闭合复位交锁髓内钉内固定联合仙灵骨葆胶囊治疗儿童胫腓骨骨折的机制研究

The mechanism study on Xianling Gubao Jiaonang combined with closed reduction and interlocking intramedullary nail fixation in the treatment of children fracture of tibia and fibula

目的研究仙灵骨葆胶囊联合闭合复位交锁髓内钉内固定治疗儿童胫腓骨骨折的机制。方法选取我院收治的84例胫腓骨骨折患儿,随机分为治疗组和对照组,各42例。对照组采用闭合复位交锁髓内钉内固定治疗,治疗组在对照组治疗方法的基础上给予仙灵骨葆胶囊口服,2周后观察2组的细胞因子水平和血液流变学相关指标。结果治疗后2组抗酒石酸盐酸性磷酸酶异构体5b(TRACP-5b)、人胶原交联羧基末端肽(CTX)显著降低,C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、高迁移率族蛋白B1(HMGB-1)、骨碱性磷酸酶(BALP)和骨钙素(BGP)显著升高,与同组治疗前比较,差异均有统计学意义(P<0.05),且治疗组降低或升高幅度大于对照组(P<0.05)。治疗后2组血浆黏度(PV)、全血黏度高切(WHV)、全血黏度中切(WMV)和全血黏度低切(WLV)显著降低,血小板计数(PLT)、纤维蛋白原(FIB)和D-二聚体(D-D)显著升高,与同组治疗前比较,差异均有统计学意义(P<0.05),且治疗组降低或升高幅度大于对照组(P<0.05)。结论仙灵骨葆胶囊联合闭合复位交锁髓内钉内固定治疗儿童胫腓骨骨折,能够明显抑制患儿的炎症水平,改善血液循环,促进骨折愈合,且效果优于单纯闭合复位交锁髓内钉内固定治疗。

Objective To study the mechanism of Xianling Gubao Jiaonang combined with closed reduction and interlocking intramedullary nail fixation in the treatment of children fracture of tibia and fibula. Methods 84 cases of children with fracture of tibia and fibula were selected and randomly divided into control group and therapy group with 42 patients in each group. The control group was treated with closed reduction and interlocking intramedullary nail fixation, while the therapy group was treated with Xianling Gubao Jiaonang combined with closed reduction and interlocking intramedullary nail fixation. Cell factors and hematological parameters were com- pared after 2 weeks therapy. Results After treatment, TRACP-5b and CTX of two groups decreased significantly than these before treatment （P〈0.05） ,while BALP, BGP, CRP, TNF-α, PCT and HMGB-1 of two groups increased significantly than before treatment （P〈0.05） , and the degree of improvement and reduction in therapy group were higher than these in control group （P〈0.05）. PV,WHV, WMV and WLV of two groups after treatment dropped obviously,while PLT,FIB and D-D increased significantly with significant differences（P〈0.05）, the degree of improvement and reduction in therapy group were higher than these in control group（ P〈0.05 ）. Conclusion Xianling Gubao Jiaonang combined with closed reduction and interlocking intramedullary nail fixation can inhibit the inflammatory reaction in children with fracture, perfect the blood circulation, and promote the fracture healing, which has a better effect on children fracture of tibia and fibula than therapy of closed reduction and interlocking intrarnedullary nail fixation.