温针灸联合手法复位小夹板固定治疗骨质疏松性桡骨远端骨折的临床研究

Clinical Study of Needle-warm Moxibustion Combined with Manual Reduction and Splint Fixation for Osteoporotic Distal Radius Fracture

目的观察温针灸联合手法复位小夹板固定治疗骨质疏松性桡骨远端骨折的临床疗效。方法将70例骨质疏松性桡骨远端骨折患者随机分为对照组和观察组,每组35例。对照组予手法复位小夹板固定,观察组在对照组治疗基础上予温针灸。比较两组骨折愈合时间、肿胀消退时间、疼痛缓解时间、Gartland-Werley评分、腕关节功能评级及健侧桡骨远端骨密度,检测血清缺氧诱导因子-1α(HIF-1α)和趋化素水平。结果观察组骨折愈合时间、肿胀消退时间和疼痛缓解时间均短于对照组(P<0.05)。观察组Gartland-Werley评分低于对照组(P<0.05),观察组患侧腕关节功能评级优于对照组(P<0.05)。治疗后,对照组健侧桡骨远端骨密度无明显变化(P>0.05);观察组健侧桡骨远端骨密度明显升高(P<0.05),且高于对照组(P<0.05)。治疗后,对照组血清HIF-1α水平无明显变化(P>0.05),血清趋化素水平降低(P<0.05);观察组血清HIF-1α水平升高(P<0.05),血清趋化素水平降低(P<0.05),且均优于对照组(P<0.05)。结论温针灸联合手法复位小夹板固定治疗骨质疏松性桡骨远端骨折可加快骨折愈合,改善局部肿胀、疼痛症状及腕关节功能,提升健侧桡骨远端骨密度,这可能与其调节患者血清HIF-1α和趋化素水平有关。

Objective To observe the clinical efficacy of treating osteoporotic distal radius fracture(DRF)with needle-warming moxibustion plus splint fixation.Method Seventy patients with osteoporotic DRF were randomly divided into a control group and an observation group,with 35 cases in each group.The control group was treated with manual reduction plus splint fixation,and the observation group received additional needle-warming moxibustion treatment.The fracture healing time,swelling reduction time,pain relief time,Gartland-Warley score,wrist joint function grading,and distal radius bone mineral density(BMD)on the healthy side were compared between the two groups.The serum hypoxia-inducible factor-1α(HIF-1α)and chemerin levels were detected.Result The fracture healing time,swelling reduction time,and pain relief time were earlier in the observation group than in the control group(P<0.05).The Gartland-Werley score in the observation group was lower than that in the control group(P<0.05),and the affected wrist joint function grading was better in the observation group than in the control group(P<0.05).After the treatment,there was no significant change in the distal radius BMD on the healthy side in the control group(P>0.05),while that in the observation group increased notably(P<0.05)and was higher than in the control group(P<0.05).After the treatment,the serum HIF-1αlevel showed no significant difference in the control group(P>0.05),but the serum chemerin level decreased(P<0.05);in the observation group,the serum HIF-1αlevel elevated(P<0.05),and the serum chemerin level decreased(P<0.05),and the observation group was better than the control group(P<0.05).Conclusion Needle-warming moxibustion plus manual reduction and splint fixation can boost fracture healing,improve topical swelling,pain,and wrist joint function,and increase the distal radius BMD on the healthy side in treating patients with osteoporotic DRF,which may be associated with the regulation on the serum HIF-1αand chemerin levels.