西溪骨折方对胫腓骨骨折术后患者预后及血清β-CTX、Crosslaps的影响  

Effect of Xixi Guzhe Prescription(西溪骨折方)on Prognosis and Serumβ-CTX and Crosslaps of Patients with Tibiofibular Fracture after Operation

作　　者：俞学子 张龙 王殷红 叶冰兵 许远 YU Xuezi;ZHANG Long;WANG Yinhong;YE Bingbing;XU Yuan(Hangzhou Xixi Hospital,Hangzhou 310022,Zhejiang,China)

机构地区：[1]杭州市西溪医院,浙江杭州310022

出　　处：《中华中医药学刊》2025年第2期41-44,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局项目(国中医药人教函[2021]228号)。

摘　　要：目的分析西溪骨折方对胫腓骨骨折术后患者预后及血清Ⅰ型胶原羧基端肽β特殊序列(Type I collagen carboxy terminal peptideβspecial sequence,β-CTX)、骨胶原交联(Crosslaps)的影响。方法纳入2016年6月—2021年3月收治的110例胫腓骨骨折患者,使用简单随机法分为联合组和对照组各55例,两组均接受切开复位内固定治疗,联合组加用西溪骨折方。评估两组术前、术后7 d疼痛评分、压痛、肿胀度以及血清β-CTX、Crosslaps变化,和术后7 d、术后4周美国特种外科医院(Hospital for special surgery,HSS)膝关节功能评分、膝关节活动度(Range of motion,ROM)变化,比较两组骨折愈合时间,并于术后4周使用Johner-Wruh胫骨干骨折评估标准评估两组预后。结果两组术后7 d疼痛评分、压痛、肿胀度均较术前下降,血清β-CTX、Crosslaps均较术前升高,联合组术后7 d疼痛评分、压痛、肿胀度均低于对照组,血清β-CTX、Crosslaps均高于对照组(P<0.05)。两组术后4周HSS评分、ROM均较术后7 d升高,联合组术后4周HSS评分、ROM均高于对照组(P<0.05)。联合组骨折愈合时间为(15.14±2.63)周,低于对照组的(16.88±3.15)周(t=3.145,P=0.002)。联合组术后4周恢复优良率为94.55%(52/55),较对照组的81.82%(45/55)更高(P<0.05)。联合组、对照组术后并发症发生率分别为7.27%(4/55)、10.91%(6/55),组间比较差异无统计学意义(P>0.05)。结论在切开复位内固定治疗的基础上,加用西溪骨折方能够减轻患者疼痛、改善骨代谢,对于促进患者膝关节功能早期康复具有积极作用,且不会导致术后并发症风险上升。Objective To analyze the influence of Xixi Guzhe Prescription(西溪骨折方)on the prognosis of patients with tibiofibular fracture after operation and the serum type I collagen carboxy terminal peptideβspecial sequence(β-CTX)and collagen Crosslaps.Methods One hundred and ten patients with tibia and fibula fractures admitted to the hospital from June 2016 to March 2021 were randomly divided into the combined group(55 cases)and the control group(55 cases).Both groups were treated with open reduction and internal fixation,and the combined group was treated with Xixi Guzhe Prescription.The changes of pain score,tenderness,swelling degree,serumβ-CTX and Crosslaps before and 7 days after operation,and the changes of knee joint function score and knee joint range of motion(ROM)in American Special Surgery Hospital(HSS)at 7 days and 4 weeks after operation were evaluated.The fracture healing time of the two groups was compared,and the prognosis of the two groups was evaluated by Johner-Wruh tibial shaft fracture evaluation standard at 4 weeks after operation.Results The pain score,tenderness and swelling degree of the two groups decreased after 7 days,while the serumβ-CTX and Crosslaps increased.The pain score,tenderness and swelling degree of the combined group were lower than those of the control group after 7 days,while the serumβ-CTX and Crosslaps were higher than those of the control group(P<0.05).The HSS score and ROM of the two groups were higher than those of the control group at 4 weeks after operation,while those of the combined group were higher than those of the control group at 4 weeks after operation(P<0.05).The fracture healing time in the combined group was(15.14±2.63)weeks,which was lower than that in the control group(16.88±3.15)weeks(t=3.145,P=0.002).The excellent and good recovery rate in the combined group was 94.55%(52/55)after 4 weeks,which was higher than that in the control group(81.82%,45/55)(P<0.05).The incidence of postoperative complications in the combined group and the control grou

关 键 词：西溪骨折方 胫腓骨骨折 Ⅰ型胶原羧基端肽β特殊序列 骨胶原交联 

分 类 号：R274.12[医药卫生—中医骨伤科学]