补阳还五汤加减配合切开复位内固定术治疗旋后外旋型踝关节骨折的疗效观察
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摘要
目的:观察口服中药补阳还五汤配合切开复位内固定术治疗旋后外旋型踝关节骨折的疗效。方法:将所有入选的旋后外旋型踝关节骨折患者共70例,随机分为对照组与治疗组两组,每组各35例。所有患者均对症处理后行手术切开复位,然后采用钢板及空心钉内固定。治疗组于术后采用补阳还五汤加减口服,对照组术后口服伤科接骨片。两组疗程均为8周,并随访3个月。结果:疗程结束后,治疗组的总有效率为97.1%,对照组的总有效率为73.3%,两组相比,有统计学差异(P<0.05)。治疗组的平均肿痛消失时间及平均骨折愈合时间均明显短于对照组,两组相比,有统计学差异(P<0.05)。治疗组骨折愈合程度评分在第4周、6周和8周时均少于对照组,两组相比,有统计学差异(P<0.05)。结论:口服补阳还五汤配合切开复位内固定术治疗旋后外旋型踝关节骨折,可以明显提高临床疗效,缩短肿痛消失时间及骨折愈合时间,且无明显不良反应,值得临床推广使用。
Objective: To observe the efficacy of oral medicine Buyang Huanwu Decoction with open reduction and internal fixation for treatment of supination external rotation ankle fracture.Methods: All selected supination external rotation ankle fracturespatients with a total of 70 cases were randomly divided into control group and treatment group,each 35 cases.All patients underwent surgery with open reduction and symptomatic treatmentand then fixed with plate and hollow needling.The treatment group received postoperative Buyang Huanwu Decoction orally and the control group oral Shangke Jiegu sheet.Both were treated for eight weeksandfollowed for three months.Results: After treatment,the total effective rate of the treatment group was 97.1% and that of the control group 73.3%.Compared the two groups,there was a significant difference( P < 0.05).Average swellingdisappearedtime in treatment group and the average healing time were significantly shorter than those of the control group with a significant difference( P < 0.05).Fracture healing scores in the treatment group in the first four weekswere less than those of the control group at 6th week and 8th week with a significant difference( P < 0.05).Conclusion: Oral Buyang Huanwu Decoction with open reduction and internal fixation forsupination external rotation ankle fracturescan significantly improve the clinical efficacy,swelling and pain disappeared time and shorten healing timeand there is no obvious sideeffects,worthy of clinical use.
Objective: To observe the efficacy of oral medicine Buyang Huanwu Decoction with open reduction and internal fixation for treatment of supination external rotation ankle fracture.Methods: All selected supination external rotation ankle fracturespatients with a total of 70 cases were randomly divided into control group and treatment group,each 35 cases.All patients underwent surgery with open reduction and symptomatic treatmentand then fixed with plate and hollow needling.The treatment group received postoperative Buyang Huanwu Decoction orally and the control group oral Shangke Jiegu sheet.Both were treated for eight weeksandfollowed for three months.Results: After treatment,the total effective rate of the treatment group was 97.1% and that of the control group 73.3%.Compared the two groups,there was a significant difference( P < 0.05).Average swellingdisappearedtime in treatment group and the average healing time were significantly shorter than those of the control group with a significant difference( P < 0.05).Fracture healing scores in the treatment group in the first four weekswere less than those of the control group at 6th week and 8th week with a significant difference( P < 0.05).Conclusion: Oral Buyang Huanwu Decoction with open reduction and internal fixation forsupination external rotation ankle fracturescan significantly improve the clinical efficacy,swelling and pain disappeared time and shorten healing timeand there is no obvious sideeffects,worthy of clinical use.
引文
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[18]李瑞.药理学[M].5版.北京:人民卫生出版社,2002:205-207.
[2]荣国威.骨折[M].北京:人民卫生出版社,2004:1178-1182.
[3]陆宸照.踝关节损伤的诊断和治疗[M].上海:上海科学技术文献出版社,1998:114-881.
[4]庄起昌,何小文,李爱长.踝关节骨折伴下胫腓关节分离的治疗[J].中国骨伤,2000(1):21-22.
[5]武勇.足踝部骨折[M].北京:人民卫生出版社,2009:208-252.
[6]蒋协达,王大伟.骨科临床疗效评价标准[S].北京:人民卫生出版社,2005:225-227.
[7]梁军,于建华,郑得志,等.踝关节骨折的手术治疗[J].中华骨科杂志,2002,22(10):603-607.
[8]王亦璁.骨与关节损伤[M].3版.北京:人民卫生出版社,2001:1096-1115.
[9]毛宾尧.足外科学[M].北京:人民卫生出版社,1992:128-135.
[10]Ramsey PL,Hamilton W.C hanges in tibiotalar area of contact caused by lateral talar shift[J].J Bone Joint Surg A m,1976,58(3):356-357.
[11]Wilson CF.Ftactures and dislocations of the ankle.In:Rockwood CA,ed.Fractures in Adults.Vo1.2.Second Edition[M].Philadelphia:JB Lippincott CO,1984:1665-1701.
[12]卢世璧,王继芳,王岩,等.坎贝尔骨科手术学[M].济南:济南科学技术出版社,2005:2624-2625.
[13]吴永胜,刘明义.中西医结合治疗旋后外旋型踝关节骨折脱位32例[J].中国中医骨伤科杂志,2012,20(9):62-63.
[14]高学敏.中药学[M].北京:人民卫生出版社,2001:1264.
[15]翁为良.中药临床药理学[M].北京:人民卫生出版社,2002:393-396.
[16]宋立人.现代中药学大辞典[M].北京:人民卫生出版社,2001:105-2196.
[17]陈长勋.中药药理学[M].上海:上海科学技术出版社,2006:106.
[18]李瑞.药理学[M].5版.北京:人民卫生出版社,2002:205-207.