中药熏洗对老年人桡骨远端骨折手法复位并小夹板外固定后临床指标的影响

Effects of traditional Chinese medicine fumigation on the clinical parameters of distal radius fracture in the elderly patients after manipulative reduction and external fixation with small splint

目的探讨中药熏洗对老年人桡骨远端骨折手法复位并小夹板外固定后临床指标的影响。方法选择2015年11月至2018年11月宁波市中医院收治的老年桡骨远端骨折患者180例,采用随机数字表法分为对照组和观察组,每组90例。两组患者均进行手法复位并小夹板固定治疗,观察组在对照组治疗基础上加用中药熏洗治疗。比较两组患者血浆黏度、血清肿瘤坏死因子α(TNF-α)、白细胞介素1(IL-1)、白细胞介素6(IL-6)水平、临床疗效和不良反应发生情况。结果治疗前两组患者血浆黏度以及血液中相关炎性因子(TNF-α、IL-1、IL-6)指标差异均无统计学意义(t=-0.171、-0.126、0.483、0.459,均P>0.05);治疗后两组上述指标均较治疗前明显降低(观察组:t=38.970、14.684、72.258、53.612;对照组:t=20.098、19.045、33.962、34.822,均P<0.05),且观察组较对照组更低(t=-30.239、-7.043、-31.815、-10.359,均P<0.05)。观察组总有效率为88.88%(80/90),明显高于对照组的71.11%(64/90),差异有统计学意义(χ^2=8.889,P<0.05)。结论对于老年桡骨远端骨折患者实施复位并小夹板固定后结合中药熏洗治疗可明显改善患者血液流变学指标,降低机体炎性因子水平,疗效显著,无不良反应,值得在临床上推广应用。

Objective To explore the effect of traditional Chinese medicine fumigation and washing on the clinical indicators of elderly patients with distal radius fractures after small splint fixation.Methods From November 2015 to November 2018,180 elderly patients with fracture of the distal radius in Ningbo Hospital of Traditional Chinese Medicine were selected,and they were divided into control group and observation group according to the random digital table method,with 90 cases in each group.The two groups were given manual reduction and small splint fixation treatment,and the observation group was treated with traditional Chinese medicine fumigation on the basis of the control group therapy.The related inflammatory cytokines in patients plasma and serum viscosity(TNF-α,IL-1,IL-6)were detected,and the clinical curative effect and adverse reactions were observed.Results Before treatment,there were no statistically significant differences in plasma viscosity and blood inflammatory factors(TNF-α,IL-1,IL-6)between the two groups(t=-0.171,-0.126,0.483,0.459,all P>0.05).After treatment,the above indicators in the two groups were significantly lower than those before treatment(observation group:t=38.970,14.684,72.258,53.612;control group:t=20.098,19.045,33.962,34.822,all P<0.05),which in the observation group were lower than those in the control group(t=-30.239,-7.043,-31.815,-10.359,all P<0.05).The total effective rate of the observation group was 88.88%(80/90),which was higher than 71.11%(64/90)of the control group,the difference was statistically significant between the two groups(χ^2=8.889,P<0.05).Conclusion For the elderly patients with distal radius fracture,the combination of reduction and small splint fixation and fumigation with traditional Chinese medicine can significantly improve the hemorheology of the patients and reduce the contents of inflammatory factors in the body,with significant efficacy and no adverse reactions,which is worthy of clinical application.