闭合复位内固定术联合壮筋续骨汤治疗胫腓骨干骨折临床观察

Clinical Observation of Closed Reduction and Internal Fixation Combined with Zhuangjin Xugu Tang for Diaphyseal Fracture of Tibia and Fibula

目的:观察闭合复位内固定术联合壮筋续骨汤治疗胫腓骨干骨折的临床疗效。方法:将97例胫腓骨干骨折随机分为研究组50例与对照组47例。对照组给予闭合复位内固定术及术后常规治疗,研究组在对照组的基础上加用壮筋续骨汤治疗,2组均持续治疗2个月。比较2组治疗前后血管内皮生长因子(VEGF)、骨形态发生蛋白-2 (BMP-2)、胰岛素样生长因子-1 (IGF-1)水平,以及不良事件发生情况,并根据中医证候积分变化评定临床疗效。结果:研究组总有效率为96.00%,对照组为82.97%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组VEGF、BMP-2、IGF-1水平比较,差异均无统计学意义(P>0.05);治疗后,2组上述各项骨生化指标均较治疗前升高(P<0.05),且研究组各项指标均高于对照组(P<0.05)。研究组不良事件发生率为6.00%,低于对照组的17.02%,差异无统计学意义(P>0.05)。结论:闭合复位内固定术联合壮筋续骨汤治疗胫腓骨干骨折可提高临床疗效,改善骨生化指标,术后并发症相对较少。

Objective:To observe the clinical effect of closed reduction and internal fixation combined with Zhuangjin Xutu Tang for diaphyseal fracture of tibia and fibula. Methods:A total of 97 cases of patients with diaphyseal fracture of tibia and fibula were randomly divided into the study group and the control group, with 50 and 47 cases in each group respectively. The control group was treated with closed reduction and internal fixation as well as routine postoperative treatment, and the study group was additionally treated with Zhuangjin Xugu Tang based on the treatment of the control group. Both groups were treated for two months. Before and after treatment,the levels of vascular endothelial growth factor(VEGF),bone morphogenetic protein 2(BMP-2) and insulin-like growth factor 1(IGF-1) and the incidence of adverse events were compared between the two groups;the clinical effect was evaluated according to the changes of traditional Chinese medicine(TCM) syndrome scores. Results:The total effective rate was96.00% in the study group and 82.97% in the control group, the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of the levels of VEGF,BMP-2 and IGF-1 between the two groups(P>0.05). After treatment, the above bone biochemical indexes in the two groups were increased when compared with those before treatment(P<0.05),and the indexes in the study group were higher than those in the control group(P<0.05). The incidence of adverse events was 6.00% in the study group,lower than that of 17.02% in the control group,the difference being significant(P<0.05). Conclusion: The therapy of closed reduction and internal fixation combined with Zhuangjin Xutu Tang for patients with diaphyseal fracture of tibia and fibula can effectively enhance the clinical effect,improve bone biochemical indexes,and postoperative complications were relatively few.