补肾活血汤对老年股骨转子间骨折患者术后康复的影响

发布时间：2018-11-02 15:52

【摘要】：目的:通过临床研究,观察补肾活血汤对肾虚血瘀型老年股骨转子间骨折患者术后康复的临床疗效。方法:选取常州市中医医院2015年8月～2016年2月收治的52例老年股骨转子间骨折患者按入院先后顺序,采用随机数字表分组法分为观察组(26例)和对照组(26例),所有患者均由同一组医师行闭合复位后股骨近端防旋髓内钉固定术(PFNA),术后常规予抗血栓、预防感染及口服钙片等营养支持治疗。观察组在常规治疗基础上加服自拟补肾活血汤,每日一剂,疗程为24周。观察对比两组患者治疗前、术后特定时间的血清钙(Ca)、磷(P)、碱性磷酸酶(ALP)、疼痛、骨密度(BMD)、髋关节功能Harris评分。结果:两组骨代谢生化指标(Ca、P、ALP)组间比较,术前及术后1、2周均无统计学差异(P0.05)。两组患者治疗前VAS评分、腰椎BMD值接近(P0.05),术后1周两组VAS评分无统计学差异(P0.05),术后2周观察组VAS评分明显优于对照组(P0.05);术后12周两组腰椎BMD值无统计学差异(P0.05),术后24周观察组腰椎BMD值明显优于对照组(P0.05);两组术前及术后2、12、24周髓关节功能Harris评分比较,术前及术后2周、12周无统计学差异(P0.05),术后24周,有统计学差异(P0.05),观察组优于对照组。两组术后24周髋关节功能Harris评分,观察组优良率为88.46%,对照组优良率为65.38%,组间比较(P0.05),观察组优于对照组。结论:口服补肾活血汤治疗老年股骨转子间骨折疗效肯定,能减轻骨折患者术后疼痛症状,改善骨代谢,增强BMD,促进髋关节功能的恢复。
[Abstract]:Objective: to observe the clinical effect of Bushen Huoxue decoction on postoperative rehabilitation of senile patients with intertrochanteric fracture of femur due to kidney deficiency and blood stasis. Methods: 52 elderly patients with intertrochanteric fracture of femur were selected from Changzhou Hospital of traditional Chinese Medicine from August 2015 to February 2016. According to the order of admission, they were divided into observation group (n = 26) and control group (n = 26). All the patients were treated by the same group of doctors after closed reduction and intramedullary nail fixation of the proximal end of femur with antithrombotic therapy, prevention of infection, oral calcium tablets and other nutritional support therapy after (PFNA),. On the basis of routine treatment, the observation group was treated with Bushen Huoxue decoction once a day for 24 weeks. The pain of serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP),) and bone mineral density (BMD),) hip function Harris score were observed and compared between the two groups before and after treatment. Results: there was no significant difference in bone metabolism biochemical index (Ca,P,ALP) between the two groups before and 1 week after operation (P0.05). The VAS score of the two groups before treatment, lumbar BMD value was close (P0.05), there was no significant difference in the VAS score between the two groups at 1 week after operation (P0.05). The VAS score in the observation group was significantly better than that in the control group at 2 weeks after operation (P0.05). There was no significant difference in lumbar BMD between the two groups at 12 weeks after operation (P0.05). The BMD value of lumbar spine in observation group was significantly better than that in control group at 24 weeks after operation (P0.05). There was no significant difference in Harris score between the two groups before and after 2 weeks (P0.05) and 24 weeks after operation (P0.05), and the observation group was superior to the control group. The Harris score of hip function was 88.46 in the observation group and 65.38in the control group 24 weeks after operation. The comparison between the two groups (P0.05) showed that the observation group was superior to the control group. Conclusion: oral Bushen Huoxue decoction is effective in treating senile femoral intertrochanteric fracture. It can relieve postoperative pain symptoms, improve bone metabolism and enhance BMD, to promote hip joint function recovery in elderly patients with femoral intertrochanteric fracture.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9

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