应力刺激联合当归补血汤治疗下肢骨干粉碎性骨折的临床研究

Effects of Stress Stimulation combined with Danggui Buxue Decoction for the Treatment of Comminuted Shaft Fracture of Lower Extremity:A Randomized Controlled Clinical Study

目的：评价应力刺激联合当归补血汤治疗下肢骨干粉碎性骨折的临床疗效。方法：选择120例符舍下肢骨干粉碎性骨折并均行内固定手术治疗的患者，随机分为3组：叩击组（骨应力刺激仪）、中药组（当归补血汤）与联合组（当归补血汤联合骨应力刺激仪）。术后对患肢疼痛、肿胀程度及负重情况、骨痂生长情况及骨折愈合时间进行评价，并分析6个月时骨折延迟愈合率及12个月时骨折不愈合率。结果：患者随访时间为11～17个月（平均13．8个月）。术后1周及3个月时中药组与联合组在肿痛改善方面均明显优于叩击组（P〈0．017）。术后3、6及12个月时，叩击组与联合组的骨痂生长及患肢负重情况均优于中药组（P〈0．017）。叩击组、中药组及联合组的临床愈合时间分别为（88．32±3．61）d、（98．26±6．24）d、（82．65±3．26）d；骨折延迟愈合率分别为7．5％、25．0％、5．0％；骨折不愈合率分别为12．5％、7．5％、2．5％。结论：早期运用骨应力刺激仪联合当归补血汤治疗下肢骨干粉碎性骨折术后的患者，可加快消除患肢肿胀并减轻术后患肢疼痛，促进下肢骨折的愈合，降低骨折延迟愈合及不愈合率。

Objective：To evaluate the clinical efficacy of stress stimulation combined with Danggui Buxue Decoction for the treatment of cornminuted shaft fracture of lower extremity. Methods： One hundred and twenty patients with comminuted shaft fracture of lower extremity were randomly divided into stress stimulation group （SS）, Danggui Buxue Decocion group （DBD） and DBD combined with stress stimulation group （Combined）. Pain, swelling degree, full weight bearing as well as the condition of the callus and healing time of the affected limb were separately evaluated after the operation. The rates of delayed union at 6th month and non--union at 12th month were analyzed. Results：All patients were followed up for 12-16 months （13.5 months on average）. The improvements in pain and limb swelling degrees in DBD and Combined groups were more significant than those in the SS group （P〈0. 017） at the 1st week and 3 th month after surgery. Condition of the cal- lus, the healing time, full weight bearing time, rates of delayed union and non-union in the SS and Combined groups were significantly better than those in the DBD group at the 3 th, 6 th, 12 th month （P〈0. 017）. The fracture healing time in the SS, DBD and Combined groups were （88. 32±3.61）d, （98.26±6.24）d, and （82. 655±3.26）d respectively. The rates of delayed union were 7.5%, 25.0%, 5.0% and rates of non-union were 12.5%, 17.5%, and 2.5% respectively. Conclu- sion：Early-stage stress stimulation combined with DBD is an effective way to reduce the pain and swelling, promote fracture healing in treating the comminuted shaft fracture of lower extremity.