复元活血汤结合康复训练辅助肱骨头置换治疗难复性肱骨近端骨折疗效分析

Therapeutic Effect of Applying Fuyuan Huoxue Decoction Combined with Rehabilitation Training Assisted Humeral Head Replacement in the Treatment of Refractory Proximal Humeral Fractures

目的:研究复元活血汤联合康复训练,在肱骨头置换治疗难复性肱骨近端骨折中的疗效。方法:回顾本院2013年6月~2017年6月收治的62例难复性肱骨近端骨折患者资料,30例进行康复训练辅助肱骨头置换术的患者设为对照组;32例采取复元活血汤结合康复训练辅助肱骨头置换治疗的患者设为联合组。比较两组的术后肿胀程度评分、疼痛程度评分、Neer肩关节功能评分、临床疗效、并发症。结果:联合组患者优良率96.88%,对照组患者优良率73.33%;两组患者肿胀程度比较有差异(Z=-2.133,P=0.032)。术后1天两组患者疼痛评分比较无差异(P>0.05),联合组患者术后1周、术后4周疼痛评分低于对照组(P>0.05)。联合组治疗后的Neer肩关节功能总分显著高于对照组,差异具有统计学意义(P<0.05)。对照组临床总有效率80.00%(24/30),显著低于联合组临床总有效率93.75%(30/32),差异具有统计学意义(P<0.05)。对照组并发症率为13.33%(4/30),与联合组并发症率9.38%(3/32)比较,差异无统计学意义(P>0.05)。结论:复元活血汤联合康复训练,能够在不增加并发症的基础上,显著提高肱骨头置换治疗难复性肱骨近端骨折的临床疗效,促进患者关节功能早日恢复,适合广泛用于临床。

Objective: To investigate the therapeutic effect of Fuyuan Huoxue Decoction combined with rehabilitation training assisted humeral head replacement in the treatment of refractory proximal humeral fractures.Methods: In this study,62 cases of refractory proximal humeral fractures treated in our hospital from June 2013 to June 2017 were reviewed.30 patients with rehabilitation training assisted humeral head replacement were treated as controlled group,and based on this,30 patients treated with Fuyuan Huoxue Decoction were enrolled as the combined group.The postoperative swelling and pain score,Neer shoulder joint function scores,clinical curative effect and complication were compared between the two groups.Results: The excellent and good rate was 96.88% in the combined group and 73.33% in the controlled group.The swelling degree in the two groups was significantly different(Z=-2.133,P = 0.032).The pain score at the postoperative 1 d showed no significant difference(P > 0.05),while the pain scores at the postoperative 1 week and 4 weeks in the combined group were significantly lower than those in the controlled group(P < 0.05).The total score of Neer’s shoulder joint function in the combined group was significantly higher than that in the controlled group,the difference was statistically significant(P < 0.05).The total effective rate in the controlled group was 80.00%(24/30),which was significantly lower than that in the combined group(93.75%,30/32),with statistical significance(P < 0.05).The complication rate in the controlled group was 13.33%(4/30),which was not significantly different from the complication rate in the combined group(9.38%,3/32;P > 0.05).Conclusion: Fuyuan Huoxue Decoction combined with rehabilitation training is an effective way to improve the therapeutic effect and promote the joint function recovery without increasing the complications for patients with refractory proximal humeral fractures,which is worthy of application.