桃红四物合黄芪当归补血汤对老年下肢骨折术后愈合效果及并发症的影响

Effects of Taohong Siwu Decoction combined with Huangqi Danggui Buxue Decoction on postoperative healing and complications in elderly patients with lower limb fracture

目的观察桃红四物合黄芪当归补血汤对老年下肢骨折术后愈合效果及并发症的影响。方法将130例老年下肢骨折患者按照随机数字表法分为2组,均予手术治疗,对照组65例术后予鹿瓜多肽注射液治疗,治疗组65例术后予桃红四物合黄芪当归补血汤治疗。2组均连续治疗2周。比较2组治疗前、术后3个月愈合效果;比较2组并发症发生率;比较2组治疗前、术后3个月生长因子、炎症因子变化;比较2组不良反应发生情况。结果2组术后3个月骨痂边缘、断端边缘、骨痂密度、骨痂量评分均较本组治疗前升高(P<0.05);术后3个月治疗组骨痂边缘、断端边缘、骨痂密度、骨痂量评分均高于对照组(P<0.05)。治疗组并发症发生率7.69%(5/65),对照组并发症发生率24.62%(16/65),治疗组并发症发生率低于对照组(P<0.05)。2组术后3个月血管内皮生长因子受体1(VEGFR1)、血小板衍生因子受体(PDGFR)、成纤维细胞生长因子受体1(FGFR1)水平均较本组治疗前升高(P<0.05),术后3个月治疗组VEGFR1、PDGFR、FGFR1水平均高于对照组(P<0.05)。2组术后3个月半乳糖凝集素-3(Galectin-3)、基质金属蛋白酶2(MMP-2)、缓激肽B2(BKB2)水平均较本组治疗前降低(P<0.05),术后3个月治疗组Galectin-3、MMP-2、BKB2水平均低于对照组(P<0.05)。治疗组不良反应发生率13.85%(9/65),对照组不良反应发生率9.23%(6/65),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论老年下肢骨折术后应用桃红四物合黄芪当归补血汤治疗,能促进下肢骨折愈合,降低术后并发症发生率,提高生长因子水平,抑制炎性反应,治疗安全。

Objective To observe the effects of Taohong Siwu Decoction combined with Huangqi Danggui Buxue Decoction on postoperative healing and complications in elderly patients with lower limb fracture(LLF).Methods A total of 130 elderly patients with LLF were randomly assigned into the treatment group(n=65)and the control group(n=65).After LLF surgery,the control group additionally received Lugu Peptide Injection,and the treatment group additionally received Taohong Siwu Decoction combined with Huangqi Danggui Buxue Decoction.A 2-week treatment was performed to compare healing effect,incidence of complications,growth factor,inflammatory factor.The adverse reactions were assessed.Results After treatment,the scores of edge of fracture callus and broken ends,fracture callus density,osteophyte volume in groups were increased(P<0.05),which were increased in the treatment group compared with the control group(P<0.05).The incidence of complications was 7.69%(5/65)in the treatment group,lower than that of 24.62%(16/65)in the control group(P<0.05).The vascular endothelial growth factor receptor-1(VEGFR-1),platelet-derived growth factor receptor(PDGFR),fibroblast growth factor receptor-1(FGFR1)in groups after treatment were increased(P<0.05),which were higher in the treatment group than in the control group(P<0.05).After treatment,Galectin-3,matrix metalloproteinase-2(MMP-2),bradykinin B2(BKB2)in groups were decreased(P<0.05),the reduction in the treatment group was more common compared with the control group(P<0.05).The difference was not statistically significant in the incidence of adverse reactions between the treatment group and the control group(13.85%[9/65]vs 9.23%[6/65],[P>0.05],respectively).Conclusion For elderly patients with LLF,Taohong Siwu Decoction combined with Huangqi Danggui Buxue Decoction can promote the healing of lower limbs,reduce the incidence of postoperative complications,increase the level of growth factors,inhibit inflammatory reactions,and with good safety.