西医常规与中医辨证论治联合在老年髋部骨折围手术期治疗中的应用价值
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摘要
目的研究西医常规与中医辨证论治联合在老年髋部骨折围手术期并发症治疗中的应用价值。方法将2011年6月至2015年6月期间收治的86例采用手术治疗的老年髋部骨折按照随机数值表法分为治疗组43例与对照组43例。对照组患者给予西医常规治疗,治疗组患者在对照组治疗的基础上给予中医辨证论治;治疗后观察比较两组的治疗效果、术后3、6个月Harris功能评分及术后并发症等情况。结果治疗后两组疼痛评分均低于治疗前,差异有统计学意义(P<0.05);且治疗后疼痛评分治疗组明显低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组患者Harris功能评分高于对照组,两组比较差异有统计学意义(P<0.05)。治疗后治疗组出现术后并发症患者明显低于对照组,差异有统计学意义(P<0.05)。结论西医常规与中医辨证论治联合在老年髋部骨折围手术期治疗中具有明显优势,不仅疗效优于西医常规治疗,而且患者的并发症、病死率及电解质紊乱等发生较少,值得在临床推广使用。
Objective To explore the application value on hip fracture in elderly patients in perioperative period with routine Western medicine and traditional Chinese medicine based on pattern/syndrome differentiation.Methods From June 2011 to June 2015,86 cases of senile hip fracture after operation were collected and divided into a treatment group(43 cases) and a control group(43 cases) according to random number table.In the control group,the routine Western medicine was used.In the treatment group,on the base of the control group,the treatment based on syndrome/pattern differentiation in TCM was added.After treatment,the therapeutic effect,Harris score in 3 and 6 months after operation and post-operative complications were observed and compared between the two groups.Results After treatment,the pain scores were lower than those before treatment in the two groups,indicating the significant difference(P<0.05).After treatment,the pain score in the treatment group was lower obviously than the control group,indicating the significant difference(P<0.05).After treatment,the incidence of the post-operative complication in the treatment group was lower than the control group,indicating the significant difference(P<0.05).Conclusion The combined treatment of the routine Western medicine and TCM based on pattern/syndrome differentiation presents the advantages in perioperative treatment.The therapeutic effect of this combined therapy is better than the routine Western medicine and it reduces the incidence of complication,death rate and electrolyte disturbance.Hence,this combined therapy deserves to be promoted in clinical practice.
Objective To explore the application value on hip fracture in elderly patients in perioperative period with routine Western medicine and traditional Chinese medicine based on pattern/syndrome differentiation.Methods From June 2011 to June 2015,86 cases of senile hip fracture after operation were collected and divided into a treatment group(43 cases) and a control group(43 cases) according to random number table.In the control group,the routine Western medicine was used.In the treatment group,on the base of the control group,the treatment based on syndrome/pattern differentiation in TCM was added.After treatment,the therapeutic effect,Harris score in 3 and 6 months after operation and post-operative complications were observed and compared between the two groups.Results After treatment,the pain scores were lower than those before treatment in the two groups,indicating the significant difference(P<0.05).After treatment,the pain score in the treatment group was lower obviously than the control group,indicating the significant difference(P<0.05).After treatment,the incidence of the post-operative complication in the treatment group was lower than the control group,indicating the significant difference(P<0.05).Conclusion The combined treatment of the routine Western medicine and TCM based on pattern/syndrome differentiation presents the advantages in perioperative treatment.The therapeutic effect of this combined therapy is better than the routine Western medicine and it reduces the incidence of complication,death rate and electrolyte disturbance.Hence,this combined therapy deserves to be promoted in clinical practice.
引文
[1]叶华.中西结合治疗老年髋部骨折围手术期并发症及病死率临床观察[J].新中医,2016,48(4):97-98.
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[3]付亚辉,王鹏飞,王宝辉,等.老年髋部骨折患者围手术期深静脉血栓形成的发生规律及血浆D-二聚体的变化特点[J].中华创伤骨科杂志,2016,18(8):264-266.
[4]Li HB,Chen XR,Qian Y,et al. Prevention and control of postoperative infections in elderly patients with hip fracture[J]. Chinese Journal of Nosocomiology,2013,23(2):344-346.
