接骨木康方联合高压氧治疗胫骨中下段骨折的临床疗效观察

Clinical curative effect observation of Jiegumukang formula combined with hyperbaric oxygen in the treatment of middle and lower tibial fractures

目的观察接骨木康方联合高压氧治疗胫骨中下段骨折术后愈合的疗效。方法选取2016年1月至2018年1月南京中医药大学附属中西医结合医院创伤骨科收治的胫骨中下段骨折患者60例,按照随机数字表法将患者分为对照组和观察组,每组各30例。所有患者均采用切开复位内固定术,术后常规予以预防感染、切口无菌换药及指导康复训练等措施。对照组术后采用口服中药汤剂接骨木康方;观察组在对照组治疗方法基础上于术后第3天起予以高压氧治疗,10 d为1个疗程,共3个疗程。比较2组患者骨折术后疼痛评分、临床疗效、骨折周围软组织肿胀消退与伤口愈合时间及膝、踝关节功能。结果高压氧治疗后第2、4、6天,观察组的疼痛评分低于对照组,差异均有统计学意义(P<0.05);高压氧治疗后1个月,2组疼痛评分差异无统计学意义(P>0.05)。治疗后观察组的总有效率高于对照组[96.7%(29/30)vs.73.3%(22/30)],差异有统计学意义(P<0.05)。治疗后观察组患者骨折周围创伤软组织肿胀消退时间和切口愈合时间均短于对照组,差异均有统计学意义(P<0.01)。治疗1个月后观察组患者膝、踝关节功能的优良率高于对照组[56.7%(17/30)vs.36.7%(11/30),P<0.05],治疗3个月后2组膝、踝关节功能优良率均升高,但2组间差异无统计学意义(P>0.05)。结论胫骨中下段骨折术后应用接骨木康方联合高压氧治疗可以缓解疼痛,促进骨折愈合,加快骨折周围软组织肿胀消退,缩短切口愈合期,快速恢复膝关节与踝关节功能,是有效的辅助治疗手段。

Objective To observe the clinical curative effect of Jiegumukang formula combined with hyperbaric oxygen(HBO)in the postoperative healing of middle and lower tibial fractures.Methods A total of 60 cases of tibial fracture were randomly divided into control group and observation group with 30 cases in each group.All patients received open reduction and internal fixation surgical operation,conventional infection prevention,incision aseptic dressing change,and rehabilitation training after surgery.Then,the patients in the control group was treated with orally intaking of Jiegumukang formula a traditional Chinese medicine decoction.On the basis of the treatment of the control group,the observation group was given 3 courses of HBO therapy from the 3rd day after surgery with 10 days a course.After the intervention,the scores of visual analogue scale(VAS)for pain,the time lengths to the subsidence of edema around fracture and wound healing,and the functional activities of knee joint and ankle joint were observed and compared.Results After treatment,the VAS scores of the observation group were lower than those of the control group on 2 d,4 d,and 6 d after HBO with statistically significant differences(P<0.05),but there was no significant difference between the VAS scores of the two groups one month later(P>0.05).After treatment,the total clinical efficacy of the observation group[92.4%(29/30)]was significantly better than that of the control group[67.9%(22/30)]with a statistically significant difference(P<0.05).After treatment,the time lengths to the subsidence of the soft tissue edema and wound healing were significantly shorter than those in the control group with statistically significant differences(P<0.01).One month after treatment,the excellence rate of knee joint and ankle joint function of the observation group[56.7%(17/30)]were better than those of the control group[36.7%(11/30)](P<0.05).Three months after treatment,the excellence rates of the two groups were all improved,but there was no significant difference between them(P>0.05).Conclusion Jiegumukang formula combined with HBO can relieve pain,promote fracture healing,shorten the time length to the subsidence of edema,promote wound healing,and enhance the functional restoration of knee joint and ankle joint.It is an effective adjuvant treatment.