骨伤复原汤治疗胫骨慢性骨髓炎的疗效及对Paley、HHS评分的影响
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摘要
目的:探讨骨伤复原汤治疗胫骨慢性骨髓炎的疗效及对Paley、HHS评分的影响。方法:选取2014年3月—2016年12月在本院接受治疗胫骨慢性骨髓炎患者78例,采用随机法分为对照组和观察组,每组患者各39例。对照组患者采用胫骨骨皮瓣修复联合西医常规抗炎治疗,观察组患者在对照组治疗基础上联合骨伤复原汤治疗。观察并比较两组患者治疗前和治疗后1个月患者C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及血清碱性磷酸酶(ALP)水平。采用疼痛评分、Paley评价、膝关节HHS评分和Baird-Jackson评分评价患者疗效及关节功能恢复差异。结果:两组患者治疗前CRP、TNF-α、IL-6及ALP水平比较无统计学差异(P>0.05)。两组患者治疗后CRP、TNF-α及IL-6水平较治疗前下降,ALP水平较治疗前上升(P<0.05)。观察组患者治疗后CRP、TNF-α及IL-6水平低于对照组患者治疗后,ALP水平高于对照组患者治疗后(P<0.05)。两组患者治疗前VAS评分比较无统计学差异(P>0.05)。观察组患者治疗1个月、3个月和6个月时VAS评分均低于对照组患者(P<0.05)。观察组患者治疗后优良率为94.87%,对照组患者治疗后优良率为82.05%,两组患者治疗后优良率比较无统计学差异(P>0.05)。两组患者治疗前HHS评分和Baird-Jackson评分比较无统计学差异(P>0.05)。两组患者治疗后HHS评分和Baird-Jackson评分较治疗前上升,观察组患者治疗后HHS评分和Baird-Jackson评分高于对照组患者治疗后(P<0.05)。结论:骨伤复原汤治疗胫骨慢性骨髓炎可有效减轻疼痛,降低炎症反应,促进关节功能恢复,值得临床推广应用。
Objective:To investigate the effect of Bone Fracture Restoring Decoction on chronic osteomyelitis of tibia and its influence on Paley and HHS score. Methods:From March 2014 to December 2016,78 patients with chronic osteomyelitis of the tibia were treated in our hospital. They were randomly divided into the control group and the observation group,with 39 patients in each group. The patients in the control group were treated with the combination of tibial bone flap repair and Western medicine routine anti-inflammatory treatment. The observation group was treated with the combination of Bone Restoring Decoction on the basis of the treatment of the control group. The C-reactive protein( CRP),tumor necrosis factor alpha( TNF-α),interleukin-6( IL-6) and serum alkaline phosphatase( ALP) levels were observed and compared between the two groups before and 1 month after treatment. The pain score,Paley evaluation,knee HHS score and Baird-Jackson score were used to evaluate the effect of the treatment and the recovery of joint function. Results:The CRP,TNF-α,IL-6 and ALP levels in the two groups before treatment were not statistically different( P > 0. 05). After treatment,the levels of CRP,TNF-α and IL-6 in the two groups were lower than those before treatment,and the level of ALP was higher than before treatment( P < 0. 05). After treatment,the levels of CRP,TNF-α and IL-6 in the observation group were lower than those in the control group,and the level of ALP in the treatment group was higher than that in the control group( P < 0. 05). There was no significant difference in VAS scores between the two groups before treatment( P > 0. 05). The scores of VAS in the observation group were lower than those in the control group at1 month,3 months and 6 months( P < 0. 05). After treatment,the excellent and good rate was 94. 87% in the observation group and 82. 05% in the control group after treatment. There was no significant difference between the two groups after treatment( P >0. 05). There was no significant difference in HHS score and Baird-Jackson score between the two groups before treatment( P >0. 05). The scores of HHS and Baird-Jackson in the two groups were higher than those before treatment,and the scores of HHS and Baird-Jackson in the observation group were higher than those in the control group after treatment( P < 0. 05). Conclusion:Treatment of chronic osteomyelitis of the tibia with Bone Fracture Restoring Decoction can effectively relieve pain,reduce inflammatory reaction and promote the recovery of joint function. It is worthy of clinical application.
Objective:To investigate the effect of Bone Fracture Restoring Decoction on chronic osteomyelitis of tibia and its influence on Paley and HHS score. Methods:From March 2014 to December 2016,78 patients with chronic osteomyelitis of the tibia were treated in our hospital. They were randomly divided into the control group and the observation group,with 39 patients in each group. The patients in the control group were treated with the combination of tibial bone flap repair and Western medicine routine anti-inflammatory treatment. The observation group was treated with the combination of Bone Restoring Decoction on the basis of the treatment of the control group. The C-reactive protein( CRP),tumor necrosis factor alpha( TNF-α),interleukin-6( IL-6) and serum alkaline phosphatase( ALP) levels were observed and compared between the two groups before and 1 month after treatment. The pain score,Paley evaluation,knee HHS score and Baird-Jackson score were used to evaluate the effect of the treatment and the recovery of joint function. Results:The CRP,TNF-α,IL-6 and ALP levels in the two groups before treatment were not statistically different( P > 0. 05). After treatment,the levels of CRP,TNF-α and IL-6 in the two groups were lower than those before treatment,and the level of ALP was higher than before treatment( P < 0. 05). After treatment,the levels of CRP,TNF-α and IL-6 in the observation group were lower than those in the control group,and the level of ALP in the treatment group was higher than that in the control group( P < 0. 05). There was no significant difference in VAS scores between the two groups before treatment( P > 0. 05). The scores of VAS in the observation group were lower than those in the control group at1 month,3 months and 6 months( P < 0. 05). After treatment,the excellent and good rate was 94. 87% in the observation group and 82. 05% in the control group after treatment. There was no significant difference between the two groups after treatment( P >0. 05). There was no significant difference in HHS score and Baird-Jackson score between the two groups before treatment( P >0. 05). The scores of HHS and Baird-Jackson in the two groups were higher than those before treatment,and the scores of HHS and Baird-Jackson in the observation group were higher than those in the control group after treatment( P < 0. 05). Conclusion:Treatment of chronic osteomyelitis of the tibia with Bone Fracture Restoring Decoction can effectively relieve pain,reduce inflammatory reaction and promote the recovery of joint function. It is worthy of clinical application.
