舒筋汤熏洗辅助治疗老年人远端桡骨折45例分析

Effect of Shujin decoction fumigation and washing in the treatment of distal radius fractures in the elderly

目的观察舒筋汤熏洗辅助治疗老年人桡骨远端骨折的临床效果。方法选择台州市中西医结合医院2016年1月至2018年1月收治的老年桡骨远端骨折患者90例为观察对象,采用随机数字表法分为对照组45例和观察组45例,对照组给予锁定钢板内固定治疗,观察组在对照组的基础上于术后给予自拟舒筋汤熏洗,连续治疗8周。记录肿胀消退时间、骨折愈合时间及住院时间,采用视觉模拟评分法(VAS)评估术后4、8周疼痛情况,术后6个月进行Gartland-Werley及McBride腕关节功能恢复效果评估,记录术后并发症发生情况,结果对照组肿胀消退、骨折愈合及住院时间分别为(8.02±2.45)d、(42.50 ±4.20)d、(14.86 士2.48)d,均明显长于观察组的(5.85±1.64)d、(34.30 ±5.60)d、(10.28 ±2.44)d(t =5.036、9.531、4.372,均P<0.05)。对照组术后4周、8周VAS评分分别为(6.50 ±1.45)分、(4.55 ± 1.74)分,均明显高于观察组的(5.26±1.16)分、(3.02 ± 1.02)分(t = 3.653、3.436,均 P <0.05 )。对照组 Gartland-Werley 腕关节功能恢复优良率为53%(24/45),明显低于观察组的78%(35/45)(x^2 =9.202,P<0.05);对照组的McBride腕关节功能恢复优良率为51%(23/45),明显低于观察组76%(34/45)(X^2=9.011 ,P <0.05)。对照组并发症发生率为18%(8/45),明显高于观察组的2%(l/45)(x^2 =6.049.P <0.05)。结论自拟舒筋汤熏洗辅助治疗老年桡骨远端骨折效果较好,能促进术后肿胀消退和骨折愈合,改善腕关节功能.降低并发症发生率,提高临床效果。

Objective To observe the clinical effect of Shujin decoction combined with locking plate internal fixation in the treatment of senile distal radius fracture.Methods From January 2016 to January 2018,90 patients with distal humeral fractures in Taizhou Hospital of Integrated Traditional Chinese and Western Medicine were selected and divided into two groups according to the random number table,with 45 patients in each group.The control group was treated with locking plate internal fixation alone.The observation group was given self 一 made Shujin decoction on the basis of the control group, and the patients were treated for 8 weeks.The swelling regression time, fracture healing time and hospitalization time were recorded.The pain score at 4 and 8 weeks after operation were calculated by the visual analog scale( VAS).The Gartland - Werley and McBride wrist joint function recovery was evaluated 6 months after operation.The occurrence of post - complication was recorded.Results The swelling subsidence, fracture healing and hospitalization time of the control group were (8.02 ± 2.45 ) cl,(42.50 ±4.20) d,(14.86 ± 2.48 ) d, respectively, which were significantly longer than those of the observation group [(5.85 ± 1.64)d,(34.30 ±5.60)d,(10.28 ±2.44) d].The differences were statistically significant(t= 5.036,9.531,4.372, all P < 0.05 ).The VAS scores of the control group at 4 and 8 weeks after operation were ( 6.50 ± 1.45 ) points,(4.55 ± 1.74 ) points, respectively, which were significantly higher than those of the observation group [( 5.26 ± 1.16 ) points,( 3.02 ± 1.02) points], the differences were statistically significant(t=3.653,3.436, all P < 0.05 ).The excellent and good rate of Gartland - Werley wrist function recovery in the control group was 53%(24/45), which was significantly lower than that in the observation group [ 78%( 35/45 )], the difference was statistically significant (X^2= 9.202, P < 0.05).The excellent rate of McBride wrist joint function recovery in the control group was 51 %(23/45), which was significantly lower than that in the observation group [76%(34/45)],the difference was statistically significant(X^2= 8.011 ,P <0.05).The incidence rate of complications in the control group was 18%(8/45),which was significantly higher than that in the observation group [2%( 1/45 )], the difference was statistically significant(X^2= 6.049 ,P < 0.05 ).Conclusion Self - made Shujin decoction combined with locking plate internal fixation in the treatment of senile distal radius fractures is effective, which can promote postoperative swelling and fracture healing, improve wrist function, reduce the incidence of complications and improve clinical outcome.