自拟消肿活血方配合手法复位治疗对A3型桡骨远端骨折患者肢体肿胀疼痛及功能恢复的影响

Influence of Self-Made Xiaozhong Huoxue Decoction(自拟消肿活血方)Combined with Manipulative Reduction Therapy on Limb Swelling and Pain and Functional Recovery in Patients with Type A3 Distal Radius Fractures

目的分析自拟消肿活血方配合手法复位治疗对A3型桡骨远端骨折患者的干预效果。方法选取2019年3月—2021年8月到医院就诊的84例A3型桡骨远端骨折患者,随机分为观察组和对照组各42例。对照组接受手法复位石膏外固定术及常规康复治疗,观察组在对照组的基础上联合自拟消肿活血方治疗。比较两组治疗前、治疗3 d及7 d时的疼痛肿胀评分;比较两组治疗前及治疗4周时的中医证候积分;记录两组疼痛消失时间、肿胀消失时间及骨折愈合时间;比较两组治疗4周、8周及12周时的腕关节功能恢复情况(Gartland-Werley腕关节评分)。结果两组治疗前、治疗3 d及7 d时的VAS评分及肿胀评分呈下降趋势,且观察组治疗3 d及7 d时的上述评分显著低于对照组(P<0.05);治疗4周时骨连未坚、瘀斑、活动受限、神疲乏力证候积分较治疗前明显降低,且观察组显著低于对照组(P<0.05);观察组患者的疼痛、肿胀消失时间及骨折愈合时间显著少于对照组(P<0.05);两组治疗4周及12周时的Gartland-Werley腕关节评分优良率比较差异无统计学意义(P>0.05),观察组治疗8周时的优良率显著高于对照组,组间比较差异有统计学意义(P<0.05)。结论自拟消肿活血方配合手法复位治疗可有效缓解A3型桡骨远端骨折患者的疼痛、肿胀症状,促进腕功能恢复。

Objective To analyze the intervention effects of Self-made Xiaozhong Huoxue Decoction(自拟消肿活血方)combined with manipulative reduction therapy on patients with type A3 distal radius fractures.Methods Eighty-four patients with type A3 distal radius fractures who were treated in the hospital were selected between March 2019 and August 2021,and they were randomly divided into the observation group and the control group,with 42 cases in each group.The control group received manipulative reduction plaster external fixation and conventional rehabilitation therapy,while the observation group was given Self-made Xiaozhu Huoxue Decoction on the basis of the control group.The scores of pain and swelling before treatment and at 3 d and 7 d of treatment and scores of TCM syndromes before treatment and at 4 weeks of treatment were compared between the two groups.The pain disappearance time,swelling disappearance time and fracture healing time were recorded in the two groups.The recovery of wrist function(Gartland-Werley wrist score)of the two groups were compared at 4,8 and 12 weeks of treatment.Results The visual analogy scale(VAS)score and swelling score in the two groups before treatment and at 3 d and 7 d of treatment showed downward trends,and the above scores in the observation group at 3 d and 7 d of treatment were significantly lower than those in the control group(P<0.05).At 4 weeks of treatment,the scores of syndromes such as unconsolidated bone,ecchymosis,activity limitation and fatigue were significantly reduced compared with those before treatment,and the scores in the observation group were significantly lower than those in the control group(P<0.05).The pain disappearance time,swelling disappearance time and fracture healing time in the observation group were significantly shorter compared with those in the control group(P<0.05).There was no statistical significance in the excellent or good rate of Gartland-Werley wrist score between the two groups at 4 and 12 weeks of treatment(P>0.05),and the excellent and good rate at 8 weeks of treatment was significantly higher in the observation group than that in the control group(P<0.05).Conclusion Self-made Xiaozhong Huoxue Decoction combined with manipulative reduction can effectively relieve the pain and swelling and promote the recovery of wrist function in patients with type A3 distal radius fractures.