补肾活血汤配合瑶药分期熏蒸治疗骨质疏松性桡骨远端骨折的临床研究
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摘要
目的:观察补肾活血汤配合瑶药熏药分期治疗骨质疏松性桡骨远端骨折的临床疗效。方法:选取2016年1月-2017年6月柳州市中医医院符合入选标准的病例100例,入选病例按数字随机表法随机分为四组,每组25例。内外治结合组用补肾活血汤配合瑶药熏蒸治疗;补肾活血组单用补肾活血汤内服治疗;瑶药熏蒸药组单用瑶药熏蒸治疗;对照组复位后不予药物处理。结果:治疗3～10周,补肾活血汤配合瑶药熏蒸疗法明显优于其他三组,且治疗时间越长,其优势越明显(P <0.05,P <0.01),在治疗10周及12周后,四组患者RUSS评分又处于相近的状态(P> 0.05);治疗4周、6周、8周后,内外治结合组桡骨远端骨密度均高于其他三组(P <0.05),治疗10周及12周后,内外治结合组骨密度明显高于其他三组,差异更加显著(P <0.01);内外治结合组临床愈合时间小于4周,明显短于补肾活血组及瑶药熏蒸组(P <0.05);内外治结合组G-W评分优良率及PRWE问卷评分均优于其他三组(P <0.05,P <0.01)。结论:补肾活血汤配合瑶药熏药分期治疗骨质疏松性桡骨远端骨折的疗效可靠,能促进骨折愈合,提升骨折端骨密度,改善腕关节功能,减少骨折后并发症的发生,适于临床推广。
Objective: To observe the clinical efficacy of The Bushen Huoxue decoction( 补肾活血汤) plus Yao medicine( 瑶药 staging fumigation osteoporotic on the distal radius fracture. Methods: 100 cases of distal radius fracture treated in Liuzhou Traditional Chinese Medicine Hospital from June 2016 to June 2017 were selected. According to the random number table, they were divided into the the Bushen Huoxue group, the Yao medicine fumigation group, the internal and external treatment group and the control group, 25 cases in each group. The Bushen Huoxue decoction group was treated with the Bushen Huoxue decoction; the Yao medicine fumigation group was treated with fumigation by different kinds of Yao medicine staged intervention; the internal and external treatment group was treated with the Bushen Huoxue decoction plus Yao medicine fumigation; there was no other treatment in the control group. Results: For 3 weeks to 10 weeks, the Bushen Huoxue decoction plus Yao medicine fumigation was superior to the other three groups; the treatment time longer,the advantage was more obvious(P<0.05, P<0.01). After treatment for 10 weeks and 12 weeks, the RUSS scores in four groups were in a similar state(P>0.05). After treatment for 4 weeks, 6 weeks and 8 weeks, the bone mineral density of the distal radius in the internal and external treatment group was higher than that in the other three groups(P<0.05). After treatment for 10 weeks and 12 weeks, the bone mineral density in the combination group was significantly higher than that in the other three groups(P<0.01); the clinical healing time in the internal and external treatment group was less than 4 weeks, significantly shorter than that in the Bushen Huoxue group and Yao medicine fumigation group(P<0.05); the excellent and good rate of G-W score and PRWE questionnaire scores in the internal and external treatment group were better than other three groups(P<0.05, P<0.01). Conclusion: The Bushen Huoxue decoction plus fumigation of Yao medicine staged treatment is reliable and suitable for clinical application, can promote fracture healing, increase bone mineral density at fracture ends, improve wrist function, and reduce complications after fracture.
Objective: To observe the clinical efficacy of The Bushen Huoxue decoction( 补肾活血汤) plus Yao medicine( 瑶药 staging fumigation osteoporotic on the distal radius fracture. Methods: 100 cases of distal radius fracture treated in Liuzhou Traditional Chinese Medicine Hospital from June 2016 to June 2017 were selected. According to the random number table, they were divided into the the Bushen Huoxue group, the Yao medicine fumigation group, the internal and external treatment group and the control group, 25 cases in each group. The Bushen Huoxue decoction group was treated with the Bushen Huoxue decoction; the Yao medicine fumigation group was treated with fumigation by different kinds of Yao medicine staged intervention; the internal and external treatment group was treated with the Bushen Huoxue decoction plus Yao medicine fumigation; there was no other treatment in the control group. Results: For 3 weeks to 10 weeks, the Bushen Huoxue decoction plus Yao medicine fumigation was superior to the other three groups; the treatment time longer,the advantage was more obvious(P<0.05, P<0.01). After treatment for 10 weeks and 12 weeks, the RUSS scores in four groups were in a similar state(P>0.05). After treatment for 4 weeks, 6 weeks and 8 weeks, the bone mineral density of the distal radius in the internal and external treatment group was higher than that in the other three groups(P<0.05). After treatment for 10 weeks and 12 weeks, the bone mineral density in the combination group was significantly higher than that in the other three groups(P<0.01); the clinical healing time in the internal and external treatment group was less than 4 weeks, significantly shorter than that in the Bushen Huoxue group and Yao medicine fumigation group(P<0.05); the excellent and good rate of G-W score and PRWE questionnaire scores in the internal and external treatment group were better than other three groups(P<0.05, P<0.01). Conclusion: The Bushen Huoxue decoction plus fumigation of Yao medicine staged treatment is reliable and suitable for clinical application, can promote fracture healing, increase bone mineral density at fracture ends, improve wrist function, and reduce complications after fracture.
