补肾活血中药辅助闭合复位髓内钉内固定术治疗股骨粗隆间骨折的临床观察

Clinical Observation of Closed Reduction and Intramedullary Nail Internal Fixation Assisted by Traditional Chinese Medicine for Tonifying the Kidney and Activating Blood Circulation in the Treatment of Femoral Intertrochanteric Fracture

目的:探究补肾活血中药辅助闭合复位髓内钉内固定术治疗股骨粗隆间骨折的临床效果。方法:选取2019年8月-2021年6月上饶市广丰区中医院收治的84例股骨粗隆间骨折患者,以随机数字表法分为常规组(n=42)和联合组(n=42)。常规组使用闭合复位髓内钉内固定术治疗,联合组在对照组基础上加用补肾活血中药治疗。比较两组临床效果。结果:治疗后,两组血浆黏度(PV)、全血高切黏度、全血低切黏度、纤维蛋白原均低于治疗前,且联合组均低于常规组(P<0.05)。末次随访时,两组数字疼痛评定量表(NRS)评分均低于术前,髋关节功能评分(Harris)评分均高于术前,且联合组NRS评分低于常规组,联合组Harris评分高于常规组,差异均有统计学意义(P<0.05)。联合组完全负重时间、下地行走时间及骨折愈合时间均短于常规组(P<0.05)。术后3个月,联合组骨折复位优良率高于常规组(P<0.05)。联合组下肢深静脉血栓发生率低于常规组(P<0.05)。结论:股骨粗隆间骨折闭合复位髓内钉内固定术后加用补肾活血中药可提高患者术后恢复效果,改变血液流变学,缓解疼痛,促进髋关节恢复,且可降低下肢深静脉血栓的发生。

Objective:To explore the clinical effect of closed reduction and intramedullary nail internal fixation assisted by traditional Chinese medicine for tonifying the kidney and activating blood circulation in the treatment of femoral intertrochanteric fracture.Method:A total of 84 patients with femoral intertrochanteric fracture who were treated in Guangfeng District Hospital of Traditional Chinese Medicine of Shangrao City from August 2019to June 2021 were selected,they were divided into conventional group(n=42)and combined group(n=42)according to random number table method.Conventional group were treated with closed reduction and intramedullary nail internal fixation,and the combination group was treated with traditional Chinese medicine for tonifying the kidney and activating blood circulation on the basis of the control group.The clinical effect were compared between two groups.Result:After treatment,the plasma viscosity(PV),whole blood high shear viscosity,whole blood low shear viscosity and fibrinogen in the both groups were lower than those before treatment,and those in the combination group were lower than those in the conventional group(P<0.05).At last follow-up,the numerical pain rating scale(NRS)scores in both groups were lower than those before surgery,and the hip joint function(Harris)scores in both groups were higher than those before surgery,The NRS score in the combined group was lower than that in the conventional group,and the Harris score in the combined group was higher than that in the conventional group,the differences were statistically significant(P<0.05).The time of complete weight-bearing,walking time and fracture healing time in the combined group were shorter than those in the conventional group(P<0.05).At 3months after surgery,the excellent and good rate of fracture reduction in the combined group was higher than that in the conventional group(P<0.05).The incidence of lower extremity deep vein thrombosis in the combined group was lower than that in the conventional group(P<0.05).Conclusion:After closed reduction and intramedullary nail internal fixation in the treatment of femoral intertrochanteric fractures,the addition of traditional Chinese medicine for tonifying the kidney and activating blood circulation can improve the postoperative recovery effect,change hemorheology,relieve pain,promote hip joint recovery,and reduce deep vein thrombosis of lower extremities.