补阳还五汤对老年股骨颈骨折经髋关节置换术治疗患者临床疗效、血液流变学及关节功能的影响

Effect of Buyang Huanwu Decoction on Clinical Efficacy,Hemorheology and Joint Function for Elderly Patients with Femoral Neck Fracture Treated by Hip Replacement

目的:探讨补阳还五汤对老年股骨颈骨折经髋关节置换术治疗患者临床疗效、血液流变学及关节功能的影响。方法:回顾性分析2018年5月~2020年5月本院收治的86例老年股骨颈骨折患者临床资料,根据治疗方案分组的差异分为对照组45例(髋关节置换术后予以皮下注射低分子肝素钙注射液治疗,并进行负重运动)、联合组41例(在对照组的基础上联合补阳还五汤治疗)。两组持续治疗6个月,对比2组X射线评分、临床疗效,及液流变学指标、运动功能改善情况,并观察2种治疗方案的安全性。结果:(1)治疗后2组X射线评分成显著升高趋势(P<0.05),联合组X射线评分升高幅度显著高于对照组(P<0.05)。(2)治疗后两组血液流变学各指标均有明显改善(P<0.05),联合组改善程度显著高于对照组(P<0.05)。(3)对照组总有效率77.78%显著低于联合组95.12%,比较差异具有统计学意义(P<0.05)。(4)与治疗前比较,2组患者步行能力评分明显降低,FMES评分明显升高(P<0.05);联合组步行能力评分低于对照组,FMES评分高于对照组(P<0.05)。(5)联合组不良反应总发生率(4.88%)显著低于对照组(15.56%),比较差异具有统计学意义(P<0.05)。结论:补阳还五汤可有效预防老年股骨颈骨折经髋关节置换术后DVT的发生,安全性较高,可改善患者血液流变学指标及运动功能,临床使用价值大。

Objective:To explore the effect of Buyang Huanwu Decoction on the clinical efficacy,hemorheology and joint function for elderly patients with femoral neck fracture treated by hip replacement.Methods:The clinical data of 86 elderly patients with femoral neck fractures admitted to this hospital from May 2,018 to May 2,020 were retrospectively analyzed.According to the difference in treatment,they were divided into 45 cases in the controlled group(subcutaneous injection of low-molecular-weight heparin calcium after hip replacement and then and weight-bearing exercise)and 41 cases in the combination group(supplemented with Buyang Huanwu Decoction).Patients in the two groups were continuously treated for 6 months.The X-ray scores,clinical efficacy,and improvement of hemorheology indexes and motor function between the two groups were compared,and the safety of the two treatment options was observed.Results:(1)After treatment,the X-ray scores of the two groups increased significantly(P<0.05),and the increasing of X-ray scores of the combined group was significantly higher than that of the controlled group(P<0.05).(2)After treatment,the indexes of hemorheology in the two groups significantly improved(P<0.05),and the improvement in the combined group was significantly higher than that in the controlled group(P<0.05).(3)The total effective rate of the controlled group was 77.78%,which was significantly lower than the 95.12%of the combination group,and the difference was statistically significant(P<0.05).(4)Compared with those before treatment,the walking ability scores of the two groups significantly reduced,and the FMES score significantly increased(P<0.05).The walking ability score of the combined group was lower than that of the controlled group,and the FMES score was higher than that of the controlled group(P<0.05).(5)The total incidence of adverse reactions in the combined group(4.88%)was significantly lower than that in the controlled group(15.56%),and the difference was statistically significant(P<0.05).Conclusion:Buyang Huanwu Decoction can effectively prevent the occurrence of DVT after hip arthroplasty in elderly patients with femoral neck fractures.It has high safety and can improve the patients’hemorheology indexes and motor function.It has great clinical value.