桡骨远端骨折采用小夹板外固定、内外用中药治疗对骨代谢、骨折愈合及炎性因子的影响

The Distal Fracture of the Radial Distal of the Treatment on Bone Metabolism and Fracture Healing and Inflammatory Factors of Traditional Chinese Medicine

目的探讨小夹板外固定配合中药外敷与内服治疗对桡骨远端骨折疗效、骨代谢、骨折愈合及炎性因子的影响。方法桡骨远端骨折患者75例,随机分为两组,对照组32例,观察组43例。对照组采用小夹板外固定配合中药外敷,观察组在对照组的基础上加用中药内服。入院第1天及治疗30天后晨起抽静脉血检测血清骨代谢、骨折愈合及炎性因子的指标水平。根据Gartland-Werlkey腕关节功能评价标准评价腕关节功能恢复情况。应用SPSS20.0软件,所获数据采用方差分析、t检验和2检验。结果对照组治疗前后维生素D_3、白介素-1、白介素-6、肿瘤坏死因子-α水平变化比较,P<0.0005。观察组治疗前后维生素D_3、白介素-1、白介素-6、肿瘤坏死因子-α水平变化比较,P<0.0005。两组治疗后维生素D_3、白介素-1、白介素-6、肿瘤坏死因子-α水平变化比较,P<0.0005。对照组治疗前后I型胶原交联羧基末端肽、Ⅱ型胶原交联羧基末端肽、抗酒石酸酸性磷酸酶5b、核转录子-κB受体活化因子、核转录子-κB受体活化因子配体水平比较,P<0.0005。观察组治疗前后I型胶原交联羧基末端肽、Ⅱ型胶原交联羧基末端肽、抗酒石酸酸性磷酸酶5b、核转录子-κB受体活化因子、核转录子-κB受体活化因子配体水平比较,P<0.0005。两组治疗后I型胶原交联羧基末端肽、Ⅱ型胶原交联羧基末端肽、抗酒石酸酸性磷酸酶5b、核转录子-κB受体活化因子、核转录子-κB受体活化因子配体水平比较,P<0.0005。对照组治疗前后骨硬化素、骨保护素、骨钙素、I型前胶原羧基端肽水平变化比较,P<0.0005;对照组治疗前后ALP水平变化比较,P<0.05。观察组治疗前后骨硬化素、碱性磷酸酶、骨保护素、骨钙素、I型前胶原羧基端肽水平变化比较,P<0.0005。两组治疗后骨硬化素、碱性磷酸酶、骨保护素、骨钙素、I型前胶原羧基端肽水平变化比较,P<0.0005。对照组优良率为68.75%,观察组优良率为81.39%。两组比较,P>0.05。结论桡骨远端骨折伤后血清学开始升高,炎性因子10天恢复正常血清骨代谢与骨愈合指标骨折后开始升高,30天达到高峰,以后逐渐下降,90天时基本恢复到伤前;中药内服、外敷恢复较快。

Objective To investigate the small splint external fixation with traditional Chinese medicine external treatment with internal and curative effect of distal radius fractures, bone metabolism and fracture healing and the influence of inflammatory cytokines. Methods 75 patients were randomly divided into two groups and 32 in the control group. In the control group, a control group was applied to the control group. The serum bone metabolism, fracture healing and inflammatory factor index were detected in the morning after the first day of hospitalization and 30 days after treat- ment. According to the gartland-werlkey wrist function evaluation standard, the function of wrist joint function is evaluated. Using SPSS20.0 software, the data obtained using variance analysis, t test and Z2 test. Results The control group was compared with the variation of D3, IL-1, IL-6 and tnf-alpha, P〈0.0005. The observed group was compared with the variation of D3, IL-1, IL-6, tnf-alpha, and P〈0.0005. The two groups of treated patients were compared with D3, IL-1, IL-6, tnf-alpha, and P〈0.0005. The control group before and after treatment of CTX-I, CTX- II, TRACP5b, RANK, RANKL level comparison, P〈0.0005. Observation group before and after treatment of CTX-I, CTX- II, TRACP5b, RANK, RANKL level comparison, P〈0.0005. Two groups after treatment CTX-I, CTX- II, TRACP5b, RANK, RANKL level comparison,P〈0.0005. In the control group, the comparison of SO, OPG, BGP, and PICP was compared. The comparison of ALP levels in the control group was compared with P〈0.05. The observed group treatment was compared to the changes in the ALP, OPG, BGP, and PICP, P〈0.0005. Two groups of treatments were compared with the ALP, OPG, BGP, and PICP, P〈0.0005. The control group had a good rate of 68.75%. The optimal ratio of observation group was 81.39%. Two groups, P〉0.05. Conclusions The distal radius fractures serological began to rise after injury, inflammato- ry factor 10 days normal serum bone metabolism and bone after the index fracture healing began to rise, peaking in 30 days, gradually decline, after 90 days basically recovered to the front of the injury; The internal medicine of traditional Chinese medicine and the application of external compresses are quick.