补肾活血汤加减治疗老年股骨转子间骨折临床研究
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摘要
目的:观察补肾活血汤加减治疗老年股骨转子间骨折的临床疗效。方法:将86例老年股骨转子间骨折患者随机分为对照组和观察组各43例,对照组术后实施常规治疗,观察组在常规治疗基础上采用补肾活血汤加减治疗,两组均连续治疗12周,比较两组患者治疗后下床活动时间、骨折愈合时间、髋关节功能、髋关节Harris评分及临床疗效。结果:观察组下床活动时间及骨折愈合时间明显短于对照组(P <0. 05);对照组治疗后髋关节功能优良率为69. 77%,观察组髋关节功能优良率为88. 37%,两组髋关节功能优良率比较,差异有统计学意义(P <0. 05);治疗后观察组髋关节Harris评分明显高于对照组,VAS评分明显低于对照组(P <0. 05);治疗后观察组第二腰椎-第四腰椎、髋部骨密度均明显高于对照组(P <0. 05)。结论:补肾活血汤可有效改善老年股骨转子间骨折患者髋关节功能,减轻患者疼痛,同时可提高患者腰椎与髋部骨密度。
Objective: To observe the clinical curative effect of Decoction for Nourishing Kidney and Promoting Blood Circulation on intertrochanteric fracture of femur in the elderly. Methods: Eighty-six elderly patients with intertrochanteric fracture of femur were randomly divided into the control group and the observation group,with 43 cases in each group. The ones in the control group received routine treatment after operation. The ones in the observation group were treated with Decoction for Nourishing Kidney and Promoting Blood Circulation on the basis of routine treatment. Both groups were treated for 12 weeks continuously. The time of getting out of bed,fracture-healing time,hip joint function,hip joint Harris score and clinical efficacies of the two groups were compared after the treatment. Results: The time of getting out of bed and fracture healing in the observation group was significantly shorter than that in the control group( P < 0. 05). The excellent rate of hip function was 69. 77% in the control group and88. 37% in the observation group after the treatment. There was significant difference in the excellent rate of hip function between the two groups( P < 0. 05). After the treatment,the Harris score of the hip joint in the observation group was significantly higher than that in the control group,and the VAS score was significantly lower than that in the control group( P < 0. 05). After the treatment,the bone density of L2-L4 lumbar spine and hip in the observation group was significantly higher than that in the control group( P < 0. 05). Conclusion: Decoction for Nourishing Kidney and Promoting Blood Circulation can effectively improve the hip function of elderly patients with femoral intertrochanteric fracture,relieve pain,and improve the bone density of lumbar vertebrae and hip.
Objective: To observe the clinical curative effect of Decoction for Nourishing Kidney and Promoting Blood Circulation on intertrochanteric fracture of femur in the elderly. Methods: Eighty-six elderly patients with intertrochanteric fracture of femur were randomly divided into the control group and the observation group,with 43 cases in each group. The ones in the control group received routine treatment after operation. The ones in the observation group were treated with Decoction for Nourishing Kidney and Promoting Blood Circulation on the basis of routine treatment. Both groups were treated for 12 weeks continuously. The time of getting out of bed,fracture-healing time,hip joint function,hip joint Harris score and clinical efficacies of the two groups were compared after the treatment. Results: The time of getting out of bed and fracture healing in the observation group was significantly shorter than that in the control group( P < 0. 05). The excellent rate of hip function was 69. 77% in the control group and88. 37% in the observation group after the treatment. There was significant difference in the excellent rate of hip function between the two groups( P < 0. 05). After the treatment,the Harris score of the hip joint in the observation group was significantly higher than that in the control group,and the VAS score was significantly lower than that in the control group( P < 0. 05). After the treatment,the bone density of L2-L4 lumbar spine and hip in the observation group was significantly higher than that in the control group( P < 0. 05). Conclusion: Decoction for Nourishing Kidney and Promoting Blood Circulation can effectively improve the hip function of elderly patients with femoral intertrochanteric fracture,relieve pain,and improve the bone density of lumbar vertebrae and hip.
引文
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[10]张耀武,陈平波,洪汉刚,等.中医补肾活血法对原发性骨质疏松症患者骨密度、骨代谢及脆性骨折发生率的影响[J].现代中西医结合杂志,2017,26(1):65-67.
[11]彭印文,陈秋风,张志辉.骨后康颗粒对老年股骨粗隆间骨折患者术后骨代谢指标的影响[J].中成药,2017,39(4):710-713.
[12]樊珊,赵璟,成丽.镇痛泵联合补肾活血汤对髁间棘撕脱骨折内固定术后患者疼痛的影响[J].中国医学装备,2016,13(9):89-91.
[13]马志怀,王宝军,高化,等.益气活血通络汤防治股骨转子间骨折围手术期下肢静脉血栓疗效观察[J].现代中西医结合杂志,2017,26(22):2478-2481.
[14]郑光明.补肾活血方治疗骨质疏松性股骨粗隆间骨折术后的疗效观察[D].广州:广州中医药大学,2011.
[2]李艳利.中西医结合干预对老年股骨粗隆间骨折患者康复的影响[J].长春中医药大学学报,2016,32(4):789-791.
[3]申健,张小军,封鹏,等.伤科接骨片对老年股骨粗隆间骨折术后骨折愈合的初步临床研究[J].河南中医,2013,33(10):466-467.
[4]李祥波,毛思学,田治标,等.补中益气汤治疗老年股骨转子间骨折术后便秘[J].河南中医,2014,34(8):1610-1611.
[5] GARELLICK G,MALCHAU H,HERBERTS P. SPECIFIC ORGENERAL HEALTH OUTCOME MEASURES IN THE EVALUA-TION OF TOTAL HIP REPLACEMENT. A comparison betweenthe Harris hip score and the Nottingham Health Profile[J]. Journalof Bone&Joint Surgery-british Volume,1998,80(4):600-606.
[6] BODIAN C A,FREEDMAN G,HOSSAIN S,et al. The visual ana-log scale for pain:clinical significance in postoperative patients[J]. Anesthesiology,2001,95(6):1356-1361.
[7]袁智锐.骨牵引联合中药三期辨证治疗高龄股骨粗隆间骨折[J].吉林中医药,2017,37(11):1121-1124.
[8]苏城辉,邱烽磊.研究补肾活血方对骨质疏松性股骨粗隆间骨折PFNA术后早期疗效的影响[J].世界中医药,2016,15(3):1288-1289.
[9]蔡志刚,张曦,高俊,等.补肾活血汤辨证加减治疗老年股骨转子间骨折的疗效观察[J].中国中医急症,2017,26(5):911-913.
[10]张耀武,陈平波,洪汉刚,等.中医补肾活血法对原发性骨质疏松症患者骨密度、骨代谢及脆性骨折发生率的影响[J].现代中西医结合杂志,2017,26(1):65-67.
[11]彭印文,陈秋风,张志辉.骨后康颗粒对老年股骨粗隆间骨折患者术后骨代谢指标的影响[J].中成药,2017,39(4):710-713.
[12]樊珊,赵璟,成丽.镇痛泵联合补肾活血汤对髁间棘撕脱骨折内固定术后患者疼痛的影响[J].中国医学装备,2016,13(9):89-91.
[13]马志怀,王宝军,高化,等.益气活血通络汤防治股骨转子间骨折围手术期下肢静脉血栓疗效观察[J].现代中西医结合杂志,2017,26(22):2478-2481.
[14]郑光明.补肾活血方治疗骨质疏松性股骨粗隆间骨折术后的疗效观察[D].广州:广州中医药大学,2011.