中医清阳理论指导下粗隆间骨折术后辩证施治临床疗效

发布时间：2018-11-20 16:51

【摘要】：目的:在中医清阳论治理论指导下对老年粗隆间骨折术后患者进行三期辩证治疗,观察术后早期局部疼痛缓解、肿胀的消退及后期患侧髋关节功能的恢复情况。方法:回顾性研究分析从2013年12月到2015年6月期间在湖北省中医院行手术治疗的老年粗隆间骨折患者38例,其中男性患者18例,女性患者20例,年龄在64岁-89岁,平均年龄为(71.6±4.5)岁。采用股骨近端防旋髓内钉(PFNA)手术内固定,术后给予支持对症治疗,并指导患者进行科学合理的功能锻炼,其中有21例患者在常规治疗的基础上通过中医骨折三期辨证分析治疗,对早期(1-2周内)、中期(3-5周)、后期(6-8周)的不同辨证分型,给予口服辩证中草药进行调理,并且在骨折三期辩证施治用药中始终贯穿着清阳论治理论,定为观察组。另外17例患者于术后给予一般常规治疗,未给予中草药辩证方口服,定位对照组。通过观察记录视觉模拟(VAS)疼痛评分标准、肿胀的分级以及髋关节功能Harris评分来评估临床效果。结果:观察组和对照组38例患者均获得随访,随访时间为平均随访时间6.5个月。术后按视觉模拟(VAS)疼痛评分标准进行评估,术后第3天,第5天,第7天观察组与对照组疼痛缓解的比较差异有明显统计学意义(p0.05),术后第1天,第2天观察组与对照组疼痛缓解的比较差异无明显统计学意义(p0.05)。按临床肿胀的分级标准进行评估,术后第7天观察组与对照组肿胀消退的比较差异有明显统计学意义(P0.05)。按髋关节功能Harris评分来评估,观察组和对照组的髋关节功能Harris评分优良率的比较差异有明显统计学意义(P0.05)。结论:中医清阳论治指导下中医骨折三期辩证施治更有利于缓解老年粗隆间骨折术后早期患侧髋关节的疼痛,利于患肢肿胀的消退,并且在后期更有利于极大的限度恢复患侧髋关节的功能,从而大大的提高和改善患者的生存质量,体现了中医治疗骨折疾病的优势。
[Abstract]:Objective: to observe the local pain relief, swelling regression and the recovery of hip joint function of the affected side in the early stage of operation under the guidance of the theory of clearing yang and treating the diseases in aged patients with intertrochanteric fracture. Methods: from December 2013 to June 2015, 38 patients with intertrochanteric fracture underwent surgical treatment in Hubei Provincial Hospital of traditional Chinese Medicine, including 18 male and 20 female, aged from 64 to 89 years old. The average age was (71.6 卤4.5) years. The proximal femoral intramedullary nail (PFNA) was used for internal fixation, the patients were treated with support and symptomatic treatment, and the patients were given scientific and reasonable functional exercise. On the basis of routine treatment, 21 patients were treated with three stages of TCM fracture syndrome differentiation, and different syndrome differentiation types were obtained in early (1-2 weeks), middle (3-5 weeks), and later (6-8 weeks), respectively, in the early stage (within 1-2 weeks), in the middle stage (3-5 weeks), and in the late stage (6-8 weeks). Oral dialectical Chinese herbal medicine was given, and in the third phase of fracture dialectical treatment, the theory of Qingyang treatment was always running through the observation group. The other 17 patients were given general treatment after operation, no oral Chinese herbal medicine dialectical prescription, localization control group. The clinical efficacy was evaluated by observing and recording the pain score of visual analog (VAS), the grade of swelling and the Harris score of hip function. Results: 38 patients in the observation group and the control group were followed up for an average of 6.5 months. The pain relief of the observation group was significantly different from that of the control group on the 3rd, 5th, 7th day after operation (p0.05), and on the first day after operation, the pain relief was significantly different between the observation group and the control group (p0.05). There was no significant difference in pain relief between the observation group and the control group on the second day (p 0.05). According to the grading criteria of clinical swelling, there was significant difference between the observation group and the control group in the regression of swelling on the 7th day after operation (P0.05). According to the hip function Harris score evaluation, the observation group and the control group hip function Harris score excellent and good rate difference was statistically significant (P0.05). Conclusion: the third stage dialectical treatment under the guidance of the treatment of clearing yang in TCM is more helpful to alleviate the pain of hip joint in the early stage of intertrochanteric fracture in the elderly and to reduce the swelling of the affected limb. And in the later stage is more conducive to greatly restore the affected hip joint function, thus greatly improve and improve the quality of life of patients, reflecting the advantages of TCM treatment of fracture disease.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

【相似文献】