三期辨证联合手法整复夹板固定治疗老年伸直型桡骨远端骨折疗效观察

Three stage syndrome differentiation combined with manual reduction and splint fixation in the treatment of extended distal radius fracture in the elderly

目的观察行气消瘀—接骨续筋—补肝益肾三期辨证联合夹板固定治疗老年伸直型桡骨远端骨折的临床疗效。方法将我院2015年12月至2018年12月治疗的老年伸直型桡骨远端骨折患者80例,随机分为研究组和对照组各40例,2组皆行手法整复夹板外固定术,对照组术后口服盘龙七片;研究组依据行气消瘀—接骨续筋—补肝益肾三期辨证用药治疗。2周为1疗程,2个疗程后取除夹板。分别观察2组患者治疗前,治疗后1疗程、2疗程、3疗程的视觉模拟评分(VAS)、骨折临床愈合时间测定、Dienst功能评分和优良率。结果治疗前2组患者VAS评分比较差异无统计学意义(P>0.05),治疗后2组患者不同时间点VAS评分均较治疗前明显下降(P<0.05);其中治疗后1疗程、治疗后2疗程、治疗后3疗程研究组VAS评分均显著低于对照组,差异有统计学意义(P<0.05)。治疗后2组Dienst功能评分均较治疗前明显提高(P<0.05);其中研究组Dienst功能评分及优良率显著高于对照组,差异有统计学意义(P<0.05)。治疗后研究组较对照组骨折愈合时间明显缩短(P<0.05),差异有统计学意义。结论三期辨证联合手法整复夹板固定对老年伸直型桡骨远端骨折患者,能够明显改善患者的疼痛、肿胀症状,促进骨折的愈合及功能的早期恢复。本研究将现代医学与中医学的三期辩证、手法整复、夹板固定相结合,方法科学合理,为治疗老年伸直型桡骨远端骨折患者提供循证医学基础,值得临床推广。

Objective To observe the clinical effect of three-stage syndrome differentiation combined with splint fixation in the treatment of extended distal radius fracture in the elderly.Methods Eighty elderly patients with distal radius fractures treated in our hospital from December 2015 to December 2018 were randomly divided into a study group and a control group,each with 40 cases.Both groups were treated with manual splint external fixation.The control group received Panlong Qi tablets orally after surgery;the study group was treated with three phases of syndrome differentiation based on Qi-eliminating blood stasis-boning and continuity-reinforcing liver and kidney-reinforcing kidney.Two weeks were one course.Visual analogue score(VAS),fracture healing time measurement,Dienst function score and excellent and good rate of the two groups of patients before treatment,1 course after treatment,2 courses after treatment,3 courses after treatment.Results There was no significant difference in VAS score between the two groups before treatment(P>0.05).After treatment,the VAS score of the two groups at different time points was significantly lower than that before treatment(P<0.05).The VAS score of the study group was significantly lower than that of the control group after treatment for one course,two courses and three courses,respectively(P<0.05).The difference was statistically significant(P<0.05).After treatment,the Dienst function score of the two groups was significantly higher than that before treatment(P<0.05).Among them,the Dienst function score and excellent and good rate of the study group were significantly higher than those of the control group,the difference was statistically significant(P<0.05).The fracture healing time of the study group after treatment was significantly shorter than that of the control group(P<0.05),and the difference was statistically significant.Conclusions The three-stage syndrome differentiation combined with manual reduction and splint fixation can significantly improve the pain and swelling symptoms of the elderly patients with extended distal radius fracture,and promote the healing of the fracture and early recovery of the function.This study combines modern medicine with three-stage dialectics of traditional Chinese medicine,manual reduction an splint fixation.The method is scientific and reasonable.It provides evidence-based medicine basis for the treatment of elderly patients with extended distal radius fracture in the future,and is worthy of clinical promotion.