跌打养营汤联合外固定架治疗老年股骨髁间骨折随机平行对照研究

The Traumatic Yangying Decoction(跌打养营汤) combined with External Fixator for Treatment of Femoral Intercondylar Fracture Randomized Controlled Study

[目的]观察跌打养营汤联合外固定架治疗老年股骨髁间骨折疗效。[方法]使用随机平行对照方法,将50例住院患者按就诊日期的单双号分为两组。对照组25例院内组合式外固定架,交叉克氏针将股骨髁间骨块固定,斜型骨块使用拉力螺钉固定,股骨近端拧入2枚螺纹针,用连接杆和半环弓将螺钉和克氏针连接起来,拧紧所有螺母。治疗组25例跌打养营汤,桃仁、红花各15g,土鳖虫2g,骨补脂10g,自然铜、当归、熟地各15g,甘草20g。水煎500mL,2次/d,口服;固定治疗同对照组。连续治疗20d为1疗程。观测临床症状、下地负重时间、骨折愈合时间、术后疼痛,关节活动度、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组痊愈5例,显效13例,有效7例,无效0例,总有效率100%。对照组痊愈4例,显效10例,有效9例,无效2例,总有效率86.67%。临床疗效两组间无明显差异(P>0.05)。下地负重时间、术后疼痛时间、关节活动度治疗组改善优于对照组(P<0.05),骨折愈合时间两组间无明显差异(P>0.05)。[结论]跌打养营汤联合外固定架治疗老年股骨髁间骨折,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the clinical effect by using traumatic Yangying decoction combined external fixator in the treatment for fracture of femoral condyle among the elderly patients. [Methods] 50 patients were randomly divided into single and double group according to their treatment date using the method of randomized controlled trial. 25 cases in the control group is treated by the combination of external fixator, the Kirschner needle was crossed between femoral condyle fracture fixation, inclined bones was fixed by tension screws, proximal femoral was screwed in 2 pieces of thread needle and then linked the needle and the screw by the link rod and half ring bow, finally screwed up all the nuts inside. 25 cases in the treating group was treated by traumatic Yangying decoction which is consisted of 15g of peach kernel, 15g of safflower, 2g of cockroach, 10g of bone supplement, 15g of natural copper, angelica, rehmannia and 20g of liquorice. Boiled with water for 500 ml,twice a day for oral administration. Treatment for fixing is same as control group. Continiousely treating in 20 days for one course. Obsering the clinical symptoms, lower weight bearing time, fracture healing time,postoperative pain, joint mobility, adverse reactions.Determine the efficacy by continuous treatment for 2 courses. [Results] In the treatment group, 5 cases were cured, 13 cases were markedly effective, 7 cases were effective, 0 cases were ineffective, the total effective rate was 100%. In the control group, 4 cases were cured, 10 cases were markedly effective, 9 cases were effective, 2 cases were ineffective, the total effective rate was 86.67%. There was no significant difference in clinical efficacy between the two groups （P〉0.05）. The treatment group was better than the control group （P〈0.05）, and there was no significant difference between the two groups （P〉0.05） in the treatment group after the time of loading, the time of postoperative pain and the activity of the joint. [Conclusion] The curative effect is satisfied by traumatic Yangying decoction combined with external fixator for treatment of femoral intercondylar fracture, no serious adverse reactions and it is worthy for promotion.