中医辨证联合西医常规治疗股骨粗隆间骨折的临床效果及安全性

Clinical safety and efficacy of TCM syndrome differentiation plus western medicine on intertrochanteric fracture of femur

目的:分析股骨粗隆间骨折患者应用西医常规治疗联合中医辨证治疗的临床效果和安全性。方法:2015年1月-2018年1月期间,选取于我院治疗的39例股骨粗隆间骨折患者,根据相近入院时间,随机分为观察组、对照组。对照组患者(19例)予西医常规治疗,即股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)内固定术,观察组患者(20例)在PFNA常规治疗基础上予中医辨证分期治疗。对比两组患者的血浆中D-二聚体水平、相关观察指标、髋关节功能、临床效果以及并发症发生情况。结果:T0时,观察组的血浆中D-二聚体水平与对照组的相比,差异没有统计学意义(P>0.05);T1、T2、T3、T4、T5时,观察组的血浆中D-二聚体水平(2.53±0.10)mg/L、(2.02±0.22)mg/L、(1.75±0.22)mg/L、(1.12±0.06)mg/L、(0.39±0.02)mg/L以及骨痂生成时间(10.48±1.06)周,骨折愈合时间(11.08±1.73)周,下地时间(13.20±1.43)周,负重时间(75.16±3.41)d,并发症发生率(5.00%)显著低于对照组血浆中D-二聚体水平(2.70±0.12)mg/L、(2.82±0.11)mg/L、(2.63±0.20)mg/L、(1.52±0.13)mg/L、(0.62±0.03)mg/L以及骨痂生成时间(13.52±1.23)周,骨折愈合时间(14.32±1.35)周,下地时间(16.71±1.60)周,负重时间(98.51±4.61)d,并发症发生率(21.05%);观察组的髋关节Harris评分(90.30±1.92)分、总有效率(95.00%)显著高于对照组的髋关节Harris评分(84.06±1.68)分、总有效率(78.95%),差异具有统计学意义(P<0.05)。结论:PFNA联合中医辨证治疗能够有效促进股骨粗隆间骨折患者髋关节功能恢复正常,降低血浆中D-二聚体水平,防止下肢深静脉血栓形成等并发症的发生,安全性高,临床可推广使用。

Objective: To analyze the clinical safety and efficacy of western medicine plus TCM syndrome differentiation on intertrochanteric fracture of femur. Methods: From January 2015 to January 2018, 39 patients were randomly divided into the observation group and the control group. 19 cases in the control group was given conventional western medicine plus the proximal femur prevent rotation intramedullary nailing fixation. 20 cases in the observation group were given TCM syndrome differentiation more. Results: The incidence of complications in the observation group(5.00%) was significantly lower than that in the control group;and the total effective rate(95.00%) in the observation group was significantly higher than that in the control group(P<0.05). Conclusion: PFNA plus TCM syndrome differentiation on intertrochanteric fracture of femur showed a good effect, can improve hip function, reduce D-dimer level, prevent from complications, with high safety.