新伤续断汤联合短节段经伤椎置钉治疗胸腰段骨折的临床疗效观察
发布时间：2018-11-20 05:38
【摘要】：目的:观察新伤续断汤联合短节段伤椎置术治疗单节段胸腰段骨折的临床疗效,初步探讨新伤续断汤对胸腰段骨折愈合的作用机制。方法:收集本院2015年11月至2016年8月单节段胸腰段骨折患者60例,按照入院顺序以随机数字表法分为中药组、对照组各30例。2组患者均由同组手术组医师行短节段伤椎置钉术治疗,对照组术后常规止痛、抗感染、功能锻炼等,不予其他可影响骨质代谢的药物治疗。中药组在对照组的基础上,术后第三天开始服用新伤续断汤,连续4周,观察随访6个月,记录术前及术后VAS评分、ODI评分、BALP,以CT检查观察骨折愈合的情况,并在术后6个月对2组患者进行疗效评价,数据用SPSS22.0软件进行统计学分析。结果:2组最终完成57例,其中中药组完成28例,对照组完成29例。比较2组患者术前基线特征(年龄、性别、损伤节段、术前VAS评分、ODI评分、BALP),均未见显著性差异(P0.05),具有可比性。2组VAS评分、ODI评分随着时间的延长而降低,中药组下降更为明显,同一时间点组间比较,中药组在术后1、3、6个月均低于对照组,差异有统计学意义(P0.05)。2组患者术后BALP随着时间延长而呈上升的趋势,且中药组上升的幅度大于对照,术后中药组各时间点BALP值均高于对照组,差异有统计学意义(P0.05)。经CT检查,2组术后3、6个月均有骨小梁通过骨折端,中药组骨折断端CT值在术后3、6个月高于对照组,差异具有统计学意义(P0.05)。术后6个月中药组治愈率高于对照组(P0.05)。结论:1、新伤续断汤联合短节段伤椎置钉术能有效缓解胸腰段骨折患者疼痛症状,促进骨折愈合,改善脊柱活动功能,临床疗效确切;2、新伤续断汤能明显提高胸腰段骨折患者行短节段伤椎置钉术后骨特异性碱性磷酸酶的活性,从而促进骨折椎体的愈合。
[Abstract]:Objective: to observe the clinical effect of Xinshangdianshu decoction (XSCD) combined with short segmental injury vertebra insertion in treating single segment thoracolumbar fracture, and to explore the mechanism of Xinshangdianling decoction (XSWD) on the healing of thoracolumbar fracture. Methods: sixty patients with single segment thoracolumbar fracture from November 2015 to August 2016 were collected and randomly divided into two groups according to the order of admission. The patients in the control group were treated by short segmental spinal screw insertion. The patients in the control group were treated with routine analgesic, anti-infection, functional exercise, and no other drugs could affect the bone metabolism. On the basis of the control group, the traditional Chinese medicine group began to take Xinshanglianling decoction on the third day after operation for 4 weeks. The patients were followed up for 6 months. The VAS score, ODI score before and after operation were recorded, and the fracture healing was observed by BALP, with CT examination. 6 months after operation, two groups of patients were evaluated, and the data were statistically analyzed by SPSS22.0 software. Results: 57 cases were finished in group 2, 28 cases in Chinese medicine group and 29 cases in control group. The baseline features (age, sex, injury segment, preoperative VAS score and ODI score, BALP),) were not significantly different between the two groups (P0.05). The VAS score and ODI score of the two groups decreased with time. Compared with the control group at the same time point, the BALP of the traditional Chinese medicine group was significantly lower than that of the control group at 1 and 6 months after operation (P0.05). The BALP of the two groups increased with the prolongation of time. And the increase of the Chinese medicine group is larger than that of the control group, the BALP value of the traditional Chinese medicine group is higher than that of the control group at each time point after operation, the difference is statistically significant (P0.05). CT examination showed that the trabeculae of the two groups passed through the fracture end 3 and 6 months after operation, and the CT value of the broken end of the fracture in the Chinese medicine group was higher than that in the control group at 3 and 6 months after operation, the difference was statistically significant (P0.05). 6 months after operation, the cure rate of TCM group was higher than that of control group (P0.05). Conclusion: 1. Xinshangdianshu decoction combined with short segment spinal screw insertion can effectively relieve pain symptoms of patients with thoracolumbar fracture, promote fracture healing, improve spinal movement function, and the clinical curative effect is accurate. 2. Xinshangdiaxian decoction can obviously improve the activity of bone specific alkaline phosphatase after short segmental spinal screw insertion in patients with thoracolumbar fracture, and thus promote the healing of fracture vertebral body.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3
本文编号：2343931
[Abstract]:Objective: to observe the clinical effect of Xinshangdianshu decoction (XSCD) combined with short segmental injury vertebra insertion in treating single segment thoracolumbar fracture, and to explore the mechanism of Xinshangdianling decoction (XSWD) on the healing of thoracolumbar fracture. Methods: sixty patients with single segment thoracolumbar fracture from November 2015 to August 2016 were collected and randomly divided into two groups according to the order of admission. The patients in the control group were treated by short segmental spinal screw insertion. The patients in the control group were treated with routine analgesic, anti-infection, functional exercise, and no other drugs could affect the bone metabolism. On the basis of the control group, the traditional Chinese medicine group began to take Xinshanglianling decoction on the third day after operation for 4 weeks. The patients were followed up for 6 months. The VAS score, ODI score before and after operation were recorded, and the fracture healing was observed by BALP, with CT examination. 6 months after operation, two groups of patients were evaluated, and the data were statistically analyzed by SPSS22.0 software. Results: 57 cases were finished in group 2, 28 cases in Chinese medicine group and 29 cases in control group. The baseline features (age, sex, injury segment, preoperative VAS score and ODI score, BALP),) were not significantly different between the two groups (P0.05). The VAS score and ODI score of the two groups decreased with time. Compared with the control group at the same time point, the BALP of the traditional Chinese medicine group was significantly lower than that of the control group at 1 and 6 months after operation (P0.05). The BALP of the two groups increased with the prolongation of time. And the increase of the Chinese medicine group is larger than that of the control group, the BALP value of the traditional Chinese medicine group is higher than that of the control group at each time point after operation, the difference is statistically significant (P0.05). CT examination showed that the trabeculae of the two groups passed through the fracture end 3 and 6 months after operation, and the CT value of the broken end of the fracture in the Chinese medicine group was higher than that in the control group at 3 and 6 months after operation, the difference was statistically significant (P0.05). 6 months after operation, the cure rate of TCM group was higher than that of control group (P0.05). Conclusion: 1. Xinshangdianshu decoction combined with short segment spinal screw insertion can effectively relieve pain symptoms of patients with thoracolumbar fracture, promote fracture healing, improve spinal movement function, and the clinical curative effect is accurate. 2. Xinshangdiaxian decoction can obviously improve the activity of bone specific alkaline phosphatase after short segmental spinal screw insertion in patients with thoracolumbar fracture, and thus promote the healing of fracture vertebral body.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3
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