自拟接骨促愈汤联合等速运动训练在肘关节恐怖三联征患者康复中的应用效果

Application effect of Jiegucuyu decoction combined with isokinetic training in the rehabilitation of patients with terrible triad of the elbow

目的观察自拟接骨促愈汤联合等速运动训练在肘关节恐怖三联征患者康复中的应用效果。方法将96例肘关节恐怖三联征患者随机分为观察组48例和对照组48例,2组入院后均行切开复位内固定术,对照组术后给予等速运动训练,观察组在对照组治疗基础上给予自拟接骨促愈汤口服治疗,6周为1个疗程,2组均治疗2个疗程。观察2组治疗前后肘关节屈曲、伸直、前臂旋前、前臂旋后、关节屈伸范围及肘关节Mayo功能评分变化情况,统计2组治疗后上肢功能的Fugl-Meyer评分(FMA)以及日常生活活动能力的Barthel指数(BI)评分,并记录2组临床结局及并发症发生情况。结果 2组治疗后6周、12周的肘关节屈曲、伸直、前臂旋前、前臂旋后、关节屈伸范围均较治疗前显著改善(P均<0.05),观察组改善情况优于对照组(P均<0.05);2组治疗后6周、12周肘关节Mayo功能评分中的疼痛、屈伸运动幅度、日常生活功能、关节稳定性及总分均升高(P均<0.05),观察组明显高于对照组(P均<0.05);观察组治疗后上肢功能的FMA评分、BI评分均显著优于对照组(P均<0.05),骨折愈合时间、住院费用、住院时间、并发症发生率均低于对照组(P均<0.05)。结论自拟接骨促愈汤联合等速运动训练能够促进肘关节恐怖三联征患者术后的康复进程,促进关节愈合并改善肘关节功能,提高上肢功能及日常生活活动能力,并能降低术后并发症发生率。

Objective It is to observe the application effect of Jiegucuyu decoction combined with isokinetic training in the rehabilitation of patients with terrible triad of the elbow. Methods 96 patients with terrible triad of the elbow were randomly di-vided into observation group （？i=48） and control group （= 48 ）,both groups were treated with open reduction and internal fixation after admission, additionally the control group was given isokinetic training after operation, while the observation group was given isokinetic training plus Jiegucuyu decoction orally. 6 weeks as one treatment course, both groups were treated for 2 courses. The changes of motion range of elbow flexion, straighten, forearm pronation,forearm supination,and Mayo function scores before and after treatment were observed in both groups, Fugl-Meyer score （FMA） of upper limb function and Barthel index （ BI） score of ability of daily life activities were evaluated after treatment, and the clinical outcomes and occurrence of complications of two groups were recorded. Results After treatment for 6 weeks,12 weeks,the motion range of elbow flexion,straighten,forearm pronation,forearm supination were improved significantly compared with that before treatment in both groups, and the improvements in observation group were better than that in control group （F 〈0.05） ; Mayo function scores of elbow joint such as pain, movement range, daily life function, joint stability and total score were significantly increased（F 〈 0.05） , and the increase in observation group was more significant than that in control group （ P 〈 0 . 05 ） . After treatment FMA scores, BI scores of upper limb function were significantly better while fracture healing time, hospitalization costs, length of hospital stay, complication rates were lower or shorter in observation group than that in control group （F 〈0.05） . Conclu-sion Jiegucuyu decoction combined with isokinetic training can promote postoperative rehabilitation process, promote healing and improve the function of elbow joint, improve the ability of upper limb function and daily life activities, and can reduce the incidence of postoperative complications in patients with terrible triad of the elbow.