辨证分期使用中药辅助治疗儿童肱骨外髁骨折临床研究  

Effect of traditional Chinese medicine as an adjunctive therapy for children with humeral lateral condyle fracture:Based on differentiation stage

作　　者：任波 陈伟[1] 肖元 康持 解礼伟 周英[1] REN Bo;CHEN Wei;XIAO Yuan;KANG Chi;XIE Liwei;ZHOU Ying(Department of Pediatric Orthopedics,Sichuan Province Orthopedic Hospital,Chengdu,Sichuan 610041)

机构地区：[1]四川省骨科医院儿童骨科,四川成都610041

出　　处：《河北中医》2024年第6期911-914,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：四川省中医药管理局科学技术研究专项课题(编号:2020JC0096);四川省中医药管理局四川省名中医工作室传承建设项目(川中医药办发[2022]16号);四川省中医药标准化技术委员会2020年度四川省中医药标准化研究立项项目(编号:2020075)。

摘　　要：目的观察辨证分期使用中药配合克氏针内固定术治疗儿童肱骨外髁骨折的效果。方法采用回顾性研究,根据治疗方案的差异将68例Jakob分型Ⅲ型儿童肱骨外髁骨折患儿分为观察组(35例)和对照组(33例)。对照组患儿采用闭合复位克氏针内固定术治疗,术后3天内予小儿伤科一号方,观察组在对照组治疗基础上于术后中后期(术后3天~5周)加用双龙接骨丸口服治疗。采用儿童疼痛行为评估量表(FLACC)对患儿术后第3天和第7天疼痛情况进行评价,采用Femadez-esteve骨痂X线评分对2组患儿术后第3、6周骨痂形成情况评价,采用Flynn肘关节评分标准对2组患儿术后3个月肘关节功能情况进行评价。结果术后第3天,2组FLACC评分比较差异无统计学意义(P>0.05);术后第7天2组FLACC评分均较本组术后第3天降低(P<0.05),且观察组低于对照组(P<0.05)。术后第6周,2组骨痂评分均较本组术后第3周升高(P<0.05);术后第3、6周,观察组骨痂评分均高于对照组同期(P<0.05)。术后3个月,观察组肘关节功能优良率为91.4%(32/35),对照组为66.7%(22/35),观察组肘关节功能优良率高于对照组(P<0.05)。结论辨证分期使用中药配合克氏针内固定术可有效促进儿童肱骨外髁骨折术后骨折愈合,缓解术后疼痛,提高肘关节功能恢复优良率。Objective To observe the effect of traditional Chinese medicine(TCM)based on differentiation stage as an adjunctive therapy combined with Kirschner wire internal fixation(KWIF)in children with humeral lateral condyle fracture(HLCF).Methods This was a retrospective study.Totally 68 children with HLCF(Jakob typeⅢ)were assigned into observation group(n=35)and control group(n=33)based on the therapeutic regimens.All patients were managed by closed reduction and KWIF,those in control group were treated with Xiaoer Shangke Yihao Formula(form 1 day to 3 days postoperatively),and those in observation group were additionally treated with oral Shuanglong Jiegu Pill(form 3 days to 5 weeks postoperatively)based on the control group.Face,Legs,Activity,Cry,Consolability(FLACC)scale scores at 3 and 7 days postoperatively,Femadez-esteve scale scores for callus X-ray evaluation at 3 and 6 weeks postoperatively,and Flynn elbow joint function score at 3 months postoperatively were compared between the two groups.Results The difference was not statistically significant in FLACC scores at 3 days postoperatively between groups(P>0.05).FLACC scores in the both groups at 7 days postoperatively were significantly lower than those at 3 days postoperatively(P<0.05),which were significantly lower in the observation group than in the control group(P<0.05).The score for callus X-ray evaluation at 6 weeks postoperatively in the both groups was significantly higher than that at 3 weeks postoperatively(P<0.05),which at 3 and 6 weeks postoperatively were significantly higher in the observation group than in the control group(P<0.05).The excellent rate of elbow joint function at 3 months postoperatively in the observation group was significantly higher than that in the control group(91.4%[32/35]vs 66.7%[22/35],P<0.05).Conclusion TCM based on differentiation stage as an adjunctive therapy combined with KWIF in children with HLCF can effectively promote postoperative fracture healing,relieve postoperative pain,and improve the recovery of elbow joi

关 键 词：肱骨外髁骨折 儿童 植物药疗法 辨证 分期 骨折愈合 

分 类 号：R274.110.531[医药卫生—中医骨伤科学]