独活寄生汤加减对胫腓骨骨折术后膝关节功能及骨折愈合速度的影响

The Influence of Modified Pubescent Angelica and Mistletoe Decoction on Postoperative Activity and Fracture Healing Speed of Tibia and Fibula Fracture

目的:观察独活寄生汤加减对胫腓骨骨折术后膝关节功能及骨折愈合速度的影响。方法:将80例胫腓骨骨折患者按照随机数字表法分为对照组和观察组,每组各40例。两组均进行手术治疗,对照组术后给予常规西药治疗,观察组给予独活寄生汤加减治疗。观察两组患者术后肿胀消失和骨折愈合时间,比较两组患者治疗前后膝关节功能水平[关节活动度(rangeofmotion,ROM)、膝关节特种外科医院评分(hospital for special surgery,HSS)]、改良Barthel指数(modified barthel index,MBI)、骨代谢指标[骨钙素(bone gla-protein,BGP)、碱性磷酸酶(alkaline phosphatase,ALP)、抗酒石酸酸性磷酸酶(tartrate resistant acid phosphatase,TRAP)]和血液流变学指标(血浆黏度、红细胞刚性指数、红细胞聚集指数)变化情况。结果:观察组肿胀消失时间和骨折愈合时间短于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后ROM、HSS评分及MBI评分高于本组治疗前,且治疗后观察组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后BGP、ALP水平高于本组治疗前,TRAP水平低于本组治疗前,差异具有统计学意义(P<0.05)。两组患者治疗后血浆黏度、红细胞刚性指数、红细胞聚集指数水平低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。结论:将独活寄生汤加减应用于胫腓骨骨折患者术后的治疗中,有效缩短了骨折愈合时间,提高患者膝关节功能水平和生活质量,也可改善血液流变学指标。

Objective:To observe the influence of Modified Pubescent Angelica and Mistletoe Decoction on postoperative activity and fracture healing speed of tibia and fibula fracture.Methods:A total of 70 patients with tibia and fibula fracture were randomly divided into the control group and the observation group,with 40 cases in each group.Both groups were first treated with surgery,then the control group was additionally treated with conventional Western medicine,while the observation group was additionally treated with Modified Pubescent Angelica and Mistletoe Decoction.The swelling and fracture healing time of the two groups were observed.The changes of the knee joint function level of patients [including Range of motion(ROM),Hospital for special surgery(HSS) score],Modified Barthel Index(MBI)],bone metabolism indexes [including Bone Gla-protein(BGP),Alkaline phosphatase(ALP),Tartrate resistant acid phosphatase(TRAP)] and hemorheology indexes(including plasma viscosity,erythrocyte rigidity index,erythrocyte aggregation index) in both groups before and after treatment were compared.Results:The swelling disappearance time and fracture healing time in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the ROM,HSS and MBI scores of patients in the two groups were higher than those of the same group before treatment,and the above indexes of the observation group were higher than those of the control group,and all the differences were statistically significant(P<0.05).After treatment,the levels of BGP and ALP in the two groups were higher than those of the same group before treatment,while the level of TRAP was lower than that before treatment,and all the differences were statistically significant(P<0.05).The levels of the plasma viscosity,erythrocyte rigidity index and erythrocyte aggregation index of the two groups after treatment were lower than those of the same group before treatment,and the above indexes of the observation group were lower than those of the control group after treatment,and all the differences were statistically significant(P<0.05).Conclusion:The application of Modified Pubescent Angelica and Mistletoe Decoction in the treatment of patients with tibia and fibula fracture after operation can effectively shorten the time of fracture healing,improve the level of knee joint function and quality of life,and also enhance the level of hemorheology indexes.