逐瘀通络汤联合理筋手法对桡骨远端骨折患者术后恢复期关节僵硬的改善作用

The Improvement Effect of Stasis-Removing and Collateral-Unblocking Decoction Combined with Tendon-Regulating Manipulation on Postoperative Recovery Period Patients with Distal Radius Fractures Joint Stiffness

目的:观察逐瘀通络汤联合理筋手法对桡骨远端骨折患者术后恢复期关节僵硬的改善作用。方法:将91例桡骨远端骨折术后恢复期患者按照随机数字表法分为对照组45例和观察组46例。两组除均行功能锻炼,对照组在常规锻炼的基础上采用理筋手法,观察组在对照组治疗的基础上联合逐瘀通络汤口服及外洗。比较两组患者腕关节功能恢复情况及治疗前后腕关节功能评分、疼痛介质水平、腕关节活动影像学指标变化情况。结果:两组患者治疗后腕关节功能评分低于本组治疗前,且治疗后观察组低于对照组,差异有统计学意义(P<0.05)。观察组活动度、精细度、握力等方面改善率高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后P物质、前列腺素E、神经肽Y低于本组治疗前,观察组治疗后神经肽Y、P物质水平均低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后尺偏角、掌倾角、桡骨高度、关节面台阶高于本组治疗前,且治疗后观察组高于对照组,差异具有统计学意义(P<0.05)。结论:逐瘀通络汤联合理筋手法可有效提高桡骨远端骨折患者术后恢复期腕关节功能,有效降低相关疼痛介质水平,改善关节活动影像学指标,从而有效改善关节僵硬症状。

Objective:To observe the improvement effect of Stasis-Removing and Collateral-Unblocking Decoction combined with tendon-regulating manipulation on postoperative recovery period patients with distal radius fractures joint stiffness.Methods:A total of 91 patients with postoperative recovery of distal radius fractures were randomly divided into the control group with 45 cases and the observation group with 46 cases according to random number table method.Except for receiving functional exercise by both groups,the control group received intervention with tendon-regulating manipulation on the basis of the routine exercise,while the observation group received treatment with Stasis-Removing and Collateral-Unblocking Decoction for oral administration and external washing.The recovery of wrist joint function between two groups,as well as the changes in wrist joint function scores,pain mediator levels,and wrist joint activity imaging indicators before and after treatment were compared.Results:After treatment,the wrist joint function scores of the two groups were lower than those of the same group before treatment,and the observation group's was lower than that of the control group after,with a statistically significant difference(P<0.05);The improvement rate of activity,precision,grip strength and other aspects in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05);the levels of substance P,prostaglandin E and neuropeptide Y in the two groups were lower than those before treatment,and the levels of neuropeptide Y and substance P in the observation group were lower than those in the control group,with statistically significant differences(P<0.05);the ulnar deviation angle,palm angle,radius height,and joint surface steps of the two groups were higher than those of the same group before treatment,and the observation group's above indexes were higher than those of the control group,with statistically significant differences(P<0.05).Conclusion:Stasis-Removing and Collateral-Unblocking Decoction combined with tendon-regulating manipulation can effectively improve the wrist joint function score of patients with distal radius fractures during the postoperative recovery period,effectively reduce the level of related pain mediators,improve joint activity imaging indicators,and thus effectively enhance joint stiffness symptoms.