仙灵骨葆胶囊联合冲击波治疗下肢长骨骨不连的临床观察

发布时间：2018-06-23 04:50

本文选题：冲击波 + 仙灵骨葆胶囊　；参考：《福建中医药大学》2016年硕士论文

【摘要】：目的：观察仙灵骨葆胶囊联合冲击波治疗下肢长骨骨不连的临床疗效,为下肢长骨骨不连治疗提供临床依据。方法：纳入2014年2月至2015年2月期间在我院治疗的符合标准的60名下肢长骨骨不连患者,按入院时间先后顺序对应随机数字表,随机分为冲击波组和联合组(仙灵骨葆胶囊联合冲击波),每组30名患者。其中男性34例,女性26例,平均年龄为38.53±6.12(24-50岁),采用前瞻性研究方法。冲击波组采用冲击波治疗仪治疗,在骨不连区域骨折线上选3个点作为基准点,冲击治疗探头垂直治疗部位,每个冲击点1000次,避开内固定物侧治疗,同时避开大血管及神经密集区。胫骨冲击能量选择为3.5 bar,股骨冲击能量选择为4.0 bar,频率为6Hz,每周治疗一次,总共治疗4次。联合组在按冲击波治疗方法治疗的同时口服仙灵骨葆胶囊(0.5g／粒),一次3粒,一日2次。治疗时间为1个月。分别于治疗后的3个月、6个月、12个月时记录各组患者的VAS评分、患肢负重情况评分、X线骨痂Lane-Sandhu评分、骨不连愈合时间,于治疗后12个月记录不愈合数, 采用SPSS18.0软件进行统计学分析。结果：平均随访时间为12.5个月(12-14个月)。在随访期间内,冲击波组、仙灵骨葆胶囊联合冲击波组均无血管神经损伤等不良反应事件发生：其中共有3例患者采用冲击波治疗中出现轻微酸痛,适应一周后酸痛缓解,有5例患者口服仙灵骨葆胶囊出现便秘,予番泻叶10g泡服2次而缓解。治疗后3个月时冲击波组及仙灵骨葆胶囊联合冲击波组的VAS疼痛评分无统计学差异(P0.05),治疗后6个月及12个月两组的VAS疼痛评分均有统计学差异(P0.05)。冲击波组和仙灵骨葆胶囊联合冲击波组在治疗后3个月、6个月及12个月时患肢负重情况均有差异,仙灵骨葆胶囊联合冲击波组的患肢负重情况评分均优于冲击波组(P0.05)。仙灵骨葆胶囊联合冲击波组在治疗后3个月、6个月及12个月时骨痂生长均优于冲击波组(P0.05)。在治疗12个月后骨不连不愈合率方面冲击波组高于仙灵骨葆胶囊联合冲击波组(PO.05)。仙灵骨葆胶囊联合冲击波组在临床愈合时间优于冲击波组(PO.05)。结论：仙灵骨葆胶囊联合冲击波治疗下肢长骨骨不连患者,可以缓解患肢的疼痛,促进骨折的临床愈合,联合组的作用优于单纯使用冲击波组,因此,仙灵骨葆胶囊联合冲击波可作为治疗下肢长骨骨不连的一种治疗方法。
[Abstract]:Objective: to observe the clinical effect of Xianling Gubao capsule combined with shock wave in the treatment of lower extremity long bone nonunion and to provide clinical basis for the treatment of lower extremity long bone nonunion. Methods: from February 2014 to February 2015, 60 patients with lower extremity long bone nonunion who were treated in our hospital from February 2014 to February 2015 were included in a random digital table according to the order of admission time. They were randomly divided into shock wave group and combined group (Xianling Gubao capsule combined shock wave) with 30 patients in each group. There were 34 males and 26 females with an average age of 38.53 卤6.12 (24-50 years). The shock wave group was treated with shock wave therapy instrument. Three points were selected as reference points on fracture line of nonunion area. The perpendicular treatment site of shock therapy probe was used for 1000 times, avoiding internal fixation side treatment. At the same time avoid large vessels and nerve dense areas. The impact energy of tibia and femur was 3.5 bar. and 4.0 bar. the frequency was 6Hz. once a week for a total of 4 times. In the combined group, Xianling Gubao capsule (0.5g/) was taken orally at the same time as shock wave therapy, 3 capsules once a day, 2 times a day. The treatment time was 1 month. VAS scores, limb load scores and Lane-Sandhu score of callus were recorded at 3 months, 6 months and 12 months after treatment, respectively. The number of nonunion was recorded 12 months after treatment. SPSS 18.0 software was used for statistical analysis. Results: the average follow-up time was 12.5 months (12-14 months). During the follow-up period, there were no adverse events such as vascular and nerve injury in shock wave group, Xianling Gubao capsule combined shock wave group. Five patients with constipation were treated with 10 g Senna leaf and relieved by taking Xianling Gubao capsule. There was no significant difference in VAS pain score between the shock wave group and Xianling Gubao capsule combined shock wave group 3 months after treatment (P0.05), but there was significant difference in VAS pain score between the two groups at 6 months and 12 months after treatment (P0.05). There were significant differences between the shock wave group and the Xianling Gubao capsule combined shock wave group at 3 months, 6 months and 12 months after the treatment, and the score of the affected limb weight in the Xianling Gubao capsule combined shock wave group was better than that in the shock wave group (P0.05). The callus growth of Xianling Gubao capsule combined with shock wave group was better than that of shock wave group at 3 months, 6 months and 12 months after treatment (P0.05). After 12 months of treatment, the nonunion rate of bone nonunion in shock wave group was higher than that in Xianling Gubao capsule combined shock wave group (PO. 05). The healing time of Xianling Gubao capsule combined with shock wave group was better than that of shock wave group (PO. 05). Conclusion: the combination of Xianling Gubao capsule and shock wave can relieve the pain of the affected limb and promote the clinical healing of the fracture. The combined group is superior to the shock wave group. Xianling Gu Bao capsule combined with shock wave can be used as a treatment method for lower extremity bone nonunion.
【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】：2016
【分类号】：R274.9

【相似文献】