牛膝活血汤辅助治疗踝关节骨折患者的疗效及应用价值  

Curative effect and application value of Niuxi Huoxue Decoction in adjuvant treatment for patients with ankle joint fracture

作　　者：张亚磊 宁增恩 李建 ZHANG Ya-lei;NING Zeng-en;LI Jian

机构地区：[1]商丘市中医院骨二科,河南商丘476000

出　　处：《中国疗养医学》2024年第8期60-64,共5页Chinese Journal of Convalescent Medicine

摘　　要：目的探讨牛膝活血汤辅助切开复位钢板内固定术治疗踝关节骨折患者的临床疗效,并分析其对踝关节功能、炎症因子水平的影响。方法回顾性选取2021年1月至2023年10月商丘市中医院收治的130例踝关节骨折患者,依据治疗方案不同分为对照组65例(切开复位钢板内固定术)、观察组65例(切开复位钢板内固定术+牛膝活血汤)。比较两组临床疗效及治疗前后踝关节活动度、视觉模拟评分(VAS)、美国矫形足踝协会(AOFAS)评分、骨转换标志物[β-Ⅰ型胶原羧基端肽(β-CTx)、N-端骨钙素(N-MID)、碱性磷酸酶(ALP)、骨钙素(BGP)]、炎症因子[白细胞介素-1(IL-1)、白细胞介素(IL-1β)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[丙二醛(MDA)、晚期氧化蛋白产物(AOPP)、超氧化物歧化酶(SOD)]及安全性分析。结果观察组临床疗效高于对照组(96.92%VS 84.62%,P<0.05);治疗后,观察组背伸角度、跖屈角度、AOFAS评分分别为(26.78±7.92)°、(45.85±11.28)°、(85.63±6.54)分,高于对照组的(19.26±5.42)°、(33.62±9.22)°、(63.02±5.14)分,VAS评分(2.11±0.50)分低于对照组(4.76±0.38)分,P<0.05;治疗后,观察组血清β-CTx、N-MID、IL-1、IL-1β、TNF-α、MDA、AOPP水平分别为(533.21±97.74)ng/L、(36.35±10.11)μg/L、(18.82±4.27)μg/L、(3.42±1.04)pg/mL、(8.26±2.01)pg/mL、(6.08±1.06)μmol/L、(13.22±3.41)μmol/L,低于对照组的(701.24±103.75)ng/L、(50.27±9.75)μg/L、(25.03±4.34)μg/L、(5.69±1.19)pg/mL、(13.22±3.40)pg/mL、(8.74±1.21)μmol/L、(20.19±4.73)μmol/L,血清ALP、BGP、SOD水平分别为(94.11±18.37)U/L、(5.75±1.31)μg/L、(98.57±12.85)U/mL,高于对照组(80.02±16.67)U/L、(4.52±1.40)μg/L、(77.46±15.82)U/mL,P<0.05;两组均未发生明显不良反应。结论踝关节骨折患者切开复位钢板内固定术后使用牛膝活血汤治疗的疗效确切,可改善踝关节功能,减轻疼痛程度,促进骨代谢恢复,纠正炎症-氧化应激紊乱,且具有一定安全性Objective To investigate the clinical effect of Niuxi Huoxue Decoction adjuvant open reduction and steel plate internal fixation surgery in the treatment of ankle joint fracture,and analyze its influence on ankle joint function and levels of inflammatory factors.Methods A total of 130 patients with ankle fracture admitted to Shangqiu Hospital of Traditional Chinese Medicine from January 2021 to October 2023 were retrospectively selected,and divided into control group(65 cases,open reduction plate internal fixation)and observation group(65 cases,open reduction plate internal fixation+Niuxi Huoxue decoction)according to different treatment plans.Clinical efficacy,and the index levels of ankle motion,visual analogue scale(VAS),American orthopaedic foot and ankle society(AOFAS)score,bone turnover markers(β-CTx,N-MID,ALP,and BGP)and inflammatory factors(interleukin-1[IL-1],interleukin[IL-1β],tumor necrosis factor-α[TNF-α]),oxidative stress index(Malondialdehyde[MDA],advanced oxidation protein products[AOPP],superoxide dismutase[SOD])and safety analysis before and after treatment were compared between the two groups.Results The clinical efficacy of the observation group was higher than that of the control group(96.92%VS 84.62%,P<0.05);After treatment,the observation group had a back extension angle,plantar flexion angle,and AOFAS score of(26.78±7.92)°,(45.85±11.28)°,and(85.63±6.54)points,respectively,which were higher than the control group's(19.26±5.42)°,(33.62±9.22)°,and(63.02±5.14)points.The VAS score of(2.11±0.50)points was lower than that of the control group(4.76±0.38)points,P<0.05;After treatment,the serum levels ofβ-CTx,N-MID,IL-1,IL-1β,TNF-α,MDA,and AOPP in the observation group were(533.21±97.74)ng/L,(36.35±10.11)μg/L,(18.82±4.27)μg/L,(3.42±1.04)pg/mL,(8.26±2.01)pg/mL,(6.08±1.06)μmol/L,and(13.22±3.41)μmol/L,respectively,lower than the control group's(701.24±103.75)ng/L,(50.27±9.75)μg/L,(25.03±4.34)μg/L,(5.69±1.19)pg/mL,(13.22±3.40)pg/mL,(8.74±1.21)μmol/L,and(20.19±4.73)

关 键 词：踝关节骨折 切开复位钢板内固定术 牛膝活血汤 踝关节功能 炎症因子 

分 类 号：R687.3[医药卫生—骨科学]