中医联合持续被动活动在踝关节骨折中的应用  

Application of traditional Chinese medicine combined with continuous passive activity in ankle joint fracture

作　　者：韩康[1] 刘媛媛[1] 王甜甜[2] 朱利[1] 郭得立 周兴华[1] 李涛[1] HAN Kang;LIU Yuanyuan;WANG Tiantian;ZHU Li;GUO Deli;ZHOU Xinghua;LI Tao(The Second Department of Orthopedics,Baoding First Central Hospital,Baoding 071000,China;The First Department of Rehabilitation Medicine,Baoding First Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院骨二科,河北保定071000 [2]保定市第一中心医院康复医学一科,河北保定071000

出　　处：《长春中医药大学学报》2023年第5期538-542,共5页Journal of Changchun University of Chinese Medicine

基　　金：河北省2021年度中医药类科研计划课题项目(2021276)。

摘　　要：目的探讨踝关节骨折患者术后以中药组方煎服联合持续被动活动对其踝关节功能及炎症反应的影响。方法86例研究对象均选自保定市第一中心医院2019年10月-2021年10月收治的踝关节骨折患者,以随机数字表法分为观察组和对照组,各43例。2组均接受切开复位内固定术。对照组术后进行持续被动活动;观察组在此基础上加用舒筋活血汤,2组均治疗1个月并随访2个月。比较2组术后3个月临床疗效、中医证候积分、不良反应;术前及术后3个月踝关节功能、疼痛评分、踝关节主动活动度;术后1 d、15 d炎性因子水平。结果术后3个月,观察组的优良率为95.35%,较对照组的81.40%高;相较于术前,术后3个月2组踝关节功能评分、踝关节主动活动度均升高,观察组高于对照组;疼痛评分则降低,观察组低于对照组;术后3个月与对照组的关节疼痛、关节肿胀、关节红热、活动障碍评分相比,观察组更低;相较于术后1 d,2组术后15 d血清IL-1β、IL-6、TNF-α水平均降低,且观察组低于对照组;术后3个月,观察组不良反应总发生率低于对照组,差异有统计学意义(均P<0.05)。结论踝关节骨折患者术后以中药组方煎服联合持续被动活动能改善临床症状,抑制炎症反应,减轻疼痛感,更利于患者配合进行持续被动活动锻炼,恢复踝关节功能,同时减少不良反应。Objective To investigate the effect of decoction of traditional Chinese medicine combined with continuous passive activity on ankle joint function and infl ammatory response in patients with ankle joint fracture after operation.Methods A total of 86 subjects were selected from the patients with ankle fractures who were treated in Baoding First Central Hospital from October 2019 to October 2021.They were divided into the observation group and the control group according to random number table method,with 43 cases in each.Both groups underwent open reduction and internal fi xation.The control group received continuous passive activity after operation,and the observation group was treated with Shujin Huoxue decoction on the basis of treatment in the control group.Both groups were treated for 1 month and followed up for 2 months.The clinical efficacy,TCM syndrome scores,and adverse reactions at 3 months after operation were compared between the 2 groups.Ankle joint function,pain score,and active range of motion of ankle joint in both groups before operation and at 3 months after operation were compared;infl ammatory factor levels at 1 and 15 days after operation were compared between 2 groups.Results At 3 months after operation,the excellent and good rate of the observation group(95.35%)was higher than that of the control group(81.40%).Compared with before operation,the ankle joint function score and ankle active range of motion in 2 groups increased at 3 months after operation,and the observation group were higher than the control group;the pain score decreased,the observation group was lower than the control group.Compared with the control group,the observation group had lower scores of joint pain,joint swelling,joint redness,and movement disorder at 3 months after operation.Compared with 1 day after operation,the serum levels of IL-1β,IL-6 and TNF-αin 2 groups decreased at 15 days after operation,and the observation group was lower than the control group.At 3 months after operation,the total incidence of adverse

关 键 词：踝关节骨折 持续被动活动 中药组方 踝关节功能 疼痛 炎性因子 

分 类 号：R683.42[医药卫生—骨科学]