骨二方联合膝关节功能锻炼对髌骨骨折术后膝关节功能的影响

The effects of the Gu’er Fang plus functional exercise on knee joint function after patella fracture surgery

目的:探讨骨二方联合膝关节功能锻炼对髌骨骨折术后膝关节功能的影响,为中医药恢复膝关节功能提供依据。方法:选取2017年1月-2018年12月广州市正骨医院骨伤一区收治的髌骨骨折患者40例,随机分为试验组和对照组,每组各20例,所有患者均予以髌骨骨折内固定术,对照组患者术后进行膝关节功能锻炼,试验组予以膝关节功能锻炼联合口服骨二方,疗程为2周,并且随访至术后6个月。通过临床总有效率、膝关节视觉模拟疼痛评分法(Visual Analogue Scale,VAS)评分、膝关节Lysholm评分、膝关节被动活动度(ROM)、骨折愈合时间、住院总时间、总医疗费用、术后并发症发生率评价患者的疗效。结果:疗程结束后试验组的总有效率高于对照组,差异具有统计学意义(P<0.05);术后24 h、72 h、7 d、28 d两组患者的膝关节VAS评分均较术前显著下降(P<0.05),且各个时间点试验组的膝关节VAS评分均低于对照组(P<0.05);术后7 d、28 d、3个月、6个月两组患者的膝关节Lysholm评分、ROM均较术前显著升高(P<0.05),且各时间点试验组的膝关节Lysholm评分、ROM均高于对照组(P<0.05);疗程结束后,试验组的骨折愈合时间、住院总时间均短于对照组(P<0.05),而总医疗费用和术后并发症的发生率均低于对照组(P<0.05)。结论:骨二方联合膝关节功能锻炼可以加快髌骨骨折愈合时间,改善膝关节功能,缓解症状,降低术后并发症的发生率。

Objective:To explore the effects of Gu’er Fang(骨二方)plus functional exercise on the knee joint function after patella fracture surgery,and provide a basis for the restoration of knee function in TCM.Methods:40 cases were randomly divided into the experimental group and the control group,with 20 cases in each group.All patients were given patella fractures fixation surgery,the patients in the control group were given knee functional exercises after surgery,and the experimental group was given knee functional exercises after surgery plus Gu’er Fang for 2 weeks,and all the patients were followed up 6 months after surgery.Results:After the treatment,the total efficiency in the experimental group was higher than the control group,and the difference was statistically significant(P<0.05).The VAS scores of knee in the groups at 24 h,72 h,7 d,and 28 d after surgery were significantly lower than before(P<0.05),and the VAS scores of knee VAS in the experimental group at each time point were lower than the control group(P<0.05).7 days,28 days,3 months,and 6 months after surgery,the knee Lysholm scores and ROM scores of the knee joint in the groups were significantly higher than before(P<0.05),and those indexes in the experimental group at each time point were higher than the control group(P<0.05).After treatment,the fracture healing time and total hospitalization time in the experimental group was shorter than the control group(P<0.05),while the total medical cost and the incidence of postoperative complications were lower than the control group(P<0.05).Conclusion:Gu’er Fang and functional exercise can accelerate the healing of patella fracture,improve knee joint function,relieve symptoms,and reduce the incidence of postoperative complications.