补阳还五汤治疗桡骨远端骨折并发正中神经损伤临床研究

Clinical Study on Buyang Huanwu Tang for Distal Radius Fracture Complicated with Median Nerve Injury

目的:观察补阳还五汤治疗桡骨远端骨折并发正中神经损伤的临床疗效。方法:将桡骨远端Colles骨折并发正中神经损伤患者60例,采用随机分配的原则将其分为治疗组和对照组,每组30例。2组患者均进行中医手法复位后夹板固定,观察组联合补阳还五汤治疗,对照组联合甲钴胺片治疗,3周为1个疗程,共治疗3个疗程。观察比较2组患者治疗后3周、9周、6个月血清胶质细胞源性神经营养因子(GDNF)、半胱氨酸天冬氨酸蛋白酶-3(Caspase-3)水平及周围神经康复效果。结果:治疗3、9周,总有效率观察组分别为73.3%、83.3%,对照组为40.0%、70.0%,2组比较,差异均有统计学意义(P<0.05);治疗6个月,总有效率观察组96.7%,对照组为86.7%,2组比较,差异无统计学意义(P>0.05)。治疗3周、9周、6个月,观察组患者血清GDNF水平均高于对照组,差异有统计学意义(P<0.05)。治疗3周,2组患者血清中Caspase-3水平相当,差异无统计学意义(P>0.05);治疗后9周、6个月,观察组患者血清Caspase-3水平均低于对照组(P<0.05)。结论:补阳还五汤治疗桡骨远端骨折正中神经损伤疗效肯定,可显著改善患者血清GDNF、Caspase-3水平,促进患者病情康复。

Objective: To observe the clinical effect of Buyang Huanwu tang in the treatment of distal radius fracture complicated with median nerve injury. Methods:A total of 60 patients with distal radius fracture(Colles fracture) complicated with median nerve injury were randomly divided into the treatment group and the control group,30 patients in each group.Patients in both groups were adopted with splint fixation after Chinese medicine manipulation to restore position. The observation group was additionally treated with Buyang Huanwu tang,while the control group was additionally treated with mecobalamin tablets. Both groups were treated for three courses,three weeks being one course. The levels of glial celllinederived neurotrophic factor(GDNF),Cystein-asparate protease-3(Caspase-3) and the rehabilitation of peripheral nerve after treatment of three weeks,nine weeks and six months in the two groups were observed and compared. Results:After three and nine weeks of treatment,the total effective rates were 73.3% and 83.3% in the observation group and 40.0% and 70.0% in the control group, respectively, the difference being significant(P<0.05). After six months of treatment, the total effective rate was 96.7% in observation group and 86.7% in control group,there being no significant difference(P>0.05).After three weeks,nine weeks and six months of treatment,the levels of GDNF in serum in the observation group were higher than those in the control group respectively, the difference being significant(P<0.05). After three weeks of treatment,the level of Caspase-3 in serum was similar between the two groups,there being no significant difference(P>0.05);after nine weeks and six months of treatment,the levels of Caspase-3 in serum in the observation group were lower than those in the control group respectively(P<0.05). Conclusion: Buyang Huanwu tang has definite therapeutic effect in treating patients with distal radius fracture complicated with median nerve injury,which can significantly improve the levels of GDNF and Caspase-3 and promote their recovery.