自拟活血消肿熏洗方联合功能锻炼对创伤性胫骨平台骨折术后患肢肿胀、骨代谢及膝关节功能恢复的影响  

Effects of self-made Huoxue Xiaozhong Xunxi Decoction combined with functional exercise on postoperative swelling of affected limbs,bone metabolism and recovery of knee function in patients with traumatic fracture of tibial plateau

作　　者：邵加龙[1] 薛锦标[1] 要少飞 钟世荣 张琛琳 蔡春岳 汤继磊 Shao Jialong;Xue Jinbiao;Yao Shaofei;Zhong Shirong;Zhang Chenlin;Cai Chunyue;Tang Jilei(Department of Orthopaedics,Qidong Hospital of Traditional Chinese Medicine,Qidong 226200,China;Department of Orthopedics,Qidong People's Hospital,Qidong 226200,China)

机构地区：[1]启东市中医院骨伤科,启东226200 [2]启东市人民医院骨科,启东226200

出　　处：《国际中医中药杂志》2023年第11期1376-1381,共6页International Journal of Traditional Chinese Medicine

摘　　要：目的探讨自拟活血消肿熏洗方联合功能锻炼对创伤性胫骨平台骨折(FTP)术后患者患肢肿胀、骨代谢及膝关节功能恢复的影响。方法随机对照试验研究。选择2018年1月-2022年1月启东市中医院80例FTP术后患者作为观察对象,按随机数字表法分为2组,每组40例。FTP术后对照组给予功能锻炼,观察组在对照组基础上联合自拟活血消肿熏洗方治疗。2组均连续治疗8周。记录2组围手术期手术时间、切口长度、术中出血量、术后引流量、下床时间,观察术后患肢肿胀程度及疼痛情况,记录患者消肿时间、止痛时间、骨折愈合及完全负重时间;采用美国特种外科医院(HSS)膝关节评分系统评估膝关节功能;采用ELISA法检测血清中的骨形态发生蛋白-2(BMP-2),全自动免疫发光分析仪检测总Ⅰ型前胶原氨基端肽(t-PINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)。记录2组患者术后并发症发生情况。结果 2组手术时间、切口长度、术中出血量、术后引流量、下床时间比较,差异无统计学意义(P>0.05)。观察组总有效率为97.5%(39/40)、对照组为80.0%(32/40),2组比较差异有统计学意义(χ^(2)=6.14,P=0.013)。观察组消肿时间、止痛时间、骨折愈合时间及完全负重时间均早于对照组(P<0.01)。观察组治疗10 d VAS评分、患肢肿胀程度低于对照组(t值分别为7.05、3.81,P<0.01)。观察组治疗8周血清BMP-2[(625.16±67.43)μg/L比(542.35±53.27)μg/L,t=6.10]、t-PINP[(54.16±7.29)μg/L比(50.34±6.12)μg/L,t=2.54]、β-CTX[(1.26±0.38)μg/L比(1.04±0.23)μg/L,t=3.13]水平高于对照组(P<0.05)。治疗期间,观察组并发症发生率为2.5%(1/40)、对照组为7.5%(3/40),2组比较差异无统计学意义(χ^(2)=1.05,P=0.305)。结论自拟活血消肿熏洗方联合功能锻炼有助于改善FTP术后患肢疼痛、肿胀及骨代谢情况,可促进膝关节功能恢复。Objective To explore the effects of self-made Huoxue Xiaozhong Xunxi Decoction combined with functional exercise on postoperative swelling of affected limbs,bone metabolism and recovery of knee function in patients with traumatic fracture of tibial plateau(FTP).Methods Randomized controlled trial.totally 80 patients after FTP surgery in the Qidong Hospital of Traditional Chinese Medicine were enrolled and divided into two groups by random number table method from January 2018 to January 2022,with 40 cases in each group.After surgery,control group was treated with functional exercise,while observation group was additionally treated with self-made Huoxue Xiaozhong Xunxi Decoction.All were treated continuously for 8 weeks.The perioperative indexes(operation time,incision length,intraoperative blood loss,postoperative drainage volume,leaving bed time)in the two groups were recorded.The postoperative swelling and pain of affected limbs were observed,and detumescence time,pain relief time,fracture healing time and complete weight-bearing time were recorded.The knee function was evaluated by Hospital for Special Surgery(HSS).The level of serum bone morphogenetic protein-2(BMP-2)was detected by ELISA,and total n-terminal propeptide of typeⅠprecollagen(t-PINP)andβ-crossLaps(β-CTX)were detected by full-automatic immunoluminescence analyzer.The occurrence of postoperative complications in the two groups was recorded.Results There was no significant difference in operation time,incision length,intraoperative blood loss,postoperative drainage volume or leaving bed time between the two groups(P>0.05).The total effective rate of the observation group was 97.5%(39/40),while the control group was 80.0%(32/40),with statistical significance(χ^(2)=6.14,P=0.013).The detumescence time,pain relief time,fracture healing time and complete weight-bearing time were earlier in the observation group than control group(P<0.01).After 10 d of treatment,VAS score and swelling degree in observation group were lower than those in the control

关 键 词：骨折 胫骨平台骨折 活血消肿熏洗方 熏洗疗法 功能锻炼 骨代谢 

分 类 号：R274.1[医药卫生—中医骨伤科学]