骨康颗粒对老年骨质疏松性股骨粗隆间骨折术后疼痛康复的疗效观察

发布时间：2018-03-18 19:40

本文选题：老年骨质疏松症　切入点：股骨粗隆间骨折　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究主要目的为探讨中药骨康颗粒内服外用相结合对老年骨质疏松性股骨粗隆间骨折术后疼痛康复的临床疗效,通过对骨折术后疼痛的缓解,进一步影响髋关节活动度、骨密度及日常生活自理能力,客观评价本院中药配方颗粒骨康颗粒对老年骨质疏松性股骨粗隆间骨折术后疼痛康复的疗效,为本试验中的疗法在临床上推广应用提供临床依据。方法:将符合诊断标准及纳入标准的87例患者列为研究对象,在全部纳入者知情同意的情况下随机分为两组,对照组给予维D钙咀嚼片、鲑降钙素及骨化三醇胶丸治疗,共43例,男20例,女23例;治疗组在对照组治疗方案的基础上再加服骨康颗粒及用低频脉冲治疗仪直接患处皮肤透用骨康颗粒制成的骨康液治疗,共44例,男22例,女22例。两组治疗时间为3个月,两组均采用视觉模拟评级(VAS)评定法、髋关节功能Harris评分表、双能X线骨密度(BMD)测量法及日常生活自理能力(ADL)评分法,在治疗前后分别对患者髋关节各项功能进行评估,再经统计分析得出客观的评价。结果:经治疗后观察比较,治疗组患者临床症状改善明显优于对照组,髋关节功能改善亦优于对照组。经统计学分析,以Harris评分及分级为标准,临床疗效中在传统抗骨质疏松症治疗方法的基础上结合骨康颗粒内服外用的总有效率为82.5%,传统的抗骨质疏松症的对照组的总有效率为67.56%,两组间差异有统计学意义(p0.05)。治疗后,两组在VAS疼痛评分中,治疗前后评分均有明显下降,且均具有统计学意义(p0.05);治疗后,治疗组VAS评分较对照组低,且差异具有统计学意义(p0.05)。在髋关节功能Harris评分及日常生活自理能力(ADL)评分中,治疗前后比较评分均显著提高,差异具有统计学意义(p0.05),且治疗后治疗组的Harris评分及ADL评分较对照组高,且差异具有统计学意义(p0.05)。在对髋关节骨密度的比较中,治疗前后两组平均骨密度值均有所增加,差异无统计学意义(p0.05)。结论:骨康颗粒是针对老年骨质疏松性股骨粗隆间骨折术后疼痛的病因病机及病理表现为脆性骨折术后局部气滞血瘀,加之肝肾亏虚气血不足等特点,以局部与整体相结合辨证论治,对症选药组方,内服以补益肝肾、强筋壮骨,外用以借助低频脉冲中药离子导入对患处的局部刺激活血化瘀、消肿止痛,内外结合可有效缓解老年骨质疏松性股骨粗隆间骨折术后的疼痛,从而促进患病侧髋关节的活动度以提高患者的日常生活自理能力,同时对骨质疏松性骨折术后及预防再骨折等有防治结合的作用,最终达到促进髋关节功能恢复的目的。
[Abstract]:Objective: to explore the clinical effect of the combination of internal and external application of Gukang granule on postoperative pain recovery of senile osteoporotic femoral intertrochanteric fracture, and to relieve the pain after fracture. To further influence hip motion, bone mineral density (BMD) and self-care ability of daily life. Objective to evaluate the curative effect of Gukang granule, a traditional Chinese medicine prescription, on postoperative pain recovery of senile osteoporotic femoral intertrochanteric fracture. Methods: 87 patients who met the diagnostic criteria and the inclusion criteria were selected as the study subjects, and were randomly divided into two groups with the informed consent of all the participants. The control group was treated with vitamin D calcium chewable tablets, salmon calcitonin and calcitonin and oscitic triol colloid pills, 43 cases were male 20 cases, female 23 cases; In the treatment group, 44 cases (22 males and 22 females) were treated with Gukang granules and treated with Gukang granules on the skin directly affected by low frequency pulse therapy instrument. The treatment time of the two groups was 3 months, the treatment group was treated with Gukang granules on the basis of the treatment plan of the control group. Both groups were assessed with visual analogue rating (VAS), hip function Harris scale, dual energy X-ray bone mineral density (BMD) measurement and ADL score before and after treatment. Results: after treatment, the clinical symptoms of the patients in the treatment group were significantly better than those in the control group, and the improvement of hip function was also superior to that of the control group. By statistical analysis, the Harris score and grading were taken as the standard. The total effective rate was 82.5 in combination with the traditional anti-osteoporosis treatment method, and 67.56 in the traditional anti-osteoporosis control group. The difference between the two groups was statistically significant (P 0.05). After treatment, the total effective rate was 82.5 and 67.56 in the traditional anti-osteoporosis control group, and the difference between the two groups was statistically significant. After treatment, the VAS score of the treatment group was lower than that of the control group, and the VAS score of the treatment group was significantly lower than that of the control group. The difference was statistically significant (P 0.05). In the scores of hip function Harris and ADL, the scores before and after treatment were significantly higher than those before and after treatment. The difference was statistically significant (P 0.05), and the scores of Harris and ADL in the treatment group were higher than those in the control group, and the difference was statistically significant (P 0.05). In the comparison of bone mineral density of hip joint, the average BMD of both groups increased before and after treatment. Conclusion: the causes and pathogenesis of postoperative pain in senile osteoporosis intertrochanteric fracture are characterized by local stagnation of qi and blood stasis after brittle fracture and deficiency of liver and kidney deficiency of qi and blood. Combined with local and integral differentiation of symptoms and signs, select the prescription for symptoms, take orally to tonify the liver and kidney, strengthen the muscles and strong bones, and external use to promote blood circulation and remove blood stasis and relieve swelling and pain by introducing low frequency pulsed Chinese medicine ions. The combination of internal and external therapy can effectively relieve the pain after the operation of osteoporotic femoral intertrochanteric fracture, thus promote the motion of the affected hip joint and improve the self-care ability of the patient in daily life. At the same time, it can prevent and cure osteoporosis fracture and prevent refracture, which can promote the recovery of hip joint function.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9

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