[5]王晓伟,孙天胜,刘智,等.老年髋部骨折后发生谵妄的研究现状[J].中华骨科杂志,2016,36(13):878-880.
[6]Takawira CM,Alexa M,Iain KM. Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures:Qualitative systematic review[J]. Injury,2015,46(12):2325-2334.
[7]中华医学会.临床诊疗指南-骨科分册[M].北京:人民卫生出版社,2009:36.
[8]白波,吴德全,李军民,等.外科学[M]. 3版.北京:人民卫生出版社,2014:56.
[9]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:66.
[10]孙家元,张英泽.老年髋部骨折围手术期处理[J].国际骨科学杂志,2013,34(1):11-14.
[11]Rubin CD. Evaluation and management of hip fracture risk in the aged[J]. American Journal of the Medical Sciences,2012,343(3):233-242.
[12]Jorma P,Harri P,Ville MM,et al. Mortality and cause of death in hip fracture patients aged 65 or older-a population-based study[J]. Bmc Musculoskeletal Disorders,2011,12(1):1-6.
[13]孟庆峰,韩基雄,汪少源,等.老年髋部骨折围手术期处理[J].中国伤残医学,2016,24(7):168-169.
[14]易松,朱婵,王贵梅,等.中西医结合预防老年髋部骨折围手术期并发电解质紊乱的临床疗效观察[J].四川中医,2015,33(1):130-132.
[15]Hossain M,Andrew JG. Is there a difference in perioperative mortality between cemented and uncemented implants in hip fracture surgery?[J]. Injury,2012,43(12):2161-2164.
[16]胡勇斌,傅强,俞能宝,等.老年髋部骨折围手术期中医药治疗进展[J].中国药师,2013,16(4):616-618.
[2]姚其洪.中西结合治疗老年髋部骨折围手术期并发症分析[J].中国现代药物应用,2014,8(18):135-136.
[3]付亚辉,王鹏飞,王宝辉,等.老年髋部骨折患者围手术期深静脉血栓形成的发生规律及血浆D-二聚体的变化特点[J].中华创伤骨科杂志,2016,18(8):264-266.
[4]Li HB,Chen XR,Qian Y,et al. Prevention and control of postoperative infections in elderly patients with hip fracture[J]. Chinese Journal of Nosocomiology,2013,23(2):344-346.
[5]王晓伟,孙天胜,刘智,等.老年髋部骨折后发生谵妄的研究现状[J].中华骨科杂志,2016,36(13):878-880.
[6]Takawira CM,Alexa M,Iain KM. Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures:Qualitative systematic review[J]. Injury,2015,46(12):2325-2334.
[7]中华医学会.临床诊疗指南-骨科分册[M].北京:人民卫生出版社,2009:36.
[8]白波,吴德全,李军民,等.外科学[M]. 3版.北京:人民卫生出版社,2014:56.
[9]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:66.
[10]孙家元,张英泽.老年髋部骨折围手术期处理[J].国际骨科学杂志,2013,34(1):11-14.
[11]Rubin CD. Evaluation and management of hip fracture risk in the aged[J]. American Journal of the Medical Sciences,2012,343(3):233-242.
[12]Jorma P,Harri P,Ville MM,et al. Mortality and cause of death in hip fracture patients aged 65 or older-a population-based study[J]. Bmc Musculoskeletal Disorders,2011,12(1):1-6.
[13]孟庆峰,韩基雄,汪少源,等.老年髋部骨折围手术期处理[J].中国伤残医学,2016,24(7):168-169.
[14]易松,朱婵,王贵梅,等.中西医结合预防老年髋部骨折围手术期并发电解质紊乱的临床疗效观察[J].四川中医,2015,33(1):130-132.
[15]Hossain M,Andrew JG. Is there a difference in perioperative mortality between cemented and uncemented implants in hip fracture surgery?[J]. Injury,2012,43(12):2161-2164.
[16]胡勇斌,傅强,俞能宝,等.老年髋部骨折围手术期中医药治疗进展[J].中国药师,2013,16(4):616-618.
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