自拟中药组方对年龄大于60岁肱骨近端骨折患者术后骨折愈合时间及并发症的影响

Effects of Self-designed Traditional Chinese Medicine Prescription on Postoperative Fracture Healing Time and Complications in Patients over 60 Years old with Proximal Humeral Fractures

目的:分析自拟中药组方对年龄>60岁肱骨近端骨折(PHF)患者术后骨折愈合时间及并发症的影响。方法:选取厦门市同安区中医医院2018年3月至2020年8月期间收治的114例年龄>60岁PHF患者,依照随机数字表法分为对照组与观察组,各57例。对照组患者接受微创手术治疗,观察组患者在对照组基础上接受自拟中药组方治疗,比较两组治疗效果。结果:观察组患者的手术优良率较对照组高,差异具有统计学意义(P<0.05);观察组患者的骨折愈合时间(50.14±3.87)d,较对照组(68.03±5.27)d短,差异具有统计学意义(P<0.05);观察组患者术后3 d、7 d、14 d 数字评分法(NRS)评分均较对照组低,差异具有统计学意义(P<0.05);术后1个月、3个月、6个月观察组患者的Constant–Murley肩关节功能评分(CMS)均较对照组高,差异具有统计学意义(P<0.05);术后3个月观察组患者的骨钙素(OC)、骨型碱性磷酸酶(BLAP)较对照组高,甲状旁腺激素(PTH)、Ⅰ型胶原羧基端肽β特殊序列(β–CTX)均较对照组低,差异具有统计学意义(P<0.05)。观察组患者的并发症发生率较对照组低,差异具有统计学意义(P<0.05)。结论:自拟中药组方用于年龄>60岁PHF患者,能缓解患者疼痛程度,改善肩关节功能,促进骨折愈合,调节骨代谢因子水平,提高手术治疗效果,且并发症少。

Objective To analyze the effects of self-made traditional Chinese medicine prescription on postoperative fracture healing time and complications of proximal humeral fractures (PHF) in patients over 60 years old.Methods A total of 114 PHF patients over 60 years old.in Xiamen Tong ’an District Hospital of Traditional Chinese Medicine from March 2018 to August 2020 were selected and divided into a control group and an observation group,according to random number table method,with 57 cases in each group.The control group received minimally invasive surgery treatment,and the observation group received self-made traditional Chinese medicine prescription treatment on the basis of the control group,and the treatment effect of the two groups was compared.Results The excellent rate of operation in the observation group was higher than that in the control group,and the difference was statistically significant (P < 0.05).The fracture healing time of the observation group (50.14±3.87) d was shorter than that of the control group (68.03±5.27) d,and the difference was statistically significant (P < 0.05).The numerical rating scale (NRS) score of the observation group was lower than that of the control group at 3 d,7 d and 14 d after surgery,the difference was statistically significant (P < 0.05).Constant-Murley shoulder function scores (CMS) in the observation group were higher than those in the control group at 1,3 and 6 months after surgery,and the differences were statistically significant (P < 0.05).Three months after surgery,the levels of osteocalcin (OC) and bone alkaline phosphatase (BALP) in the observation group were higher than those in the control group,and the parathyroid hormone (PTH) and the special sequence of carboxy-terminal peptide β of type Ⅰ collagen (β-CTX) were lower than those in the control group,the differences were statistically significant (P < 0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant (P < 0.05).Conclusion The self-made traditional Chinese medicine prescription for PHF patients over 60 years old can relieve the pain degree of patients,improve shoulder joint function,promote fracture healing,regulate the level of bone metabolic factors,improve the effect of surgical treatment,and fewer complications.