摘要
目的探讨手法复位联合中药熏蒸对尺桡骨骨干骨折内固定患者骨折愈合时间、血液流变学及关节功能的影响。方法回顾性选取102例尺桡骨骨干骨折内固定患者作为研究对象,按治疗方式不同分为对照组(49例)和研究组(53例)。对照组予以手法复位治疗,研究组在对照组基础上加用中药熏蒸治疗。2组均治疗6周。比较2组治疗总有效率、骨折愈合时间、影像学相关指标(桡骨高度、尺偏角、掌倾角)、腕关节活动度、血液流变学指标[红细胞聚集指数(erythrocyte aggregation index,EAI)、全血黏度(whole blood viscosity,WBV)、红细胞压积(hematocrit,HCT)、D-二聚体(D-dimer,D-D)]、骨折愈合相关因子[成纤维细胞生长因子-2(fibroblast growth factor-2,FGF-2)、胰岛素生长因子-1(insulin growth factor-1,IGF-1)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)]及并发症发生率。结果治疗后,研究组总有效率为94.34%,高于对照组的77.55%(P<0.05)。研究组骨折愈合时间较对照组缩短(P<0.05)。2组桡骨高度、尺偏角、掌倾角比较,差异无统计学意义(P>0.05)。研究组腕关节背伸、屈曲度大于对照组(P均<0.05),EAI、WBV、HCT、D-D低于对照组(P均<0.05)。研究组FGF-2、IGF-1、TGF-β1高于对照组(P均<0.05)。研究组并发症总发生率为1.89%,与对照组的10.20%比较,差异无统计学意义(P>0.05)。结论手法复位联合中药熏蒸能改善尺桡骨骨干骨折内固定患者腕关节活动度,缩短骨折愈合时间,这可能与改善血液流变学指标、调节骨折愈合相关因子表达有关。
Objective To explore the effects of manipulative reduction combined with Chinese herbal fumigation on fracture healing time,hemorheology,and joint function in patients with internal fixation of ulnar and radial shaft fractures.Methods Retrospectively selecting 102 patients with internal fixation of ulnar and radial shaft fractures as the study subjects,and they were divided into the control group(49 cases)and the study group(53 cases)according to different treatment methods.The control group was treated with manipulative reduction,while the study group was treated with Chinese herbal fumigation on the basis of the control group.Both groups were treated for 6 weeks.The total effective rate,fracture healing time,imaging related indicators(radius height,ulnar deviation angle and palmar inclination angle),wrist joint range of motion,and hemorheological indicators[erythrocyte aggregation index(EAI),whole blood viscosity(WBV),hematocrit(HCT)and D-dimer(D-D)]were compared in the two groups.The fracture healing related factors[fibroblast growth factor-2(FGF-2),insulin growth factor-1(IGF-1),and transforming growth factor-β1(TGF-β1)]and the incidence of complications were also compared.Results After treatment,the total effective rate of the study group was 94.34%,which was higher than that of the control group(77.55%)(P<0.05).The fracture healing time in the study group was shorter than that in the control group(P<0.05).There was no statistically significant difference between the two groups in terms of radius height,ulnar deviation angle,and palmar inclination angle(P>0.05).The wrist extension and flexion of the study group were greater than those of the control group(P all<0.05),while the levels of EAI,WBV,HCT,and D-D in the study group were lower than those in the control group(P all<0.05).The levels of FGF-2,IGF-1,TGF-β1 in the study group were higher than those in the control group(P all<0.05).The total incidence rate of complications in the study group was 1.89%,and there was no statistically significant difference compared to the control group(10.20%)(P>0.05).Conclusion Manipulative reduction combined with Chinese herbal fumigation could improve the wrist range of motion and shorten the fracture healing time in patients with internal fixation of ulnar and radial shaft fractures,which may be related to the improvement of hemorheological indicators and regulating the expression of fracture healing related factors.
作者
冯伟利
楚利涛
周洪保
FENG Weili;CHU Litao;ZHOU Hongbao(Department of Limbs Orthopedics,Xinmi Traditional Chinese Medicine Hospital,Xinmi 452370,China;Department of Lower Limb Orthopedics,Zhengzhou Orthopedic Hospital,Zhengzhou 450000,China;Department of Orthopedics,Zhengzhou Orthopedic Hospital,Zhengzhou 450000,China)
出处
《中西医结合研究》
2024年第1期15-19,23,共6页
Research of Integrated Traditional Chinese and Western Medicine
基金
河南省医学科技攻关计划联合共建项目(No.LHGJ20221117)。
关键词
尺桡骨骨干骨折
手法复位
中药熏蒸
血液流变学
骨折愈合
ulnar and radial shaft fractures
manipulative reduction
Chinese herbal fumigation
hemorheology
fracture healing
