分期辨证论治肱骨近端骨折的临床疗效观察

Clinical Effect of Proximal Humeral Fractures Treated by Stages Based on Syndrome Differentiation

目的:观察口服消肿化瘀汤、接骨续筋汤和壮骨强筋汤分期辨证论治肱骨近端骨折的疗效。方法:选择符合纳入标准的80例肱骨近端骨折患者,依据随机数字表将患者随机分为对照组和观察组,每组各40例。对照组采用单一微创手术,观察组在对照组治疗基础上,根据骨折病程,联合自拟中药汤剂(消肿化瘀汤、接骨续筋汤和壮骨强筋汤)内服治疗。比较两组患者临床治疗效果及骨折愈合情况;评价两组患者术后1、6、12个月患肢功能恢复情况和伤后2周、伤后7周及伤后8周的骨骼结痂情况。结果:两组患者治疗后,观察组的临床总有效率(97.5%,39/40)优于对照组(85%,34/40)(P<0.05);观察组骨折愈合时间短于对照组(P<0.05);术后1个月两组患者患肢功能恢复情况比较差异无统计学意义(P>0.05),术后6、12个月,观察组患者患肢功能恢复情况优于对照组(P<0.01)。伤后2周两组患者骨骼结痂评分相比差异无统计学意义(P>0.05),伤后7周及伤后8周,观察组患者骨骼结痂评分明显高于对照组(P<0.01)。结论:肱骨近端骨折患者在行微创手术的基础上联合分期辨证论治,骨折愈合情况良好,可促进患肢功能恢复。

Objective:To explore the curative effect of proximal humeral fracture treated by stages based on syndrome differentiation.Methods:80 patients with proximal humeral fractures were randomly divided into the control group(n=40)and the observation group(n=40).The control group was treated with single minimally invasive surgery;on which basis,the observation group was also treated with self-made Decoction(Xiaozhong Huayu Decoction,Jiegu Xujin Decoction,Zhuanggu Qiangjin Decoction)according to the stages of fracture.The clinical treatment effect and fracture healing were compared between the two groups.The functional recovery of affected limbs was evaluated in the two groups at 1 month,6 months and 12 months after operation.The bone scabs of the two groups were assessed at 2 weeks,7 weeks and 8 weeks after injury.Results:The clinical total effective rate of the observation group was 97.53%(39/40),which was significantly higher than 85%(34/40)of the control group(P<0.05).The fracture healing time was shorter in the observation group than that in the control group(P<0.05).There was no statistical difference in the functional recovery of the affected limbs between the two groups at one month after operation(P>0.05).The functional recovery of the affected limbs in the observation group was better than that in the control group at 6 and 12 months after operation(P<0.01).There was no statistical difference in the score of bone scab between the two groups at 2 weeks after injury(P>0.05).The score of bone scab in the observation group was significantly higher than that in the control group at 7 and 8 weeks after injury(P<0.01).Conclusion:Minimally invasive surgery combined with syndrome differentiation treatment by stages has the advantages in good fracture healing,and it can promote the recovery of affected limb function in treatment of proximal humeral fracture.