椎弓根钉内固定术联合复元活血汤加味治疗胸腰椎骨折临床观察

Clinical Observation of Pedicle Screw Fixation Combined with Fuyuan Huoxue Decoction in Treatment of Thoracolumbar Fractures

目的:观察椎弓根钉内固定术联合复元活血汤加味治疗胸腰椎骨折的临床观察疗效。方法:将所有入选的胸腰椎骨折患者共70例,随机分为对照组与治疗组两组,每组各35例。所有患者对症处理后均采用椎弓根针内固定术治疗。对照组术后常规应用抗生素,并口服伤科接骨片及多潘立酮片。治疗组于术后采用复元活血汤加味口服,两组疗程均为8周,并随访6个月。结果:疗程结束后,治疗组的总有效率为97.1%,对照组的总有效率为71.4%,两组相比,有统计学差异(P<0.05)。治疗组的平均肿痛消失时间、腹胀消失时间及骨折愈合时间均明显短于对照组,两组相比,有统计学差异(P<0.05)。两组术后两周双下肢感觉及肌力恢复情况比较中,治疗组总改善率明显优于对照组,两组相比,有统计学差异(P<0.05)。治疗组康复后的Cobb,s后凸角角度更接近于生理弯曲,疗效优于对照组,有统计学差异(P<0.05)。结论:椎弓根钉内固定术联合复元活血汤加味治疗胸腰椎骨折可以明显提高临床疗效,改善胃肠功能,缩短肿痛消失时间及骨折愈合时间,最大程度的恢复脊椎的生理弯曲,且无明显不良反应,值得临床推广使用。

Objective： To observe the clinical effects of the pedicle screw internal fixation combined with Fuyuan Huoxue Decoction on treating thoracolumbar fractures. Methods： All 70 patients with thoracolumbar fractures were randomly divided into control group and treatment group,35 cases in each group. All the patients were treated by pedicle screw internal fixation for symptomatic treatment. The control group used conventional antibioticsand Jiegu Tablet and Domperidone Tablets. The treatment group used Fuyuan Huoxue Decoction orally after operation. Two groups were treated for 8 weeksand 6 months of follow- up. Results： After the treatment,the total effective rate of the treatment group was 97. 1% and the total effective rate was 71. 4% in the control group（ P〈 0. 05）. Treatment group＇s average pain disappearing time,abdominal distension disappearing time and fracture healing time were significantly shorter than those of the control group and two groups had a statistically significant difference（ P〈 0. 05）. The total improvement rate of the treatment group was significantly better than that of the control group at two weeks after operation（ P〈 0. 05）. The Cobb＇s convex angle was closer to the physiological bending and the curative effect was better than that of the control group and there was statistically significant difference（ P〈 0. 05）. Conclusion： The pedicle screw internal fixation combined with Fuyuan Huoxue Decoction in the treatment of thoracic and lumbar fracture can significantly improve the clinical efficacy and the gastrointestinal function and shorten the disappearance time and healing time of swelling and pain and maximize the recovery of the spinal physiological bendingand has no obvious toxic and side effects,worthy of clinical use.