤治疗气滞血瘀型胫骨平台骨折切开复位内固定患者的临床疗效。方法:将118例气滞血瘀型胫骨平台骨折切开复位内固定患者随机分为对照组与观察组各59例。对照组采用常规治疗,观察组在对照组基础上联合加味桃红四物汤口服治疗,治疗12周后比较2组临床疗效。结果:观察组总优良率96.61%,高于对照组79.66%(P<0.05)。治疗前,2组血清白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清IL-17、TNF-α水平降低(P<0.05),且观察组低于对照组(P<0.05)。治疗前,2组血清环氧合酶-2(COX-2)、前列腺素E2(PGE2)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清COX-2、PGE2水平均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗前,2组血清碱性磷酸酶(ALP)、护骨素(OPG)、N端中段骨钙素(N-MID)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清ALP、OPG、N-MID水平均升高(P<0.05),且观察组高于对照组(P<0.05)。治疗前,2组膝关节功能(HSS)评分、健康状况调查简表(SF-36)评分、疼痛视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);治疗后,2组HSS评分、SF-36评分升高(P<0.05),VAS评分降低(P<0.05),且观察组HSS评分、SF-36评分高于对照组(P<0.05),VAS评分低于对照组(P<0.05)。结论:采用加味桃红四物汤治疗气滞血瘀型胫骨平台骨折切开复位内固定患者,有助于减轻炎症反应,调节骨代谢指标,促进膝关节功能恢复,提高临床疗效。Objective:To observe the clinical effect of modified Taohong Siwu Decoction on patients who had undergone the open reduction and internal fixation after tibial plateau fracture of qi stagnation and blood stasis type.Methods:A total of 118 patients who had undergone the open reduction and internal fixation after tibial plateau fracture of qi stagnation and blood stasis type were randomly divided into the control group and the observation group,with 59 cases in each group.The control group was given conventional treatment,and the observation group was additionally treated with an oral administration of modified Taohong Siwu Decoction based on the treatment of the control group.After 12 weeks of treatment,the clinical effects in the two groups were compared.Results:The total excellent-and-good rate in the observation group was 96.61%,higher than that of 79.66%in the control group(P<0.05).Before treatment,there was no significant difference in the levels of serum interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)between the two groups(P>0.05).After treatment,the levels of serum IL-17 and TNF-αin the two groups were decreased(P<0.05),and the above levels in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference in the levels of serum cyclooxygenase-2(COX-2)and prostaglandin E2(PGE2)between the two groups(P>0.05).After treatment,the serum COX-2 and PGE2 levels in the two groups were decreased(P<0.05),and the above levels in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference in the levels of serum alkaline phosphatase(ALP),osteoprotegerin(OPG)and N-MID osteocalcin(N-MID)between the two groups(P>0.05).After treatment,the levels of serum ALP,OPG and N-MID in the two groups were increased(P<0.05),and the above levels in the observation group were higher than those in the control group(P<0.05).Before treatment,there was no significant difference in the scores of Hospital f

关 键 词：胫骨平台骨折 骨折切开复位内固定 气滞血瘀型 桃红四物汤 炎症反应 骨代谢指标 疼痛介质 

分 类 号：R687.3[医药卫生—骨科学]