续骨伸筋汤治疗儿童尺桡骨远端骨折疗效观察

Efficacy of Xugu Shenjin Decoction in the Treatment of Children with Distal Ulnar and Radial Fractures

目的:探讨续骨伸筋汤联合手法复位小夹板固定治疗儿童尺桡骨远端骨折的临床疗效。方法:采用随机数表法,将70例尺桡骨远端干骺端骨折患儿随机分为对照组和干预组各35例,对照组采用手法复位小夹板固定治疗,用4块小夹板固定。干预组在对照组治疗基础上联合续骨伸筋汤治疗,先以蒸汽熏蒸,待药液温度适宜时,再用毛巾浸药液敷于患部,每次30 min,每日2次,每2周为1个疗程。从康复疗效指标、腕关节活动度等方面比较两种疗法的差异。结果:(1)对照组、干预组的总有效率分别为80.0%、94.3%,差异无统计学意义(P>0.05)。但干预组疼痛缓解时间、肿胀缓解时间及骨折愈合时间均短于对照组(P<0.01)。(2)治疗后,干预组患儿的疼痛、关节肿胀、肢体萎缩、瘀斑等症状评分均低于对照组(P<0.05);功能活动、自主活动、腕关节功能评分均高于对照组(P<0.05)。(3)拆除小夹板后,两组患儿的腕关节活动度指标均有所提高,但与对照组比较,干预组患儿的腕关节活动度指标,包括背伸度、旋前度、桡偏度、掌屈度、旋后度等均更好(P<0.05)。结论:续骨伸筋汤联合手法复位小夹板固定治疗儿童尺桡骨远端骨折的疗效确切,值得临床推广应用。

Objective:To probe into the clinical efficacy of Xugu Shenjin decoction combined with manual reduction and small splint fixation in the treatment of distal ulnar and radial fractures in children.Methods:Seventy children with metaphyseal fracture of distal radius and ulna were randomly divided into the control group and intervention group via the random number table method,with 35 cases in each group.The control group was treated with manual reduction and small splint fixation,and fixed with four small splints.The intervention group received Xugu Shenjin decoction on the basis of the control group.Steam fumigation was given,when the temperature of the liquid was suitable,a towel was soaked in liquid and put on the affected area,30 min each time,twice a day,every 2 weeks for a course of treatment.Differences between two treatment regimens were compared from the aspects of rehabilitation efficacy indicator and wrist range of motion.Results:(1)The overall effective rates of the control group and the intervention group were respectively 80.0%and 94.3%,with no statistically significant difference(P>0.05).The pain relief time,swelling relief time and fracture healing time in the intervention group were significantly shorter than those in the control group(P<0.05).(2)After treatment,the scores of pain indicator,joint swelling,limb atrophy and ecchymosis in the intervention group were significantly lower than those in the control group(P<0.05),the scores of functional activity,autonomous activity and wrist function in the intervention group were higher than those in the control group(P<0.05).(3)After removing the small splints,the wrist range of motion indicators in both groups were improved,yet compared with the control group,the wrist range of motion indicators such as back extension,pronation,radial deviation,palm flexion and supination were significantly better in the intervention group(P<0.05).Conclusion:The efficacy of Xugu Shenjin decoction combined with manual reduction and small splint fixation in the treatment of distal ulnar and radial fractures in children is significant,which is worthy of clinical promotion.