引文
[1]张永红,秦泗河,王栋,等.骨搬运治疗胫骨慢性骨髓炎,是否需要加用抗生素骨水泥?[J].中国矫形外科杂志,2017,25(4):331-335.
[2]仇洪.胫骨慢性骨髓炎并骨皮损患者胫骨骨皮瓣修复术后应用骨伤复原汤治疗的临床疗效[J].中药材,2015,38(2):419-421.
[3]于德军,刘丽晶,张阿新,等.腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入治疗胫骨慢性骨髓炎的疗效分析[J].中国现代医学杂志,2016,26(14):122-124.
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[8]向柄彦,郭元.载药组织工程支架的构建及其治疗兔慢性骨髓炎的疗效[J].中华创伤杂志,2015,31(3):212-216.
[9]应志强,金浙凯.76例胫骨创伤性骨髓炎的诊疗分析[J].中国现代医学杂志,2016,26(17):141-144.
[10]张鑫,孟乘飞,汪国栋,等.负压封闭引流在胫腓骨骨折术后早期感染中的应用[J].中华创伤杂志,2015,31(4):303-306.
[11]张彦龙,王泳,彭阿钦.骨搬移联合开放植骨和负压封闭引流技术治疗胫骨感染性骨缺损[J].中华创伤杂志,2017,33(2):141-146.
[12]张彦龙,彭阿钦,吴希瑞.双平面截骨骨搬移治疗胫骨大段感染性骨缺损[J].中华创伤杂志,2016,32(7):638-644.
[13]任义军,严立,胡锐,等.吻合血管的骨瓣移植治疗Cierny-MaderⅢ、Ⅳ型胫骨骨髓炎[J].中华创伤骨科杂志,2015,17(6):477-480.
[14]陈建文,颜景涛,郭悦,等.计算机辅助外固定支架在复杂胫腓骨畸形截骨矫正术中的应用[J].中华创伤骨科杂志,2015,17(7):589-593.
[15]李盛龙,王喆,宫良丰,等.新型胫骨远端前侧解剖型锁定接骨板在治疗pilon前柱骨折中的应用[J].中华创伤骨科杂志,2015,17(12):1024-1028.
[2]仇洪.胫骨慢性骨髓炎并骨皮损患者胫骨骨皮瓣修复术后应用骨伤复原汤治疗的临床疗效[J].中药材,2015,38(2):419-421.
[3]于德军,刘丽晶,张阿新,等.腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入治疗胫骨慢性骨髓炎的疗效分析[J].中国现代医学杂志,2016,26(14):122-124.
[4]祝勇刚,张大伟,赵广跃,等.抗生素骨水泥联合自体骨移植及环形外固定架修复骨髓炎后胫骨缺损[J].中国组织工程研究,2015,19(25):3942-3946.
[5]刘军,罗利芳,张寿涛,等.单边外固定架骨搬移联合自体植骨治疗下肢创伤性慢性骨髓炎[J].中华创伤杂志,2016,32(3):229-233.
[6]赵玉峰,刘华渝,任永川,等.Ilizarov骨延长和骨搬移技术治疗下肢长骨创伤后慢性骨髓炎[J].中华创伤杂志,2015,31(4):294-298.
[7]徐掭发,胡俊勇,余世明,等.VSD联合逆行比目鱼肌内侧肌瓣治疗伴软组织缺损的慢性胫骨骨髓炎[J].中华显微外科杂志,2017,40(1):72-74.
[8]向柄彦,郭元.载药组织工程支架的构建及其治疗兔慢性骨髓炎的疗效[J].中华创伤杂志,2015,31(3):212-216.
[9]应志强,金浙凯.76例胫骨创伤性骨髓炎的诊疗分析[J].中国现代医学杂志,2016,26(17):141-144.
[10]张鑫,孟乘飞,汪国栋,等.负压封闭引流在胫腓骨骨折术后早期感染中的应用[J].中华创伤杂志,2015,31(4):303-306.
[11]张彦龙,王泳,彭阿钦.骨搬移联合开放植骨和负压封闭引流技术治疗胫骨感染性骨缺损[J].中华创伤杂志,2017,33(2):141-146.
[12]张彦龙,彭阿钦,吴希瑞.双平面截骨骨搬移治疗胫骨大段感染性骨缺损[J].中华创伤杂志,2016,32(7):638-644.
[13]任义军,严立,胡锐,等.吻合血管的骨瓣移植治疗Cierny-MaderⅢ、Ⅳ型胫骨骨髓炎[J].中华创伤骨科杂志,2015,17(6):477-480.
[14]陈建文,颜景涛,郭悦,等.计算机辅助外固定支架在复杂胫腓骨畸形截骨矫正术中的应用[J].中华创伤骨科杂志,2015,17(7):589-593.
[15]李盛龙,王喆,宫良丰,等.新型胫骨远端前侧解剖型锁定接骨板在治疗pilon前柱骨折中的应用[J].中华创伤骨科杂志,2015,17(12):1024-1028.