引文
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[4]庞向华,周建飞,洪定钢,等.瑶药熏药分期治疗桡骨远端骨折疗效观察[J].现代中西医结合杂志,2017,26(25):2771-2773.
[5]中国老医学学会骨质疏松性委员会,中国人骨质疏松性诊断标准专家共诊[J].中国骨质疏松杂志,2014,20(09):1007-1010.
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[10]赵继荣,李红专,慕向前.桡骨远端骨折的非手术治疗进展[J].中国中医骨伤科杂志,2015,23(12):77-80.
[11]周庆华,韩文剑,温故强,等.特定桡骨远端骨折患者手术及手法复位治疗后的远期效果对比[J].中国医药导报,2013,10(21):96-98.
[12]王羿,党兴.补肾活血法对SD大鼠骨折模型愈合影响的实验研究[J].时珍国医国药,2012,23(12):3150-3151.
[13]熊其林,范跟东.补肾活血法联合股骨近端抗旋髓内钉治疗高龄股骨粗隆间骨折临床研究[J].现代中西医结合杂志,2017,26(16):1799-1802.
[14]莫瑞冰,曹瑞治.高龄股骨粗隆间骨折的治疗进展[J].山西医药杂志,2014,9(03):282-285.
[15]齐静姣,张平,郭进武,等.山茱萸果核提取物对佐剂性关节炎大鼠免疫调节因子的影响[J].中国临床药理学杂志,2016,32(06):549-552.
[16]李彤.瑶医核心病机“盈亏平衡理论”初探[J].广西中医药,201134(03):43-44.
[17]覃迅云,李彤.中国瑶医学[M].北京:民族出版社,2001:32-46.
[2]Hanel D P,Jones M D.Tremble T E.Treatment of complex fractures wrist fractures[J].Orthop Clin of North Am,2002,33(01)35-38.
[3]黄永铨,罗毅文,王斌,等.补肾活血汤治疗老年桡骨远端骨折的临床疗效观察[J].中国中医骨伤科杂志,2015,23(03):5-8.
[4]庞向华,周建飞,洪定钢,等.瑶药熏药分期治疗桡骨远端骨折疗效观察[J].现代中西医结合杂志,2017,26(25):2771-2773.
[5]中国老医学学会骨质疏松性委员会,中国人骨质疏松性诊断标准专家共诊[J].中国骨质疏松杂志,2014,20(09):1007-1010.
[6]Patel SP,Anthony SG,Zurakowski D,et al.Radiographic scoring system to evaluate union of distal radius fractures[J].The Journal of hand surgery,2014,39(08):1471-1479.
[7]Gartland JJ Jr,Werley CW.Evaluation of healed Colles’fractures[J].JBone Joint Surg Am,1951,33-A(04):895-907.
[8]MacDermid JC,Turgeon T,Richards RS,et al.Patient rating of wrist pain and disability:a reliable and valid measurement tool[J].Journal of orthopaedic trauma,1998,12(08):577-586.
[9]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:168-169.
[10]赵继荣,李红专,慕向前.桡骨远端骨折的非手术治疗进展[J].中国中医骨伤科杂志,2015,23(12):77-80.
[11]周庆华,韩文剑,温故强,等.特定桡骨远端骨折患者手术及手法复位治疗后的远期效果对比[J].中国医药导报,2013,10(21):96-98.
[12]王羿,党兴.补肾活血法对SD大鼠骨折模型愈合影响的实验研究[J].时珍国医国药,2012,23(12):3150-3151.
[13]熊其林,范跟东.补肾活血法联合股骨近端抗旋髓内钉治疗高龄股骨粗隆间骨折临床研究[J].现代中西医结合杂志,2017,26(16):1799-1802.
[14]莫瑞冰,曹瑞治.高龄股骨粗隆间骨折的治疗进展[J].山西医药杂志,2014,9(03):282-285.
[15]齐静姣,张平,郭进武,等.山茱萸果核提取物对佐剂性关节炎大鼠免疫调节因子的影响[J].中国临床药理学杂志,2016,32(06):549-552.
[16]李彤.瑶医核心病机“盈亏平衡理论”初探[J].广西中医药,201134(03):43-44.
[17]覃迅云,李彤.中国瑶医学[M].北京:民族出版社,2001:32-46.