活血接骨汤联合微创植骨治疗胫骨中下段骨折不愈合临床观察

Clinical Observation on Huoxue Jiegu Decoction Combined with Minimally Invasive Bone Implantation in the Treatment of Lower Segment Fracture in Tibia

目的探讨活血接骨汤联合微创植骨治疗胫骨中下段骨折不愈合疗效及对血清C反应蛋白(CRP)和白细胞介素-6(IL-6)的影响。方法选取2013年4月—2018年8月收治的64例胫骨中下段骨折不愈合患者进行研究,由随机数字表法分为对照组和观察组,每组32例,对照组给予微创植骨后应用外固定架固定治疗,并给予牡蛎碳酸钙胶囊;观察组在对照组的基础上联合活血接骨汤,2组患者均治疗一个月后随访,比较2组患者的临床疗效及对血清中炎症因子的变化影响。结果观察组总有效率(90. 63%)明显高于对照组(68. 75%),差异具有统计学意义(χ~2=4. 730,P=0. 030);治疗后,2组患者血清CRP、TNF和IL-6的水平均降低,且观察组血清CRP、TNF和IL-6的水平低于对照组(P <0. 05)。结论活血接骨汤联合微创植骨治疗胫骨中下段骨折不愈合患者疗效确切,可有效降低术后炎症反应,促进患者康复。

Objective To investigate the effect of Huoxue Jiegu decoction combined with minimally invasive bone graft on nonunion of middle and lower tibial fractures and its effect on serum C-reactive protein(CRP)and interleukin-6(IL-6).Methods From April 2013 to August 2018,64 patients with nonunion of middle and lower tibial fractures were selected and divided into control group and observation group,with 32 cases in each group.The control group was treated with external fixator after minimally invasive bone grafting,and capsules of calcium carbonate,while the observation group was given Huoxue Jiegu decoction on the basis of the control group.The patients in both groups were followed up for one month after treatment.The clinical effects of the two groups were compared and the changes of inflammatory factors in serum were compared between the two groups.Results The total effective rate(90.63%)in the observation group was significantly higher than that in the control group(68.75%),and the difference was statistically significant(χ^2=4.730,P=0.030),the serum CRP,TNF and IL-6 levels in the two groups were decreased after treatment,and the serum CRP,TNF and IL-6 levels in the observation group were lower than those in the control group(P<0.05).Conclusion Huoxue Jiegu decoction combined with minimally invasive bone grafting in the treatment of nonunion of middle and lower tibial fractures can effectively reduce postoperative inflammatory reaction and promote the recovery of patients.