穴位贴敷联合阶段性康复功能训练对股骨颈骨折术后患者功能康复、血清疼痛因子和骨代谢标志物的影响

Effects of Acupoint Application Combined with Staged Rehabilitation Function Training on Functional Rehabilitation,Serum Pain Factors and Bone Metabolism Markers in Patients with Femoral Neck Fracture after Operation

目的:探讨穴位贴敷联合阶段性康复功能训练对股骨颈骨折术后患者功能康复、血清疼痛因子和骨代谢标志物的影响。方法:纳入四川省骨科医院2021年1月~2021年10月期间收治的股骨颈骨折患者150例。根据信封抽签法将患者分为对照组(75例)和观察组(75例),对照组接受阶段性康复功能训练,观察组接受穴位贴敷联合阶段性康复功能训练,两组均干预3个月。3个月后,观察两组功能康复、视觉疼痛模拟评分法(VAS)评分、血清疼痛因子和骨代谢标志物情况,记录两组术后并发症发生率。结果:两组干预3个月后Barthel指数和Harris髋关节评分均较干预前升高,且观察组高于对照组(P<0.05)。两组干预1个月后、干预2个月后、干预3个月后视觉疼痛模拟评分法(VAS)评分逐渐下降,且观察组低于对照组(P<0.05)。两组干预3个月后骨特异性碱性磷酸酶(BALP)、骨保护素(OPG)升高,且观察组高于对照组;抗酒石酸盐酸性磷酸酶异构体(TRACP-5b)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平降低,且观察组低于对照组(P<0.05)。两组干预3个月后缓激肽(BK)、前列腺素E2(PGE2)、5-羟色胺(5-HT)、脑内神经肽Y(NPY)水平降低,且观察组低于对照组(P<0.05)。两组术后并发症发生率组间对比无统计学差异(P>0.05)。结论:穴位贴敷联合阶段性康复功能训练可促进对股骨颈骨折患者术后功能恢复,减轻术后疼痛,可能与调节骨代谢相关标志物水平有关。

Objective:To investigate the effects of acupoint application combined with staged rehabilitation function training on functional rehabilitation,serum pain factors and bone metabolism markers in patients with femoral neck fracture after operation.Methods:150 patients with femoral neck fracture who were treated in Sichuan Orthopedic Hospital from January 2021 to October 2021 were included.According to the envelope lottery method,the patients were divided into control group(75 cases) and observation group(75cases).The control group received staged rehabilitation function training,and the observation group received acupoint application combined with staged rehabilitation function training.Both groups were intervened for 3 months.After 3 months,the functional rehabilitation,visual pain analogue scale(VAS) score,serum pain factors and bone metabolism markers in the two groups were observed,and the incidence of postoperative complications in the two groups was recorded.Results:3 months after intervention,Barthel Index and Harris hip score in the two groups were higher than those before treatment,and the observation group was higher than that in the control group(P0.05).Conclusion:Acupoint application combined with staged rehabilitation function training can promote the postoperative functional recovery of patients with femoral neck fracture and reduce postoperative pain,which may be related to regulating the level of markers related to bone metabolism.