自拟健骨强筋汤熏蒸治疗老年人踝关节骨折临床疗效

Clinical Effect of Self-designed Jiangu Qiangjin Decoction Fumigation on Ankle Fracture in the Aged

目的:观察自拟健骨强筋汤熏蒸对踝关节骨折老年患者骨代谢与关节功能的影响。方法:回顾性分析在开封市中心医院2021年1月至2022年1月期间治疗的踝关节骨折老年患者资料,从中选取常规术后治疗的49例患者纳入对照组,另选取49例在常规术后治疗基础上应用自拟健骨强筋汤熏蒸治疗的患者纳入观察组。比较两组患者康复进程,观察治疗前、后患者关节功能、活动度、肌力及血清骨代谢指标的变化。结果:观察组患者关节活动功能复常时间、恢复生活行走时间、完全负重时间均短于对照组,差异具有统计学意义(P <0.05)。治疗后两组患者Olderud–Molander、美国足踝外科协会(AOFAS)、Tinetti、Baird–Jackson评分均较治疗前提高,且治疗后观察组患者Olderud–Molander、AOFAS、Tinetti、Baird–Jackson评分均高于对照组,差异具有统计学意义(P <0.05)。治疗后两组患者肌力与关节活动度均较治疗前增大,且治疗后观察组患者肌力与关节活动度均大于对照组,差异具有统计学意义(P <0.05)。治疗后两组患者骨钙素(BGP)、前胶原羧基端肽(PICP)水平均较治疗前提升,总骨Ⅰ型前胶原氨基端延长肽(Total–PINP)、Ⅰ型胶原羧基端肽β特殊序列(β–CTX)水平低于治疗前,且治疗后观察组患者BGP、PICP水平均高于对照组,Total–PINP、β–CTX水平低于对照组,差异具有统计学意义(P <0.05)。结论:自拟健骨强筋汤熏蒸治疗能够促进踝关节骨折老年患者骨折康复,增强骨代谢,更好的改善患者关节功能。

Objective To observe the effects of self-designed Jiangu Qiangjin Decoction fumigation on bone metabolism and joint function in elderly patients with ankle fracture.Methods The data of elderly patients with ankle fracture treated in Kaifeng Central Hospital from January 2021 to January 2022 were retrospectively analyzed.49 patients receiving conventional postoperative treatment were included in the control group,and 49 patients receiving fumigation treatment with self-designed Jiangu Qiangjin Decoction on the basis of conventional postoperative treatment were included in the observation group.The rehabilitation progress of the two groups was compared,and the changes of joint function,range of motion,muscle strength and serum bone metabolism indexes were observed before and after treatment.Results The time to normalizing joint movement function,walking time to return to life and full weight-bearing time in the observation group were shorter than those in the control group, and the differences were statistically significant (P < 0.05). After treatment, the scores of Olderud-Molander, American Association of Foot and Ankle Surgery (AOFAS), Tinetti and Baird-Jackson in the two groups were higher than those before treatment, and after treatment, the scores of Olderud-Molander, AOFAS, Tinetti and Baird-Jackson in the observation group were higher than those in the control group. The differences were statistically significant (P < 0.05). After treatment, the muscle strength and joint motion of the two groups were increased compared with those before treatment, and after treatment, the muscle strength and joint motion of the observation group were greater than those of the control group, the differences were statistically significant (P < 0.05). After treatment, the levels of bone gla-protein (BGP) and precollagen carboxy-terminal peptide (PICP) in the two groups were increased compared with those before treatment, the levels of total bone procollagen type I amino terminal extender peptide (Total-PINP) and the C-terminal peptide of type I collagen β Special sequence (β-ctx) were lower than those before treatment, and the levels of BGP and PICP in the observation group were higher than those in the control group after treatment. The levels of Total-PINP and β-ctx were lower than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion Self-designed Jiangu Qiangjin Decoction fumigation treatment can promote fracture rehabilitation in elderly patients with ankle fracture, enhance bone metabolism, and better improve the function of the affected joint.