促愈接骨汤配合夹板固定治疗Colles骨折的临床观察

发布时间：2018-01-13 06:01

本文关键词：促愈接骨汤配合夹板固定治疗Colles骨折的临床观察　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对比促愈接骨汤与伤科接骨片配合手法整复夹板固定治疗Colles骨折的临床疗效,从而为Colles骨折治疗方案的选择提供更优性参考。方法:本课题通过研究黑龙江中医药大学附属第一医院骨科病房及门急诊自2015年3月-2016年12月收治的60例60周岁以上Colles骨折患者,通过手法整复夹板固定配合以促愈接骨汤和夹板固定配合以伤科接骨片两种治疗方案,对骨折愈合时间和愈合情况、患肢肿胀程度、肿胀消退时间的影响,对患者疼痛视觉模拟评分法(VAS)评分,对骨折复位后12周的腕关节功能评分进行对比,以及患者骨折复位后12周的骨密度与血清参数的分析。结果:两组患者在治疗前后骨折愈合时间和愈合情况上无明显差异(P0.05),但在骨折临床愈合过程中治疗组掌倾角、尺偏角、桡骨高度的丢失略小于对照组;两组患者疼痛VAS评分比较无明显差异(P0.05),不具有统计学意义;治疗组在改善患肢肿胀程度与肿胀消退时间上优于对照组,尤其在骨折复位后1天、3天及1周这三个时间点,对腕横纹与掌横纹加快消肿的疗效比对照组好;治疗组在骨折复位后12周骨密度与血清参数的测定结果比较上均明显优于对照组;且Gartland-Werley腕关节功能评分显示:治疗组优9例,良17例,可3例,优良率86.7%;对照组优7例,良16例,可5例,优良率76.7%。治疗组在骨折复位后12周的腕关节功能优良率高于对照组。结论:本课题研究中,治疗Colles骨折使用促愈接骨汤配合手法整复夹板固定在加快患肢肿胀消退及腕关节功能恢复方面,以及在骨密度与血清参数的测定分析中,均明显优于伤科接骨片配合手法整复夹板固定治疗,值得临床推广及应用。
[Abstract]:Objective: to compare the clinical effect of CYJD and Jiejiao tablet combined with manual reduction splint fixation in the treatment of Colles fracture. So as to provide a better reference for the treatment of Colles fracture. Methods:. From March 2015 to December 2016, 60 patients with Colles fracture over 60 years old were treated in orthopedic ward and outpatient department of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. The effects of manual reduction splint fixation and splint fixation on fracture healing time and healing condition, swelling degree of affected limbs and swelling and extinction time were studied. Visual analogue score (VAS) score of pain and wrist function score 12 weeks after fracture reduction were compared. Results: there was no significant difference in fracture healing time and healing condition between the two groups before and after treatment (P 0.05). However, the loss of palmar inclination angle, ulnar deviation angle and radial height in the treatment group was slightly smaller than that in the control group during the healing process of fracture. There was no significant difference in pain VAS score between the two groups (P 0.05). The treatment group was superior to the control group in improving the swelling degree and the time of swelling regression, especially at the three time points of 3 days and 1 week after the reduction of fracture, the curative effect of the treatment group was better than that of the control group in accelerating the detumescence of the transverse and metacarpal stripes. The results of bone mineral density and serum parameters in the treatment group were significantly better than those in the control group at 12 weeks after fracture reduction. The Gartland-Werley wrist function score showed that the treatment group was excellent in 9 cases, good in 17 cases and fair in 3 cases. The excellent and good rate was 86.7%. In the control group, 7 cases were excellent, 16 cases were good, 5 cases were fair, and the excellent and good rate was 76.7.The excellent and good rate of wrist joint function in the treatment group was higher than that in the control group at 12 weeks after fracture reduction. Conclusion: in this study. The treatment of Colles fracture with CYJD combined with manual reduction splint fixation can accelerate the deterioration of swelling of affected limb and the recovery of wrist function, as well as the determination and analysis of bone mineral density (BMD) and serum parameters. It is worth popularizing and applying in clinic.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.1

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