消瘀汤对肱骨髁间骨折患者肘关节功能的影响
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摘要
目的:观察消瘀汤对肱骨髁间骨折患者肘关节功能的影响。方法:选取2015年2月至2016年4月本院收治的肱骨髁间骨折患者136例,按照随机数字表法分为对照组和观察组,每组68例。对照组给予尺骨鹰嘴截骨入路术治疗,观察组在对照组治疗的基础上加用消瘀汤内服治疗。结果:对照组有效率为77. 9%,观察组有效率为92. 6%,观察组优于对照组,差异有统计学意义(P <0. 05);观察组治疗后中医证候积分优于对照组,差异有统计学意义(P <0. 05);观察组术后肘关节功能优良率95. 6%,对照组优良率83. 8%,观察组优于对照组,差异有统计学意义(P <0. 05);观察组治疗后骨折处骨组织TGF-β、BMP-2、VEGF水平优于对照组,差异有统计学意义(P <0. 05);观察组并发症发生率优于对照组,差异有统计学意义(P <0. 05);观察组骨折平均愈合时间(8. 5±1. 6) d,对照组骨折平均愈合时间(12. 4±2. 3) d,观察组优于对照组,差异有统计学意义(P <0. 05)。结论:消瘀汤能显著改善肱骨髁间骨折患者尺骨鹰嘴截骨入路术治疗后的临床症状,改善肘关节功能,并发症少,骨折愈合快,其机制与提高骨折处骨组织TGF-β、BMP-2、VEGF的表达以促进骨折愈合有一定相关性。
Objective: To observe the clinical curative effect of elbow joint function of patients with humeral intercondylar fracture.Methods: A total of 136 patients with humeral intercondylar fracture admitted to our hospital from February 2015 to April 2016 were divided into the control group and the observation group according to random number table method,with 68 cases in each group. The ones in the control group were treated with olecranon osteotomy approach,while the ones in the observation group were treated with Decoction for Removing Blood Stasis on the basis of the control group. The effective rate of the control group was77. 9%,and that of the observation group was 92. 6%. The observation group was better than the control group,and the difference was statistically significant( P < 0. 05). After the treatment,the scores of TCM syndromes in the observation group were better than those in the control group,the difference was statistically significant( P < 0. 05). The excellent rate of elbow joint function in the observation group was 95. 6%,and 83. 8% in the control group,the observation group was better than the control group,the difference was statistically significant( P < 0. 05). Results: After the treatment,the levels of TGF-β,BMP-2 and VEGF in bone tissue at fracture site of the observation group were better than those of the control group,and all the differences were statistically significant( P < 0. 05). The incidence of complications in the observation group was better than that of the control group,and the difference was statistically significant( P < 0. 05). The average healing time of fracture in the observation group was( 8. 5 ± 1. 6)days,and the average healing time of fracture in the control group was( 12. 4 ± 2. 3) days. The observation group was better than the control group,and the difference was statistically significant( P < 0. 05). Conclusion: Decoction for Removing Blood Stasis can significantly improve the clinical symptoms of humeral intercondylar fracture patients after olecranon osteotomy,enhance elbow joint function,have fewer complications and faster fracture healing. Its mechanism is related to the increase of the expression of TGF-βBMP-2 and VEGF in bone tissue at fracture site to promote fracture healing.
Objective: To observe the clinical curative effect of elbow joint function of patients with humeral intercondylar fracture.Methods: A total of 136 patients with humeral intercondylar fracture admitted to our hospital from February 2015 to April 2016 were divided into the control group and the observation group according to random number table method,with 68 cases in each group. The ones in the control group were treated with olecranon osteotomy approach,while the ones in the observation group were treated with Decoction for Removing Blood Stasis on the basis of the control group. The effective rate of the control group was77. 9%,and that of the observation group was 92. 6%. The observation group was better than the control group,and the difference was statistically significant( P < 0. 05). After the treatment,the scores of TCM syndromes in the observation group were better than those in the control group,the difference was statistically significant( P < 0. 05). The excellent rate of elbow joint function in the observation group was 95. 6%,and 83. 8% in the control group,the observation group was better than the control group,the difference was statistically significant( P < 0. 05). Results: After the treatment,the levels of TGF-β,BMP-2 and VEGF in bone tissue at fracture site of the observation group were better than those of the control group,and all the differences were statistically significant( P < 0. 05). The incidence of complications in the observation group was better than that of the control group,and the difference was statistically significant( P < 0. 05). The average healing time of fracture in the observation group was( 8. 5 ± 1. 6)days,and the average healing time of fracture in the control group was( 12. 4 ± 2. 3) days. The observation group was better than the control group,and the difference was statistically significant( P < 0. 05). Conclusion: Decoction for Removing Blood Stasis can significantly improve the clinical symptoms of humeral intercondylar fracture patients after olecranon osteotomy,enhance elbow joint function,have fewer complications and faster fracture healing. Its mechanism is related to the increase of the expression of TGF-βBMP-2 and VEGF in bone tissue at fracture site to promote fracture healing.
