补阳还五汤结合股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的临床效果分析  

Clinical effects of Buyang Huanwu decoction combined with proximal femoral anti-rotation intramedullary nail in the treatment of femoral intertrochanteric fracture in the elderly

作　　者：金明友 JIN Mingyou

机构地区：[1]阆中市中医医院,四川南充637400

出　　处：《中医临床研究》2023年第27期127-130,共4页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨补阳还五汤结合股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)术治疗老年股骨粗隆间骨折的临床效果。方法:选取2020年8月―2021年8月四川省阆中市中医医院收治的老年股骨粗隆间骨折患者42例,采用随机数字表法分为对照组和观察组,每组21例。对照组给予PFNA术治疗,在此基础上,观察组结合补阳还五汤治疗。比较两组临床疗效、髋关节功能、凝血功能、骨代谢指标及并发症发生率。结果:观察组治疗总有效率(95.24%,20/21),高于对照组(71.43%,15/21)(χ^(2)=4.286,P <0.05)。术后1个月,两组患者Harris各项评分,骨代谢指标骨钙素(Bone Gla Protein,BGP)、I型胶原氨基端延长肽(Type 1 Procollagen Nterminal Propeptide,P1NP)、碱性磷酸酶(Alkaline Phosphatase,ALP)水平均较术前升高,且观察组高于同期对照组(均P <0.05)。术后1个月,两组患者凝血功能指标凝血酶原时间(Prothrombin Time,PT)、活化部分凝血活酶时间(Activated Partial Thromboplastin Time,APTT)、纤维蛋白原(Fibrinogen,FIB)水平均较术前降低,且观察组低于同期对照组(均P <0.05)。观察组并发症发生率(9.52%)低于对照组(38.10%)(χ^(2)=4.725,P <0.05)。结论:补阳还五汤结合PFNA术治疗老年股骨粗隆间骨折疗效显著,能有效改善患者凝血功能及机体骨代谢,促进髋关节活动功能恢复,并能降低再发骨折等并发症的发生风险,值得临床进一步推广应用。Objective:To investigate the clinical effect of Buyang Huanwu decoction(补阳还五汤)combined with proximal femoral anti-rotation intramedullary nail(PFNA)in the treatment of senile intertrochanteric fracture of femur.Methods:A total of 42 elderly patients with intertrochanteric femoral fracture admitted to Langzhong Hospital of Traditional Chinese Medicine in Sichuan Province from August 2020 to August 2021 were selected and divided into the control group(21 cases)and the observation group(21 cases)by random number table method.The control group was treated by PFNA,and the observation group was treated with Buyang Huanwu decoction combined with PFNA.The clinical efficacy,hip joint function,coagulation function,bone metabolism and the incidence of complications were compared between the two groups.Results:The total effective rate in the observation group(95.24%,20/21)was higher than that in the control group(71.43%,15/21)(χ^(2)=4.286,P<0.05).One month after surgery,Harris scores and the levels of BGP,P1NP and ALP of bone metabolism indexes in two groups were higher than those before surgery,and the observation group was higher than the control group during the same period(all P<0.05).One month after surgery,the levels of coagulation function indexes PT,APTT and FIB in two groups were lower than those before surgery,and the observation group was lower than the control group during the same period(all P<0.05).The complication rate in the observation group(9.52%)was lower than that in the control group(38.10%)(χ^(2)=4.725,P<0.05).Conclusion:Buyang Huanwu decoction combined with PFNA has significant efficacy in the treatment of elderly intertrochanteric fracture of femur,which can effectively improve the coagulation function and bone metabolism of patients,promote the recovery of hip joint activity function,and reduce the risk of recurrent fracture and other complications,which is worthy of further clinical application.

关 键 词：股骨粗隆间骨折 老年 股骨近端防旋髓内钉术 补阳还五汤 疗效 

分 类 号：R274[医药卫生—中医骨伤科学]