改良夹板联合止痛壮骨丸治疗老年急性Colles骨折并骨质疏松疗效观察

Efficacy of modified splint combined with Zhitong Zhuanggu pills on elderly acute Colles fracture with osteoporosis

目的观察改良夹板联合止痛壮骨丸治疗老年急性Colles骨折并骨质疏松患者的临床疗效。方法纳入2021年9月—2022年9月武汉中西医结合骨科医院收治的老年急性Colles骨折并骨质疏松患者120例,随机分为3组,均予手法复位及阿仑膦酸钠片、碳酸钙D 3片口服。对照组40例予以传统夹板固定,改良组40例予以改良夹板固定,联合组40例予以改良夹板固定并口服壮骨止痛丸。比较3组患者复位前及复位后即刻、复位后4周、复位后12周的掌倾角、尺偏角、桡骨高度,复位前及复位后12周中医证候评分、Garland-Werley腕关节功能评分、血清I型原胶原N-端前肽(PINP)水平、血清I型胶原交联C-末端肽(CTX)水平,统计3组治疗有效率及不良反应发生情况。结果复位后4周、12周,联合组尺偏角、掌倾角、桡骨高度均明显高于改良组和对照组(P均<0.05)。复位后12周,3组患者患肢肿痛、腰膝酸痛、神疲乏力评分及Gartland-Werley腕关节功能评分、血清PINP水平、血清CTX水平均明显低于复位前(P均<0.05),且联合组患肢肿痛、腰膝酸痛、神疲乏力评分均明显低于改良组和对照组(P均<0.05)。联合组疗效优于改良组和对照组(P均<0.05)。3组不良反应发生情况比较差异无统计学意义(P均>0.05)。结论改良夹板合止痛壮骨丸治疗老年急性Colles骨折并骨质疏松患者,可有效改善骨折愈合情况及促进腕关节功能恢复,调节骨代谢,减轻患者肿痛、乏力症状,且安全性佳。

Objective It is to observe the clinical efficacy of modified splint combined with Zhitong Zhuanggu pills in the treatment of elderly patients with acute Colles fracture and osteoporosis.Methods One hundred and twenty cases of elderly patients with acute Colles fracture and osteoporosis admitted to Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine from September 2021 to September 2022 were selected and randomly divided into 3 groups,all of which were treated with manipulative restoration and alendronate sodium tablets and calcium carbonate D3 tablets by oral administration.40 cases in the control group were fixed with traditional splints,40 cases in the modified group were fixed with modified splints,and 40 cases in the combination group were fixed with modified splints and orally administered Zhitong Zhuanggu pills.The palm angle,ulnar deviation angle and radius height before and immediately after reset,4 weeks after reset,and 12 weeks after reset,the scores of Chinese medicine syndrome,scores of Garland-Werley wrist function,the serum levels of procollagen I N-terminal propeptide(PINP),C-terminal cross linked peptide(CTX)before reset and 12 weeks after reset in the patients of the three groups were compared,and the effective rate of the treatment and the incidence of adverse reactions in the three groups were counted.Results At 4 and 12 weeks after reset,the palm angle,ulnar deviation angle and radius height of the combination group were significantly higher than those of the modified group and the control group(all P<0.05).At 12 weeks after reset,the scores of swelling and pain of the affected limbs,waist and knee pain,fatigue scores of and Gartland-Werley wrist function,the serum levels of PINP and CTX of the patients of the three groups were significantly lower than those before reset(all P<0.05),and the scores of swelling and pain of the affected limbs,waist and knee pain,fatigue scores of the combination group were significantly lower than those of the modified group and control group(all P<0.05).The efficacy of the combination group was better than those of the modified group and control group(both P<0.05).There was no statistically significant difference in the occurrence of adverse reactions among the three groups(all P>0.05).Conclusion Modified splint combined with Zhitong Zhuanggu pills can effectively improve fracture healing and promote the recovery of wrist joint function,regulate bone metabolism,alleviate the symptoms of swelling,pain and fatigue with good safety in the treatment of elderly patients with acute Colles fracture and osteoporosis.