基于倾向性评分匹配法探讨血府逐瘀汤对老年股骨粗隆间骨折患者PFNA术后康复的影响

The Effect of Xuefu Zhuyu Decoction on the Rehabilitation of Elderly Patients with Intertrochanteric Fracture of the Femur after PFNA Based on the Propensity Score Matching Method

目的:基于倾向性评分匹配法探讨血府逐瘀汤对老年股骨粗隆间骨折患者PFNA术后康复的影响。方法:回顾性分析140例行防旋股骨近端髓内钉(proximal femoral nail antirotation,PFNA)手术治疗的股骨粗隆间骨折患者,使用SPSS 22.0进行倾向性匹配评分匹配分为观察组(血府逐瘀汤治疗)和对照组(常规支持治疗)各50例,比较两组术后相关康复治疗指标,并对两组用药安全性进行评价分析。结果:观察组证候积分,术后第5、7天患肢肿胀程度,VAS评分,术后第3、7天血清白细胞及C反应蛋白水平均明显低于对照组(P<0.05),而术后第7天血清血红蛋白、红细胞压积水平和术后1个月Harris评分均显著高于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:PFNA联合血府逐瘀汤内服治疗对老年股骨粗隆间骨折术后康复恢复效果确切,可显著减轻患肢肿胀程度,在更短时间内缓解患者局部疼痛,减少术后隐性失血,提升Harris评分,快速恢复髋关节功能,且不增加患者用药安全性风险。

Objective:To investigate the influence of Xuefu Zhuyu decoction on postoperative rehabilitation of PFNA in elderly patients with intertrochanteric fracture of the femur based on the propensity score matching method.Methods:All 140 patients undergoing proximal femoral nail antirotation(PFNA)surgery were retrospectively analyzed,they were divided into 50 cases each in the observation group(Xuefu Zhuyu decoction)and the control group(conventional supportive therapy)by propensity score matching using SPSS 22.0,to compare the two groups with respect to the relevant rehabilitation indexes,to evaluate and analyze the safety of medication in the two groups.Results:The syndrome scores,the degree of swelling of the affected limbs on the fifth and seventh days after operation,the VAS score,the levels of serum leukocyte and C-reactive protein on the third and seventh days after operation of the observation group were significantly lower than those of the control group(P<0.05),while the levels of serum hemoglobin and erythrocyte pressure volume on the seventh day after operation and the Harris score at one month after operation were significantly higher than those of the control group(P<0.05);when comparing the incidences of adverse reactions of the two groups,the differences were not statistically significant(P>0.05)Conclusion:PFNA combined with oral administration of the decoction can obtain definite effects in the rehabilitation of the patients after the operation,significantly reduce the degree of swelling of the affected limbs,relieve the local pain of patients in a shorter period of time,reduce the postoperative occult blood loss,improve the Harris score,and quickly restore the function of the hip joint,without increasing the risk of the safety of patients'use of the medication.