续骨活血汤治疗股骨粗隆间骨折的临床疗效

Clinical Efficacy of Xugu Huoxue Decoction in the Treatment of Intertrochanteric Fractures of Femur

目的 探讨续骨活血汤治疗股骨粗隆间骨折(intertrochanteric fracture of femur,IFF)的临床疗效。方法 选取2020年3月—2022年3月沈阳市骨科医院收治的120例IFF患者为研究对象,根据不同的治疗方法分为两组,各60例。所有患者均行股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)术治疗,对照组术后第3天起口服碳酸钙D3片治疗,观察组在对照组基础上加服续骨活血汤治疗。比较两组临床疗效、疼痛评分、髋关节功能、骨密度(股骨头局部骨密度、髋部平均骨密度)、血液流变学指标(全血高切黏度、血浆黏度、全血低切黏度)、恢复情况(肿胀消退时间、骨折愈合时间)、不良反应发生情况。结果 观察组总有效率为96.67%(58/60),高于对照组的85.00%(51/60),差异有统计学意义(χ^(2)=4.904,P=0.027)。观察组髋关节功能评分高于对照组,骨密度大于对照组,差异有统计学意义(P均<0.05)。观察组疼痛评分、血液流变学指标均低于对照组,差异有统计学意义(P均<0.05)。观察组骨折愈合时间、肿胀消退时间均短于对照组,差异有统计学意义(P均<0.05)。治疗期间两组均未见明显不良反应。结论 续骨活血汤治疗IFF效果较好,可缓解患者疼痛,促进血液循环,改善骨密度和髋关节功能,安全可靠,利于预后。

Objective To explore the clinical efficacy of Xugu Huoxue Decoction in the treatment of intertrochanteric fracture of femur(IFF).Methods A total of 120 IFF patients admitted to Shenyang Orthopaedic Hospital from March 2020 to March 2022 were selected as the research objects.According to different treatment methods,they were divided into two groups,with 60 cases in each group.All patients were treated with proximal femoral nail anti-rotation(PFNA).The control group was treated with oral calcium carbonate D3 from the third day after operation,and the observation group was treated with Xugu Huoxue Decoction on the basis of the control group.The clinical efficacy,pain score,hip joint function,bone mineral density(local bone mineral density of femoral head,average bone mineral density of hip),hemorheological indexes(whole blood high shear viscosity,plasma viscosity,whole blood low shear viscosity),recovery(swelling regression time,fracture healing time)and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 96.67%(58/60),which was higher than that of 85.00%(51/60) in the control group,and the difference was statistically significant(χ^(2)=4.904,P=0.027).The hip function score of the observation group was higher than that of the control group,and the levels of bone mineral density were higher than those of the control group,the differences were statistically significant(all P<0.05).The pain score and hemorheology indexes of the observation group were lower than those of the control group,and the differences were statistically significant(all P<0.05).The fracture healing time and swelling regression time of the observation group were shorter than those of the control group,and the differences were statistically significant(both P<0.05).There were no obvious adverse reactions in the two groups during the treatment.Conclusion Xugu Huoxue Decoction has a good effect in the treatment of IFF,which can relieve pain,promote blood circulation,improve bone mineral density and hip joint function.It is safe and reliable and conducive to prognosis.