复元活血汤联合石氏伤科正骨夹板治疗桡骨远端骨折的临床疗效  

Clinical effect of Fuyuan Huoxue decoction combined with Shi′s orthopedics splint in treating distal radius fracture

作　　者：申钰 郑春伟 曹贺 周瑾 SHEN Yu;ZHENG Chunwei;CAO He;ZHOU Jin(Department of Orthopedics,Yangpu District Hospital of Traditional Chinese Medicine,Shanghai 200080,China)

机构地区：[1]上海市杨浦区中医医院中医骨伤科,上海200080

出　　处：《检验医学与临床》2024年第5期628-634,639,共8页Laboratory Medicine and Clinic

基　　金：上海市进一步加快中医药事业发展三年行动计划[ZY(2018-2020)-FWTX-7001];上海市杨浦区卫生健康委员会中医专项科研项目(YPZQ202106)。

摘　　要：目的 探究复元活血汤联合石氏伤科正骨夹板治疗桡骨远端骨折患者的临床疗效。方法 收集2021年1月至2023年1月在该院被诊断为桡骨远端骨折的120例患者进行前瞻性研究,依据随机数字表法将其分为治疗组和对照组,每组60例。采用酶联免疫吸附试验(ELISA)检测两组患者血清碱性磷酸酶(ALP)、骨保护素(OPG)、骨钙素(BGP)水平;检测两组患者血液流变学指标;测定两组患者视觉模拟评分法(VAS)评分与肿胀评分,并对腕关节、掌指关节活动度、Cooney腕关节功能及X射线评分进行评定。结果 整复后,治疗组患者血清ALP、BGP、OPG水平高于对照组,血浆黏度、红细胞刚性指数、红细胞聚集指数、全血黏度低于对照组,差异均有统计学意义(P<0.05)。两组患者整复前后的VAS评分存在组间、时间效应(P_(组间)=0.027、P_(时间)<0.001)。两组患者整复前后肿胀评分、Cooney评分、背伸角度、掌屈角度、X射线评分均存在时间、组间、交互效应(P_(时间)<0.05、P_(组间)<0.05、P_(交互)<0.05)。对照组不同时间肿胀评分比较结果为整复后2周和整复后4周的肿胀评分低于整复前和整复后即刻(P<0.05),整复后8周肿胀评分低于整复前、整复后即刻和整复后2周(P<0.05)。治疗组不同时间肿胀评分比较结果为整复后8周<整复后4周<整复后2周<整复后即刻和整复前(P<0.05),治疗组整复后4周、整复后8周的肿胀评分低于对照组(F=3.990、8.522,P<0.05)。对照组和治疗组不同时间Cooney评分、背伸角度比较结果为整复前<整复后即刻<整复后2周<整复后4周<整复后8周(P<0.05)。治疗组和对照组不同时间掌屈角度、X射线评分比较结果为整复前及整复后即刻<整复后2周<整复后4周<整复后8周(P<0.05)。整复后2周、4周及8周治疗组患者Cooney评分高于对照组(F=8.758、2.293、3.873,P<0.05)。整复后8周治疗组患者背伸角度、掌屈角度、X射线评分大于�Objective To explore the clinical effect of Fuyuan Huoxue decoction combined with Shi′s orthopedics splint on patients with distal radius fractures.Methods A total of 120 patients diagnosed with distal radius fractures in this hospital from January 2021 to January 2023 were enrolled in this prospective study.According to the random number table method,they were divided into treatment group and control group,with 60 cases in each group.Enzyme-linked immunosorbent assay(ELISA) was used to detect serum alkaline phosphatase(ALP),osteoprotegerin(OPG) and osteocalcin(BGP) of two groups.Indexes of hemorheology were analyzed.The visual analogue scale(VAS) score and swelling score were measured of two groups,and the wrist joint,metacarpophalangeal joint range of motion,Cooney wrist joint function and X-ray scores were evaluated.Results After restoration,the serum levels of ALP,BGP,and OPG in the treatment group were higher than those in the control group,while plasma viscosity,red blood cell rigidity index,red blood cell aggregation index,and whole blood viscosity were lower than those in the control group,with statistical significance(P<0.05).There were intergroup and time effects in VAS scores of the two groups before and after restoration(P_(intergroup)=0.027,P_(time)<0.001).The swelling score,Cooney score,back extension angle,palmar flexion angle,X-ray score existence time,intergroup,and interaction effect(P_(time)<0.05,P_(intergroup)<0.05,P_(interaction)<0.05) of the two groups before and after restoration.The comparison of swelling scores at different times in the control group showed that the swelling scores at 2 weeks and 4 weeks after restoration were lower than those before and immediately after restoration(P<0.05).The swelling score at 8 weeks after restoration in the control group was lower than before restoration,immediately after restoration,and 2 weeks after restoration(P<0.05).The comparison of swelling scores at different times in the treatment group showed that the swelling scores at 8 weeks after rest

关 键 词：复元活血汤 石氏伤科正骨夹板 桡骨远端骨折 手臂功能 血液流变学 

分 类 号：R459.7[医药卫生—急诊医学]