桃红四物汤联合复位外固定术在不稳定型桡骨远端骨折康复中的应用

Application of Taohong Siwu Decoction combined with the reduction and external fixation in the rehabilitation of patients with unstable distal radius fractures

目的观察桃红四物汤联合复位外固定术在不稳定型桡骨远端骨折康复中的应用。方法2018年1月-2020年12月收治的100例不稳定型桡骨远端骨折患者随机分为对照组与观察组,各50例。观察组用复位外固定术联合桃红四物汤进行治疗,对照组采用复位外固定术进行治疗,2组术后给予常规康复锻炼,均治疗8周。统计2组疗效、骨折修复因子、钙磷代谢指标、骨代谢指标、影像学参数。结果治疗8周后,观察组总有效率为94.00%,显著高于对照组的76.00%,P<0.05。治疗8周后与治疗前比较,2组血清血管内皮生长因子(VEGF)、骨形成蛋白-2(BMP-2)、转化生长因子-β1(TGF-β1)、碱性磷酸酶(ALP)、钙(Ca)、磷(P)、总Ⅰ型胶原氨基端延长肽(tPINP)、骨钙素(BGP)水平升高,观察组高于对照组(P<0.05)。治疗8周后与治疗前比较,2组血清抗酒石酸酸性磷酸酶-5b(TRACP-5b)水平降低,观察组低于对照组(P<0.05)。治疗8周后与治疗前比较,2组桡骨高度、尺倾角、掌倾角升高(P<0.05),但组间比较,差异无统计学意义(P>0.05)。结论桃红四物汤联合复位外固定术对不稳定型桡骨远端骨折患者进行治疗,可有效促进患者骨折修复,改善机体骨代谢及钙磷代谢情况,具有较好的治疗效果。

Objective To observe the application of Taohong Siwu Decoction combined with the reduction and external fixation in the rehabilitation of patients with unstable distal radius fractures.Methods From January 2018 to December 2020,100 patients with unstable distal radius fractures were randomly divided into a control group and an observation group,with 50 cases in each group.The observation group was treated with the reduction and external fixation combined with Taohong Siwu Decoction,while the control group was treated only with the reduction and external fixation,and the two groups were given routine rehabilitation exercises after operation,both for 8 weeks.The curative effects,fracture repair factors,calcium phosphorus metabolism indexes,bone metabolism indexes and imaging parameters of the two groups were counted.Results After 8 weeks of treatment,the total effective rate of the observation group was 94.00%,which was significantly higher than that of the control group(76.00%)(P<0.05).Compared with before treatment,the levels of the serum vascular endothelial growth factor(VEGF),bone morphogenetic protein-2(BMP-2),transforming growth factor-β1(TGF-β1),alkaline phosphatase(ALP),calcium(Ca),phosphorus(P),total propeptide of type I procollagen(tPINP)and bone gla protein(BGP)were increased in the two groups,and the observation group was higher than the control group(P<0.05).Compared with before treatment,the serum levels of tartrate-resistant acid phosphatase-5b(TRACP-5b)in the two groups were decreased,and the observation group was lower than the control group(P<0.05).Compared with before treatment,the radius height,ulnar inclination and palmar inclination were increased in the two groups(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).Conclusion In the treatment of unstable distal radius fractures,Taohong Siwu Decoction combined with the reduction and external fixation can effectively promote the fracture repair,improve the bone metabolism and calcium phosphorus metabolism,having a good therapeutic effect.