摘要
目的:探讨手术切开复位内固定联合桃红四物汤治疗肱骨髁间骨折的效果及对炎性因子的影响。方法:选择2013年2月—2018年5月医院进行治疗的肱骨髁间骨折患者92例,按照随机数字的方法将患者分为两组,对照组和观察组,每组46例,对照组给予尺骨鹰嘴截骨入路的手术切开复位联合内固定治疗,观察组在对照组治疗方法的基础上使用桃红四物汤治疗,对治疗效果进行对比。结果:经过治疗后,对照组的血管内皮生长因子从[(175.83±19.86)ng/L升高到(230.47±21.55)ng/L],骨形态发生蛋白-2从[(42.67±5.91)ng/L升高到(78.61±5.55)ng/L],血清胰岛素样生长因子-1从[(3.07±0.46)μg/L升高到(8.39±0.51)μg/L],观察组的血管内皮生长因子从[(176.69±20.36)ng/L升高到(288.91±20.47)ng/L],骨形态发生蛋白-2从[(43.11±6.03)ng/L升高到(94.87±6.68)ng/L],血清胰岛素样生长因子-1从[(3.09±0.42)μg/L升高到(12.61±2.35)μg/L],观察组的升高幅度大于对照组,数据差异均具有统计学意义(t=-13.335,-12.698,-11.902,P<0.05),在治疗后3 d,对照组的白细胞介素-6从[(9.16±1.21)ng/L升高到(18.76±2.68)ng/L],白细胞介素-10从[(62.34±6.74)ng/L升高到(87.64±7.79)ng/L],白细胞介素-18从[(18.76±2.37)ng/L升高到(30.56±2.22)ng/L],观察组的白细胞介素-6从[(9.18±1.19)ng/L升高到(14.28±2.13)ng/L],白细胞介素-10从[(63.15±6.55)ng/L升高到(75.49±6.51)ng/L],白细胞介素-18从[(18.97±2.46)ng/L升高到(24.62±2.71)ng/L],对照组的升高幅度大于观察组患者,数据差异均具有统计学意义(t=8.876、8.117、11.500,P<0.05),观察组的治疗效果优于对照组,数据差异具有统计学意义(z=-4.325,P<0.05),两组各项并发症发生率的数据差异均不具有统计学意义(χ~2=0.155、0.345、0.211、0.713,P>0.05)。结论:使用手术切开复位内固定联合桃红四物汤治疗肱骨髁间骨折,可以提升治疗效果,降低炎症反应程度,促进骨折恢复,值得在临床工作中推广。
Objective:To investigate the effect of open reduction and internal fixation combined with Taohong Siwu Decoction on intercondylar fracture of the humerus and its influence on inflammatory factors.Methods:Ninety-two patients with humeral intercondylar fractures treated in our hospital from February 2013 to May 2018 were selected.According to the random number method,the patients were divided into the control group and the observation group,with 46 patients in each group.The patients in the control group were treated with open reduction and internal fixation of the ulna olecranon osteotomy approach.The patients in the observation group were treated with Taohong Siwu Decoction on the basis of the treatment methods of the control group,and the treatment effect was compared.Result:After treatment,the vascular endothelial growth factor of the control group increased from(175.83±19.86)ng/L to 230.47±21.55)ng/L,bone morphogenetic protein-2 increased from(42.67±5.91)ng/L to(78.61±5.55)ng/L,and serum insulin-like growth factor-1 increased from(3.07±0.46)μg/L to(8.39±0.51)μg/L.The vascular endothelial growth factor in the observation group increased from(176.69±20.36)ng/L to(288.91±20.47)ng/L,bone morphogenetic protein-2 increased from(43.11±6.03)ng/L to(94.87±6.68)ng/L and serum insulin-like growth factor-1 increased from(3.09±0.42)μg/L to(12.61±2.35)μg/L.The increase of the patients in the observation group was larger than that in the control group and the difference was statistically significant(t=-13.335,-12.698,-11.902,P<0.05).On the 3 rd day after treatment,the interleukin-6 of the control group increased from(9.16±1.21)ng/L to(18.76±2.68)ng/L,interleukin-10 increased from(62.34±6.74)ng/L to(87.64±7.79)ng/L and interleukin-18 increased from(18.76±2.37)ng/L to(30.56±2.22)ng/L.Interleukin-6 in the observation group increased from(9.18±1.19)ng/L to(14.28±2.13)ng/L,interleukin-10 increased from(63.15±6.55)ng/L to(75.49±6.51)g/L,and interleukin-18 increased from(18.97±2.46)ng/L to(24.62±2.71)ng/L.The increase in the control group was larger than that in the observation group and the difference was statistically significant(t=8.876,8.117,11.500,P<0.05).The treatment effect of the observation group was better than that of the control group and the difference was statistically significant(z=-4.325,P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(χ^2=0.155,0.345,0.211,0.713,P>0.05).Conclusion:The treatment of humeral intercondylar fracture with open reduction and internal fixation combined with Taohong Siwu Decoction can improve the therapeutic effect,reduce the degree of inflammation and promote the recovery of fracture.It is worthy of popularizing in clinical work.
作者
张亚军
陈金洪
王勇
王铮峰
ZHANG Yajun;CHEN Jinhong;WANG Yong;WANG Zhengfeng(Hangzhou Fuyang Traditional Chinese Medicine Orthopedics Hospital,Hangzhou 311400,Zhejiang,China)
出处
《中华中医药学刊》
CAS
北大核心
2019年第2期479-483,共5页
Chinese Archives of Traditional Chinese Medicine
基金
浙江省中医药(中西医结合)重点学科计划项目(2017-XK-D04)
关键词
内固定
桃红四物汤
肱骨髁间骨折
炎性因子
internal fixation
Taohong Siwu Decoction
intercondylar fracture of humerus
inflammatory factors
