复元活血汤加减治疗对四肢骨折术后患者炎症因子、免疫功能及骨代谢指标的影响  

Effects of modified FuyuanHuoxue Decoction on postoperative inflammatory factors,immune function and bone metabolism index in patients with limb fracture

作　　者：靳胜利[1] 马世云[1] 马志永 JIN Shengli;MA Shiyun;MA Zhiyong(Department of Orthopedics,Cangzhou Central Hospital,Cangzhou,Hebei 061000;Department of Orthopedics,Xianxian People's Hospital,Xianxian,Hebei 062250)

机构地区：[1]河北省沧州市中心医院骨外科,河北沧州061000 [2]河北省献县人民医院骨外科,河北献县062250

出　　处：《河北中医》2023年第7期1077-1080,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：2016年沧州市科学技术研究与发展指导计划项目(编号:162302123)。

摘　　要：目的研究探讨复元活血汤加减治疗对四肢骨折术后患者炎症因子、免疫功能及骨代谢指标的影响。方法将74例四肢骨折术后患者按随机数字表法分为2组,对照组37例术后予西医常规治疗,治疗组37例在对照组基础上联合复元活血汤加减治疗。2组均治疗7天后,比较2组治疗前后炎症因子指标[包括白细胞介素2(IL-2)、IL-10、降钙素原(PCT)及肿瘤坏死因子α(TNF-α)]、免疫功能指标(包括T淋巴细胞亚群CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+))及骨代谢指标[包括活性骨碱性磷酸酶(BALP)百分率、骨钙素(OC)及Ⅰ型胶原C-末端肽交联(S-CTX)]水平变化情况,比较2组治疗后肿胀消除时间及总住院天数情况,比较2组术后并发症发生情况。结果与本组治疗前比较,2组治疗后IL-2及IL-10水平均升高(P<0.05),PCT及TNF-α水平均降低(P<0.05),且治疗组治疗后IL-2及IL-10水平均高于对照组(P<0.05),PCT及TNF-α水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均升高(P<0.05),且治疗组治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均高于对照组(P<0.05)。与本组治疗前比较,2组治疗后活性BALP百分率、OC及S-CTX水平均升高(P<0.05),且治疗组治疗后BALP百分率、OC及S-CTX水平均高于对照组(P<0.05)。治疗组肿胀消除时间(6.27±0.61)天,总住院天数(11.49±1.41)天,对照组肿胀消除时间(9.11±0.39)天,总住院天数(17.00±0.47)天,治疗组治疗后肿胀消除时间及总住院天数均少于对照组(P<0.05)。治疗组并发症总发生率2.70%(1/37),对照组并发症总发生率21.62%(8/37),治疗组并发症总发生率低于对照组(P<0.05)。结论复元活血汤治疗四肢骨折术后疗效确切,可通过调节炎症因子水平,抑制炎性反应,提高机体免疫力,调节骨代谢,从而促进骨折愈合,促进伤口恢复,减少并发症的发生。Objective To explore the effects of modified FuyuanHuoxue Decoction on postoperative inflammatory factors,immune function and bone metabolism index in patients with limb fracture.Methods Seventy-four patients undergoing limb fracture surgery were randomly assigned into the treatment group(n=37)and the control group(n=37).All patients were managed by conventional Western medicine,and those in the treatment group were additionally treated with modified FuyuanHuoxue Decoction.A 7-day treatment was performed to compare inflammatory factors(interleukin-2[IL-2],IL-10,procalcitonin[PCT],tumor necrosis factor-α[TNF-α]),immune function indexes(T lymphocyte subsets CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)),bone metabolism indexes(percentage of bone alkaline phosphatase[BALP]activity,bone-gla-protein[OC],carboxy-terminal telopeptide of type I collagen[sCTx]),detumescence time,length of hospital stay,postoperative complications.Results After treatment,IL-2 and IL-10 in groups were increased(P<0.05),while PCT and TNF-αwere decreased(P<0.05).The difference in IL-2 and IL-10,and PCT and TNF-αbetween groups was statistically significant(all P<0.05).CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in groups were increased(P<0.05),which were higher in the treatment group than in the control group(P<0.05).BALP,OC and sCTx in groups were increased(P<0.05),which in the treatment group were common compared with the control group(P<0.05).The detumescence time and length of hospital stay in the treatment group were shorter than those in the control group([6.27±0.61]days vs[9.11±0.39]days,[11.49±1.41]days vs[17.00±0.47]days,P<0.05).The total incidence of complications was 2.70%(1/37)in the treatment group,lower than that of 21.64%(8/37)in the control group(P<0.05).Conclusion For patients undergoing limb fracture surgery,modified FuyuanHuoxue Decoction has definite curative effect,which can promote fracture healing,wound recovery and reduce complications by regulating inflammatory factors,inhibiting inflammatory response,improving immunity and regulat

关 键 词：骨折 四肢 术后加速康复 中药疗法 复元活血汤 

分 类 号：R274.1[医药卫生—中医骨伤科学]