微创手术联合自拟消肿化瘀汤、接骨续筋汤及壮骨强筋汤治疗肱骨近端骨折的疗效观察

Therapeutic effects on proximal humeral fractures treated with minimally invasive surgery,the self-prepared xiaozhong huayu decoction,jiegu xujin decoction and zhuangu qiangjin decoction

目的观察微创手术联合自拟消肿化瘀汤、接骨续筋汤及壮骨强筋汤治疗肱骨近端骨折的疗效。方法选取2014年8月至2016年8月期间收治的肱骨近端骨折患者146例,随机分为治疗组(采用微创手术联合自拟消肿化瘀汤、接骨续筋汤及壮骨强筋汤治疗)和对照组(采用微创手术治疗),各73例。采用欧美肩关节评分系统Constant-Murley(C-M)对治疗后1、3、6、12个月的肩关节功能进行评价,观察骨折愈合情况,统计骨折愈合时间。结果治疗后1个月,治疗组的C-M评分与对照组比较差异无统计学意义(P>0.05),治疗后3、6、12个月的C-M评分治疗组高于对照组,两组之间比较差异有统计学意义(P<0.05)。治疗组的临床愈合时间为(49.8±1.6)d,低于对照组的(64.6±3.5)d,两组之间比较差异有统计学差异(P<0.05)。治疗组疗效评分优者高于对照组,良、一般和差评分者均低于对照组,两组比较差异有统计学意义(P<0.05)。结论在治疗肱骨近端骨折过程中,微创手术联合自拟消肿化瘀汤、接骨续筋汤及壮骨强筋汤能促进骨折愈合,其疗效优于微创手术治疗,值得临床推广应用。

Objective To observe the therapeutic effects on proximal humeral fractures treated with minimally invasive surgery,the self-prepared xiaozhong huayu decoction,jiegu xujin decoction and zhuangu qiangjin decoction. Methods From August 2014 through to August 2016,146 patients of proximal humeral fractures were collected and randomized into a treatment group(the combined treatment with minimally invasive surgery,the self-prepared xiaozhong huayu decoction,jiegu xujin decoction and zhuangu qiangjin decoction） and a control group(minimally invasive surgery）,73 cases in each one. Constant-Murley(C-M） scale was adopted to evaluate the shoulder joint function in 1,3,6 and 12 months after treatment. The healing condition was observed and the healing time was analyzed. Results After 1-month treatment,the difference was not significant in the C-M score between the treatment group and the control group(P 〈 0. 05）. In 3,6 and12 months after treatment,the C-M scores in the treatment group were higher than the control group,indicating the significant difference(P 〈 0. 05）. The clinical healing time(49. 8 ± 1. 6） d in the treatment group was lower than the control group(64. 6 ± 3. 5） d,indicating the significant difference in comparison(P 〈 0. 05）. the numbers with the excellent grade of the therapeutic effects in the treatment group were higher than the control group,the numbers with the good,fair and poor grades were lower than the control group,indicating the significant difference in comparison between the two groups(P〈 0. 05）. Conclusion In the treatment of proximal humeral fractures,the combined treatment with minimally invasive surgery,the self-prepared xiaozhong huayu decoction,jiegu xujin decoction and zhuangu qiangjin decoction promotes bone healing and the therapeutic effects are better than minimally invasive surgery. This combined therapy deserves to be promoted in clinical application.