桃红四物汤治疗不稳定型桡骨远端骨折

Effect of Taohong Siwu Decoction in the treatment of unstable distal radius fracture

目的分析桃红四物汤辅助复位外固定术治疗不稳定型桡骨远端骨折(DRF)对患者骨密度(BMD)、骨代谢及血液流变学的影响。方法选取100例不稳定型DRF患者,按随机数字表法分为联合组与手术组,各50例。手术组接受复位外固定术治疗;联合组在手术组基础上接受桃红四物汤治疗,连续治疗8周。观察2组术后8周临床疗效,比较2组术前、术后8周腕关节功能、疼痛程度、血液流变学指标、BMD、骨代谢指标及血清修复细胞因子水平,记录2组术后恢复情况。结果术后8周,联合组总有效率(96.00%,48/50)高于手术组(80.00%,40/50)(P<0.05)。术后8周,2组腕关节功能Cooney评分、BMD、血清总I型胶原氨基端延长肽(tPINP)、骨钙素(BGP)、转化生长因子-β_(1)(TGF-β_(1))、骨形态发生蛋白-2(BMP-2)、血管内皮生长因子(VEGF)水平高于术前,联合组高于手术组(P<0.05);2组视觉模拟评分(VAS)、血清抗酒石酸酸性磷酸酶-5b(TRACP-5b)水平及血液流变学指标(全血低切黏度、全血中切黏度、全血高切黏度)低于术前,联合组低于手术组(P<0.05)。联合组止痛、消肿、瘀斑消失及骨折愈合时间短于手术组(P<0.05)。结论桃红四物汤辅助复位外固定术治疗不稳定型DRF,可有效改善患者BMD、骨代谢及血液流变学,提高血清修复细胞因子水平,有助于改善患者腕关节功能,减轻患者疼痛程度,促进患者术后康复,疗效显著。

Objective To analyze the effect of Taohong Siwu Decoction on the bone mineral density(BMD),bone metabolism and hemorheology in its adjuvant treatment of unstable distal radius fracture(DRF)with the reduction and external fixation operation.Methods A total of 100 patients with unstable DRF were enrolled and divided into a combination group and an operation group according to the random number table method,with 50 cases in each group.The operation group received the treatment of reduction and external fixation,while the combination group was treated with Taohong Siwu Decoction on the basis of the operation group for 8 consecutive weeks.The clinical effects of the two groups were observed 8 weeks after operation,and the indexes of the wrist joint function,pain degree,hemorheology,BMD,bone metabolism and serum repair cytokine levels of the two groups were compared before and 8 weeks after operation,and the postoperative recovery of the two groups was recorded.Results Eight weeks after operation,the total effective rate in the combination group(96.00%,48/50)was higher than that in the operation group(80.00%,40/50)(P<0.05).Eight weeks after operation,the Cooney scores of the wrist joint function,the levels of BMD,serum total collagen I amino-terminal elongation peptide(tPINP),bone gla protein(BGP),transforming growth factor-β_(1)(TGF-β_(1)),bone morphogenetic protein-2(BMP-2)and vascular endothelial growth factors(VEGF)were higher than those before operation,and the combination group was higher than the operation group(P<0.05).The scores of visual analogue scale(VAS),levels of serum tartrate-resistant acid phosphatase-5B(TRACP-5B)and hemorheology indexes(whole blood low,whole blood middle,whole blood high shear viscosity)in the two groups were lower than those before operation,and the combination group was lower than the operation group(P<0.05).The time for analgesia,detumescence,petechiae disappearance and fracture healing in the combination group was shorter than that in the operation group(P<0.05).Conclusion Taohong Siwu Decoction in its adjuvant treatment of unstable distal radius fracture can effectively improve the indexes of BMD,bone metabolism and hemorheology of patients,increase the level of serum repair cytokines,help to improve the wrist joint function,reduce pains,promote the postoperative rehabilitation,with a significant effect.