引文
[1]邹强,宁廷民.影响肱骨髁间骨折术后肘关节功能的相关因素分析[J].中国骨与关节损伤杂志,2015,30(5):484.
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[12]MURPHY D K,RANDELL T,BRENNAN K L,et al.Treatment and displacementaffect the reoperation rate for femoral neck fracture[J].Clin OrthopRelat Res,2013,471(8):2661-2670.
[13]张波,徐博,吴昊,等.续断对兔骨折愈合过程中相关基因表达和血钙、磷含量的影响[J].氨基酸和生物资源,2016,38(2):54-57.
[14]贺旭峰,祝涛.骨碎补促进骨折愈合的机理[J].中医正骨,2013,25(11):67-69.
[15]郭福,曹顺海,庞健,等.三七对骨重建负平衡和骨转换率的影响[J].中国中医急症,2012,21(9):1488-1489.
[16]王晓娟.丹参多酚酸盐对大鼠骨髓间充质干细胞增殖及血管内皮生长因子表达的影响[J].环球中医药,2013,6(7):492-495.
[17]林晓影,杨炳友,何娅雯,等.接骨木根皮促进骨折愈合有效部位拆分及抗炎作用的研究[J].中医药信息,2016,33(3):29-32.
[2]吴琦明,李建斌,张利,等.两种手术入路治疗肱骨髁间骨折临床疗效分析[J].海南医学,2016,27(4):634-636.
[3]施莱.中药加速骨折愈合机理的研究[J].长春中医药大学学报,2010,26(4):100.
[4]邱贵兴.骨科诊疗常规[M].北京:中国医药科技出版社,2013:87.
[5]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:339-342.
[6]包德明.中西医结合对肱骨髁上髁间骨折患者IGF-Ⅰ和BMP-2水平的影响[J].中医学报,2015,30(9):1282-1284.
[7]周方.脊柱及四肢骨折的治疗决策[M].北京:北京大学医学出版社,2009:284-285.
[8]HUANG X,LEUNG F,XIANG Z,et al.Proximal femoral nail versus dynamic hip screw fixation for trochanteric fractures:a metaanalysis of randomized controlled trials[J].Scientific World Journal,2013,13(12):805.
[9]GAVASKAR A S,CHOWDARY N T.Valgus sliding subtrochanteric osteotomy for neglected fractures of the proximal femur;surgical technique and a retrospective case series[J].J Orthop Surg Res,2013,8(15):17.
[10]LIEM I S,KAMMERLANDER C,RAAS C,et al.Is there a difference in timing and cause of death after fractures in the elderly[J].Clin Orthop Relat Res,2013,471(9):2846-2851.
[11]徐建民,王兆朋,王恒孝.骨形态发生蛋白-2在兔骨折愈合过程中的作用[J].中国矫形外科杂志,2016,24(10):920-924.
[12]MURPHY D K,RANDELL T,BRENNAN K L,et al.Treatment and displacementaffect the reoperation rate for femoral neck fracture[J].Clin OrthopRelat Res,2013,471(8):2661-2670.
[13]张波,徐博,吴昊,等.续断对兔骨折愈合过程中相关基因表达和血钙、磷含量的影响[J].氨基酸和生物资源,2016,38(2):54-57.
[14]贺旭峰,祝涛.骨碎补促进骨折愈合的机理[J].中医正骨,2013,25(11):67-69.
[15]郭福,曹顺海,庞健,等.三七对骨重建负平衡和骨转换率的影响[J].中国中医急症,2012,21(9):1488-1489.
[16]王晓娟.丹参多酚酸盐对大鼠骨髓间充质干细胞增殖及血管内皮生长因子表达的影响[J].环球中医药,2013,6(7):492-495.
[17]林晓影,杨炳友,何娅雯,等.接骨木根皮促进骨折愈合有效部位拆分及抗炎作用的研究[J].中医药信息,2016,33(3):29-32.