摘要
目的:探讨补阳还五汤对老年Colles骨折手法复位小夹板外固定后患者早期骨痂X线评分及血清碱性磷酸酶水平的影响。方法:自2016年10月至2018年10月,将采用手法复位小夹板外固定治疗的60例老年Colles骨折患者分为试验组和对照组,每组30例。对照组男15例,女15例;年龄56~75(67.81±5.41)岁;骨密度(0.82±0.24)g/cm^2;术后3 d予抬肩、屈伸肘关节、五指伸直和握拳锻炼,每日3次,每次30 min,持续1个月。试验组男13例,女17例;年龄57~77(66.02±5.16)岁;骨密度(0.76±0.23)g/cm^2;在对照组康复锻炼基础上口服补阳还五汤400 ml,每日2次,7 d为1个疗程,共服4个疗程。比较两组患者复位14、28 d时RUSS评分,测定两组患者复位即刻、复位14及28 d血清碱性磷酸酶(ALP)浓度及血清钙离子浓度以观察骨折愈合情况。结果:两组患者复位固定顺利,无再次骨折及并发症发生。两组患者复位后获得随访,时间30~35(31.60±1.03) d。试验组复位14、28 d时RUSS评分分别为4.58±0.31、7.07±0.36,对照组分别为3.98±0.30、6.15±0.35,试验组RUSS评分较对照组明显提高(P<0.01)。试验组复位即刻、复位14及28 d血清碱性磷酸酶浓度分别为(90.62±12.19) mmol/L、(105.40±11.63) mmol/L、(160.86±35.77) mmol/L,对照组分别为(91.27±13.52) mmol/L、(94.60±11.10) mmol/L、(144.17±26.27) mmol/L;两组复位即刻碱性磷酸酶浓度比较差异无统计学意义(P>0.05);复位14、28 d试验组血清碱性磷酸酶浓度较对照组升高(P<0.05)。两组复位即刻、复位14及28 d血清钙浓度比较差异无统计学意义(P>0.05)。结论:补阳还五汤治疗老年Colles骨折能促进患者早期骨痂形成,有效增加机体血清碱性磷酸酶浓度,促进骨折愈合。
Objective:To explore effects of Buyang Huanwu Decoction(补阳还五汤,BYHWD) on early callus X-ray evaluation and level of serum alkaline phosphatase in elderly patients with Colles fracture after manual reduction and splint external fixation.Methods:From October 2016 to October 2018,60 elderly patients with Colles fractures were treated with manual reduction and splint external fixation and were divided into experimental group and control group.There were 30 patients in control group,including 15 males and 15 females;aged from 56 to 75 years old with an average of(67.81±5.41) years old;bone mineral density was(0.82±0.24) g/cm^2;patients were performed lift shoulders,bend and extend elbow joint,stretch five fingers and make a fist at 3 days after operation,3 times daily for 1 month,30 min once a time.There were 30 patients in experimental group,including 13 males and 17 females;aged from 57 to 77 years old with an average of(66.02±5.16) years old;bone mineral density was(0.76±0.23) g/cm^2;patients performed rehabilitation exercise as control group and combined with BYHWD,400 ml per dose,2 times daily,7 days as one course,totally 4 courses.RUSS scores at 14 and 28 days after reduction between two groups were compared,serum level of alkaline phosphatase(ALP) and serum calcium concentration were observed at immediately,14 and 28 days after reduction.Results:The patients between two groups were successfully fixed without refractures and complications occurred.The patients were followed up for 30 to 35 days with an average of(31.60±1.03) days.RUSS score in experimental group at 14 and 28 days after reduction were 4.58±0.31 and 7.07±0.36,respectively:while in control group were 3.98±0.30 and 6.15±0.35,respectively;RUSS score in experimental group was significantly higher than that of control group.Serum alkaline phosphatase concentrations in experimental group at immediately,14 and 28 days after reduction were(90.62±12.19) mmol/L,(105.40±11.63) mmol/L,and(160.86±35.77) mmol/L re spectively;while in control group were(91.27±13.52) mmol/L,(94.60±11.10) mmol/L,(144.17±26.27) mmol/L respectively;there was no statistically difference between two groups at immediately;and had statistically differences between two groups at 14 and 28 days after reduction.There was no significant difference in serum calcium concentration between two groups at immediately,14 and 28 days after reduction.Conclusion:BYHWD for elderly patients with Colles fracture could promote early formation of callus,effectively increase concentration of serum alkaline phosphatase and promote fracture healing.
作者
向兴彤
豆贲
韩世峰
孔亮
刘晓岚
XIANG Xing-tong;DOU Ben;HAN Shi-feng;KONG Liang;LIU Xiao-lan(The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410208,Hunan,China)
出处
《中国骨伤》
CAS
CSCD
2020年第3期241-246,共6页
China Journal of Orthopaedics and Traumatology
关键词
COLLES骨折
中草药
外固定器
碱性磷酸酶
Colles’ fracture
Drugs,Chinese herbal
External fixators
Alkaline phosphatase
