中医手法复位联合中药内服外敷治疗闭合性四肢骨折临床研究

Clinical Study on the Treatment of Closed Limb Fractures with TCM Manipulation Reduction Combined with Oral Administration and External Application of Chinese Medicinals

目的:观察中医手法复位联合中药内服外敷治疗闭合性四肢骨折的临床疗效。方法:选取2020年7月至2021年7月高邮市卸甲中心卫生院治疗的闭合性四肢骨折患者92例,按照随机数字表法分成常规组和试验组,各46例。常规组给予中医手法复位治疗,试验组给予中医手法复位联合中药内服外敷治疗。观察两组患者治疗前后中医症状体征评分、血沉、红细胞压积、全血比黏度、血浆比黏度、骨形态发生蛋白-2(bone morphogenetic protein-2,BMP-2)、骨γ-羧基谷氨酸蛋白(boneγ-bone gla protein,BGP)、Ⅰ型前胶原羧基端肽(carboxyterminal propeptide of type I procollagen,PICP)变化情况,并统计两组患者骨折愈合时间、不良反应发生率及临床疗效。结果:试验组治疗后中医症状体征评低于常规组,差异有统计学意义(P<0.05);试验组治疗后血沉、红细胞压积、全血比黏度、血浆比黏度均低于常规组,差异有统计学意义(P<0.05);试验组治疗后BMP-2、BGP、PICP水平均高于常规组,差异有统计学意义(P<0.05);试验组治疗后骨折愈合时间、不良反应发生率低于常规组,差异有统计学意义(P<0.05);试验组有效率为95.65%,常规组有效率为84.78%,试验组有效率高于常规组,差异有统计学意义(P<0.05)。结论:中医手法复位联合中药内服外敷治疗闭合性四肢骨折,能缓解患者疼痛肿胀,加速新骨形成,促进骨折早日愈合。

Objective:To observe the clinical efficacy of TCM manipulation reduction combined with oral administration and external application of Chinese medicinals on closed limb fractures.Methods:A total of 92 patients with closed limb fractures who were treated in Gaoyou Central Health Center from July 2020 to July 2021 were selected and randomly divided into the routine group and the experimental group,with 46 cases in each group.The routine group was treated with TCM manipulation reduction,while the experimental group was treated with TCM manipulation reduction combined with oral administration and external application of Chinese medicinals.Then the changes in the TCM symptom and sign scores,erythrocyte sedimentation rate(ESR),hematocrit,whole blood viscosity,plasma viscosity,bone morphogenetic protein-2(BMP-2),bone-bone gla protein(BGP),carboxyterminal propeptide of type I procollagen(PICP)in the two groups before and after treatment were observed.And the fracture healing time,incidence of adverse reactions,and clinical efficacy of the two groups were statistically counted.Results:After treatment,the evaluation scores of TCM symptoms and signs in the experimental group were lower than those in the conventional group,and all the differences were statistically significant(P<0.05);The ESR,hematocrit,whole blood viscosity,and plasma viscosity of the experimental group were lower than those of the routine group,and all the differences were statistically significant(P<0.05);The levels of BMP-2,BGP,and PICP in the experimental group were higher than those in the routine group,and all the differences were statistically significant(P<0.05);The fracture healing time and incidence of adverse reactions in the experimental group were lower than those in the routine group,and all the differences were statistically significant(P<0.05).The effective rate of the experimental group was 95.65%,while that of the routine group was 84.78%.The effective rate of the experimental group was higher than that of the conventional group,and the difference was statistically significant(P<0.05).Conclusion:TCM manipulation reduction combined with oral administration and external application of Chinese medicinals can alleviate pain and swelling in patients with closed limb fractures,accelerate the formation of new bones,and promote fracture healing as early as possible.