补肾活血汤联合桡动脉茎突返支骨瓣转位对陈旧性手舟骨骨折患者临床影响研究

Clinical Study on the Effect of Bushen Huoxue Decoction Combined with Transposition of Radial Sacral Sacral Recurrent Bone Flap for Old Hand Scaphoid Fracture

目的:分析补肾活血汤联合桡动脉茎突返支骨瓣转位对陈旧性手舟骨骨折患者疗效影响。方法:选取2016年9月~2020年9月防城港市中医医院收治的陈旧性手舟骨骨折患者96例,随机数字表法分成两组,对照组(48例)行桡动脉茎突返支骨瓣转位术,观察组(48例)术后加服补肾活血汤,观察患者术后腕关节功能恢复情况及血清炎性因子、骨代谢指标改变状况。结果:观察组患者优良率为95.83%,高于对照组的85.42%,差异有统计学意义(P<0.05);两组患者腕关节评分较治疗前均显著上升,且观察组高于对照组,观察组骨折愈合时间低于对照组,差异均有统计学意义(P<0.05);术后1月观察组患者血清肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)及白细胞介素-6(IL-6)含量较术后1天、对照组显著降低,差异均有统计学意义(P<0.05);术后1月观察组患者血清总骨Ⅰ型前胶原氨基端延长肽(Total-PINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)含量较术后1天、对照组显著下降,骨钙素(BGP)、Ⅰ型胶原羧基端肽(PICP)含量较术后1天、对照组显著上升,差异均有统计学意义(P<0.05)。结论:补肾活血汤联合桡动脉茎突返支骨瓣转位可明显改善陈旧性手舟骨骨折患者腕关节活动功能,促进患肢更快愈合。

Objective:To analyze the effect of Bushen Huoxue Decoction combined with transposition of the radial branch of the radial artery for the treatment of old hand scaphoid fractures.Methods:Ninety-six patients with old hand scaphoid fractures who were treated in our hospital from September 2016 to September 2020 were enrolled.The patients were randomly divided into two groups.The controlled group(48 patients)underwent radial branching of the sacral process.In the observation group(48 cases),the Bushen Huoxue Decoction was added after operation,and the recovery of wrist function and the changes of serum inflammatory factors and bone metabolic indexes were observed.Results:The excellent and good rate of the observation group was 95.83%,which was higher than 85.42%of the controlled group(P<0.05).The wrist joint scores of the two groups were significantly higher than those before treatment,and the observation group was higher than the controlled group.The fracture healing time of the observation group was lower than that of the controlled group(P<0.05).The serum tumor necrosis factor-α(TNF-α)and high mobility group protein B1(HMGB1)were observed in the observation group at 1 month after operation.The content of interleukin-6(IL-6)was significantly lower than that of the controlled group at 1 day after operation(P<0.05).The serum total bone type I procollagen was observed in the observation group 1 month after operation.The content of amino-terminal prolongation peptide(Total-PINP)and type I collagen carboxy-terminal peptideβ-CTX was significantly lower than that of the controlled group 1 day after surgery,and osteocalcin(BGP)and type I collagen carboxy terminal peptide.The content of PICP was significantly higher than that of the controlled group 1 day after operation(P<0.05).Conclusion:Bushen Huoxue Decoction combined with radial branching of the sacral scapula can significantly improve the wrist function of patients with old hand scaphoid fracture and promote faster healing of the affected limb.