血府逐瘀汤联合肱三头肌侧方入路术对肱骨髁间骨折患者肘关节功能、血清因子水平的影响

Influence of Xuefu Xiaozheng Decoction Combined with Triceps Lateral Approach on the Elbow Joint Function and the Level of Serum Factors in Patients with Intercondylar Fractures of Humerus

目的:观察血府逐瘀汤联合肱三头肌侧方入路术对肱骨髁间骨折患者肘关节功能、血清因子水平的影响。方法:将74例肱骨髁间骨折患者随机分为对照组和观察组各37例,对照组给予肱三头肌侧方入路术治疗,观察组在对照组治疗的基础上加用血府逐瘀汤加减治疗,两组均连续治疗1个月,比较两组患者临床疗效,评价治疗前后中医证候积分等。结果:观察组有效率为91.9%,优于对照组的有效率70.3%;治疗组中医证候评分显著低于对照组,差异有统计学意义(P<0.05);观察组的血清因子VEGF、BMP-2、IGF-I水平均显著高于对照组,差异有统计学意义(P<0.05);观察组骨折平均愈合时间较对照组缩短,其并发症较对照组更少,差异有统计学意义(P<0.05)。结论:血府逐瘀汤加味联合肱三头肌侧方入路术利于改善肱骨髁间骨折患者的临床症状,提高肘关节功能,促进骨折愈合,减少并发症,其机制与提高血清因子VEGF、BMP-2、IGF-I水平有一定的相关性。

Objective： To observe the influence of Xuefu Xiaozheng Decoction combined with triceps lateral approach on the elbow joint function and the level of serum factors in patients with intercondylar fractures of humerus. Methods ： Totally 74 patients with intercondylar fractures of humerus were randomized into control group and observation group, with 37 cases in each group; control group were given triceps lateral approach treatment while observation group were added with Modified Blood Stasis Expelling De- coction,1 month of treatment for both groups. The clinical effects,TCM symptom seores in both groups before and after the treat- ment were compared. Results： The effective rate was 91.9% in observation group,better than 70.3% in control group. The TCM symptom score in treatment group was markedly lower than that in control group ; the difference had statistical significance （ P 〈 0.05 ）. The elbow function ＇after surgery in observation group was obviously better than that in control group; the excellent and good effect was 94.6%, significantly higher than the 73.0% in control group, and the difference had statistical significance （ P 〈 O. 05 ）. The levels of VEGF, BMP-2 and IGF-I in observation group were apparently higher than these in control group ; the differ- once had statistical significance （P 〈0.05 ）. The average healing time of the fracture in observation group got greatly shortened and the complications were less when compared with control group ; the difference was significant （ P 〈 0. 05 ）. Conclusion ： Xuefu Xiaozheng Decoction combined with triceps lateral approach can improve the clinical symptoms ,enhance the elbow joint function, promote the healing of the fracture and reduce the complications, and the mechanism has certain relation swith the enhancement of the levels of VEGF,BMP-2 and IGF-I in patients with intercondylar fractures of humerus.