壮筋养血汤治疗晚期跟骨关节内骨折临床观察

Clinical Observation on Zhuangjin Yangxie Decoction in the Treatment of Advanced Intra-articular Calcaneal Fractures

目的探讨壮筋养血汤治疗晚期跟骨关节内骨折患者的效果及安全性。方法选择2018年6月—2020年11月大同大学附属医院收治的88例晚期跟骨关节内骨折患者为研究对象,以随机数字表法分为对照组(44例)和研究组(44例)。2组均接受切开复位内固定术治疗,对照组术后接受抗感染等西医治疗,研究组在对照组的基础上采用壮筋养血汤治疗,2组均持续治疗3个月。比较2组治疗前后Bohler角、Gissane角、跟骨宽度、足部功能评分表(Maryland),观察2组治疗期间不良反应发生情况,比较2组临床疗效。结果治疗前,2组Bohler角、Gissane角、跟骨宽度对比差异无统计学意义(P> 0.05);治疗后,2组Bohler角、Gissane角均升高(P <0.05),且研究组更高(P <0.05);治疗后,2组跟骨宽度均降低(P <0.05),且研究组更低(P <0.05);治疗前,2组Maryland评分对比差异无统计学意义(P> 0.05),治疗后,2组Maryland评分均升高(P <0.05),且研究组更高(P <0.05);2组疗效等级分布差异有统计学意义(P <0.05),且研究组优良率比对照组高(90.91%VS 72.73%,P <0.05);2组治疗期间不良反应发生率对比差异无统计学意义(χ^(2)=0.550,P=0.713)。结论壮筋养血汤联合切开复位内固定术治疗晚期跟骨关节内骨折肝肾亏虚型,可改善患者的足部功能及复位效果,疗效显著,且安全可靠。

Objective To investigate the effect and safety of Zhuangjin Yangxie decoction in the treatment of patients with advanced intraarticular calcaneal fractures. Methods Eighty-eight patients with advanced intra-articular calcaneal fractures admitted to the hospital from June 2018 to November 2020 were selected as the research objects,and were divided into a control group( n = 44) and a study group( n =44) by a random number table. Both groups received open reduction and internal fixation,the control group received anti-infection and other western medical treatment after surgery,and the study group was treated with Zhuangjin Yangxie decoction on the basis of the control group.Both groups received continuous treatment for 3 months. The Bohler angle,Gissane angle,calcaneal width,and foot function score scale( Maryland) were compared between the two groups before and after treatment. The occurrence of adverse reactions during the treatment of the two groups was observed,and the clinical efficacy of the two groups was compared. Results Before treatment,there was no significant difference in Bohler angle,Gissane angle,and calcaneal width between the two groups( P > 0. 05). AFTER treatment,Bohler angle and Gissane angle in the two groups increased( P < 0. 05),and the study group was higher( P < 0. 05). After treatment,the width of the calcaneus in the two groups was reduced( P < 0. 05),and the study group was even lower( P < 0. 05);before treatment,there was no significant difference in the Maryland scores between the two groups( P > 0. 05). After treatment,the Maryland scores of the two groups increased( P < 0. 05),and the study group was higher( P < 0. 05),the two groups had a significant difference in the grade distribution of efficacy( P < 0. 05),and the excellent and good rate of the study group was higher than that of the control group( 90. 91% VS72. 73%,P <0. 05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment( χ^(2)= 0. 550,P =0. 713). Conclusion Zhuangjin Yangxue decoction combined with open reduction and internal fixation in the treatment of patients with advanced calcaneal intra-articular fractures( liver and kidney deficiency type) can improve the patient’s foot function and reduction effect,has significant curative effect,and is safe and reliable.