活血止痛汤联合手法复位小夹板固定对桡骨远端骨折患者的临床研究

Clinical study of Huoxue Zhitong decoction combined with manual reduction and small splint fixation for patients with distal radius fracture

目的探讨活血止痛汤联合手法复位小夹板固定对桡骨远端骨折患者临床症状改善情况、腕关节活动度及血清疼痛介质水平的影响。方法选取江南大学附属医院2018年1月至2020年12月收治的44例桡骨远端骨折患者,根据随机数字表法分为对照组(22例)、观察组(22例)。对照组患者给予手法复位小夹板固定治疗,并于治疗后进行常规抓握康复训练,观察组患者在上述治疗方法的基础上联合活血止痛汤治疗,两组患者均治疗4周,并于治疗后随访4周。比较两组患者临床效果,临床症状改善时间,治疗前后腕关节活动度、血清疼痛介质水平及随访期间并发症发生情况。结果观察组患者治疗后临床总优良率高于对照组;观察组患者骨折愈合时间、疼痛消失时间及肿胀消失时间均短于对照组;与治疗前比,治疗后两组患者旋前度、旋后度、背伸度、掌屈度、桡偏度均升高,且观察组高于对照组;血清P物质(SP)、β-内啡肽(β-EP)、前列腺素E2(PGE2)、神经肽Y(NPY)水平均降低,且观察组低于对照组;随访期间,观察组患者并发症总发生率低于对照组(均P<0.05)。结论活血止痛汤联合手法复位小夹板固定治疗桡骨远端骨折,可促进患者临床症状的改善,提高腕关节的活动度,减轻机体的疼痛反应,且安全性较高。

Objective To investigate the effect of Huoxue Zhitong decoction combined with manual reduction and small splint fixation on the improvement of clinical symptoms,wrist range of motion and serum level of pain mediators in patients with distal radius fracture.Methods A total of 44 patients with distal radius fractures admitted to Affiliated Hospital of Jiangnan University from January 2018 to December 2020 were selected and divided into the control group(22 cases)and the observation group(22 cases)according to random number table method.Patients in the control group were treated with manual reduction and small splint fixation,and underwent routine grasping rehabilitation training after treatment,patients in the observation group were treated with Huoxue Zhitong decoction on the basis of the above treatment methods,patients in both groups were treated for 4 weeks and followed up for 4 weeks after treatment.The clinical effect,improvement time of clinical symptoms,wrist range of motion and serum level of pain mediators before and after treatment,as well as the complicationsoccurred during following-up were compared between the two groups.Results The total clinical excellent and good rate in the observation group was higher than that in the control group;the time of fracture healing,the time of pain disappearance and the time of swelling disappearance of patients in the observation group were shorter than those in the control group;compared with before treatment,the degrees of pronation,supination,back extension,palm flexion and radial deviation of patients in the two groups increased after treatment,and the observation group was higher than the control group;the serum levels of substance P(SP),β-endorphin(β-EP),prostaglandin E_(2)(PGE_(2)) and neuropeptide Y(NPY)of patients in the two groups decreased after treatment,and the observation group was lower than in the control group;during the following-up period,the total incidence of complications of patients in the observation group was lower than that in the control group(all P<0.05).Conclusion Huoxue Zhitong decoction combined with manual reduction and small splint fixation for the treatment of distal radius fracture,which can promote the improvement of clinical symptoms,improve wrist range of motion,reduce the body's pain response,and has a high safety.