中药内服和薰洗在胫骨平台骨折术后治疗中的应用

发布时间：2018-08-31 16:56

【摘要】：目的:探讨在胫骨平台骨折的术后治疗中应用中药内服和薰洗的临床疗效和安全性。方法:接受切开复位锁定钢板内固定手术治疗的单侧胫骨平台骨折患者78例,随机分为2组。中药联合功能锻炼组36例,术后采用中药内服(每日1剂,水煎,早晚各1次饭后半小时口服,共服60 d)和薰洗(每次20 min,每日2次,15 d为1个疗程,共治疗2个疗程)联合功能锻炼治疗。功能锻炼组42例,术后单纯采用功能锻炼治疗。按照《外科学》中的骨折临床愈合标准评估骨折愈合情况,记录骨折愈合时间,并观察并发症发生情况。术后6个月,分别参照Rasmussen膝关节功能评分标准和美国特种外科医院(hospital for special surgery,HSS)膝关节评分标准对患膝功能进行评价。结果:78例患者均获随访,随访时间7~31个月,中位数13个月。2组患者骨折均愈合,中药联合功能锻炼组骨折愈合时间较功能锻炼组短[(98.44±9.96)d,(109.78±10.13)d;t=4.967,P=0.001]。术后6个月,中药联合功能锻炼组Rasmussen评分和HSS评分均高于功能锻炼组[(27.42±3.18)分,(19.24±2.96)分,t=11.757,P=0.000;(91.16±4.98)分,(77.35±6.69)分,t=10.195,P=0.000]。中药联合功能锻炼组术后并发切口感染1例、下肢深静脉血栓形成1例、膝关节创伤性关节炎2例;功能锻炼组术后并发切口感染1例、下肢深静脉血栓形成2例、膝关节创伤性关节炎3例;2组患者并发症发生率比较,差异无统计学意义(χ~2=0.006,P=0.938)。结论:对于接受切开复位锁定钢板内固定手术治疗的胫骨平台骨折患者,术后在功能锻炼的基础上采用中药内服和薰洗,有利于骨折愈合和患膝功能恢复,疗效优于单纯功能锻炼,而在安全性方面与后者相当。
[Abstract]:Objective: to investigate the clinical efficacy and safety of traditional Chinese medicine (TCM) and fumigation in the treatment of tibial plateau fracture. Methods: 78 patients with unilateral tibial plateau fractures who received open reduction and locking plate internal fixation were randomly divided into two groups. 36 patients in the Chinese medicine combined with functional exercise group were treated with traditional Chinese medicine orally (1 dose per day, decoction, once a meal half an hour in the morning and evening for 60 days) and fumigation (20 min, per day twice a day for 15 days as a course of treatment). A total of 2 courses of treatment) combined with functional exercise treatment. 42 cases in functional exercise group were treated with functional exercise only after operation. According to the clinical healing criteria of fracture in surgery, fracture healing was evaluated, fracture healing time was recorded, and complications were observed. Six months after operation, the knee function was evaluated according to the Rasmussen knee function scale and the (hospital for special surgery,HSS knee scoring standard of American Special surgery Hospital. Results all the 78 cases were followed up for 7 ~ 31 months. The median of 13 months was 13 months. The fracture healing time of the combined functional exercise group was shorter than that of the functional exercise group [(98.44 卤9.96) d, (109.78 卤10.13) d]. Six months after operation, the scores of Rasmussen and HSS in the combined functional exercise group were significantly higher than those in the functional exercise group [(27.42 卤3.18), (19.24 卤2.96), 11.757, 0.000; (91.16 卤4.98), (77.35 卤6.69), (77.35 卤6.69)] and (77.35 卤6.69), respectively. In the traditional Chinese medicine combined functional exercise group, incision infection occurred in 1 case, deep vein thrombosis in lower extremity in 1 case, traumatic arthritis in knee joint in 2 cases, and wound infection in 1 case and deep vein thrombosis in lower extremity in 2 cases in functional exercise group. There was no significant difference in the incidence of complications in 3 patients with traumatic arthritis of the knee (蠂 2 0.006 P 0. 938). Conclusion: for the patients with tibial plateau fractures treated by open reduction and locking plate internal fixation, the internal administration and fumigation of traditional Chinese medicine on the basis of functional exercise after operation is beneficial to fracture healing and functional recovery of the affected knee. The efficacy is superior to that of simple functional exercise, and is comparable to that of the latter in terms of safety.
【作者单位】：广东省深圳市龙岗区第三人民医院;
【分类号】：R687.3

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