阿法骨化醇联合骨愈灵胶囊用于胫腓骨远端骨折老年患者术后的临床效果观察  

Clinical efficacy of alfacalcidol combined with Guyuling Capsules in elderly patients with distal tibiofibular fracture after operation

作　　者：华霖娇 王爱平[1] 任海妹[2] 刘丽颖 HUA Lin-jiao;WANG Ai-ping;REN Hai-mei(Department of Traumatology,The Second Hospital of Tangshan,Tangshan Hebei 063000,China;Department of Orthopaedics,Affiliated Hospital of Hebei University,Baoding Hebei 050031,China)

机构地区：[1]唐山市第二医院创伤科,河北唐山063000 [2]河北大学附属医院骨科,河北保定050031

出　　处：《临床和实验医学杂志》2025年第2期172-176,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究课题(编号:20191511)。

摘　　要：目的观察阿法骨化醇联合骨愈灵胶囊用于胫腓骨远端骨折老年患者术后的临床效果。方法前瞻性选取2021年4月至2022年6月唐山市第二医院收治的胫腓骨远端骨折老年患者94例作为研究对象,按照随机数字表法将其分为对照组(n=47)与研究组(n=47)。两组均采取胫前减张切口结合交锁髓内钉内固定术,对照组术后采取阿法骨化醇治疗,研究组术后采取阿法骨化醇治疗+骨愈灵胶囊治疗,治疗周期均为4周。比较两组临床指标(肿胀消失时间、疼痛消失时间、瘀斑消失时间、骨折愈合时间),术前及术后1、7、14 d疼痛情况[视觉模拟评分法(VAS)评分],治疗前、治疗4周后的骨痂评分(骨痂边缘、骨痂量、断端边缘、骨痂密度评分)及血清因子[红细胞沉降率(ESR)、丙二醛、骨形态发生蛋白-2(BMP-2)、血管内皮生长因子(VEGF)]水平。结果研究组的肿胀消失时间、疼痛消失时间、瘀斑消失时间、骨折愈合时间分别为(16.30±3.14)d、(17.51±2.05)d、(20.14±3.05)d、(5.47±2.32)周,均短于对照组[(20.14±3.02)d、(22.02±2.14)d、(24.02±3.65)d、(9.21±2.17)周],差异均有统计学意义(P<0.05)。术后1、7、14 d,两组患者的VAS评分均较术前降低,且研究组VAS评分分别为(3.32±1.04)、(2.46±0.45)、(0.87±0.18)分,均低于对照组[(4.51±1.06)、(3.32±0.87)、(1.20±0.21)分],差异均有统计学意义(P<0.05)。治疗4周后,两组患者的骨痂评分均较治疗前升高,且研究组患者的骨痂边缘、骨痂量、断端边缘、骨痂密度评分分别为(2.63±0.45)、(3.43±0.51)、(2.93±0.57)、(3.15±0.48)分,均高于对照组[(1.89±0.56)、(2.30±0.41)、(1.92±0.59)、(2.14±0.62)分],差异均有统计学意义(P<0.05)。治疗4周后,两组患者的ESR、丙二醛水平均较治疗前降低,而BMP-2、VEGF水平均较治疗前升高,且研究组患者的ESR、丙二醛水平分别为(18.32±6.13)mm/h、(2.74±0.56)nmol/mL,均低于对照组[(28.22±6.42)mm/h、(Objective To observe the clinical efficacy of alfacalcidol combined with Guyuling Capsules in elderly patients with distal tibiofibular fracture after operation.Methods A total of 94 elderly patients with distal tibiofibular fractures admitted to the Second Hospital of Tangshan from April 2021 to June 2022 were prospectively selected as subjects.They were divided into the control group(n=47)and the study group(n=47)according to the random number table method.Both groups were treated with anterior tibial reduction incision combined with interlocking intramedullary nail internal fixation.The control group was treated with alfacalcidol after operation.The study group was treated with alfacalcidol+Guyuling Capsules after operation.The treatment period was all 4 weeks.The clinical indicators(swelling disappearance time,pain disappearance time,ecchymosis disappearance time,fracture healing time),pain situation[visual analog scale(VAS)scores]at 1,7,14 d after operation,callus score(the callus edge,callus volume,fracture edge,callus density score),serum factor[erythrocyte sedimentation rate(ESR),malondialdehyde,bone morphogenetic protein-2(BMP-2),and vascular endothelial growth factor(VEGF)]levels before treatment and 4 weeks after treatment of two groups were compared.Results The swelling disappearance time,pain disappearance time,ecchymosis disappearance time,fracture healing time of the study group were(16.30±3.14)d,(17.51±2.05)d,(20.14±3.05)d and(5.47±2.32)weeks,respectively,which were shorter than those of the control group[(20.14±3.02)d,(22.02±2.14)d,(24.02±3.65)d,(9.21±2.17)weeks],the differences were statistically significant(P<0.05).At 1,7 and 14 days after operation,the VAS scores of the two groups were lower than those before operation,and the VAS scores of the study group were(3.32±1.04),(2.46±0.45)and(0.87±0.18)points,respectively,which were lower than those of the control group[(4.51±1.06),(3.32±0.87),(1.20±0.21)points],the differences were statistically significant(P<0.05).After 4 weeks of tr

关 键 词：胫腓骨远端骨折 胫前减张切口 交锁髓内钉内固定术 骨愈灵胶囊 骨形成 骨愈合 

分 类 号：R687.3[医药卫生—骨科学]