续筋接骨汤联合胫骨结节远端单平面截骨对胫骨结节骨骺炎患者髌股关节退变髌骨高度及骨密度的影响

Effect of Xujin Jiegu decoction combined with distal tibial tubercle single plane osteotomy on patellar height and bone mineral density in patients with patellofemoral joint degeneration

目的:探究续筋接骨汤联合胫骨结节远端单平面截骨对胫骨骨折合并胫骨结节骨骺炎患者髌股关节退变髌骨高度、生活质量评分及骨密度的影响。方法:选取2021年1月—2022年12月我院收治的98例胫骨骨折合并胫骨结节骨骺炎患者,按数字随机表法将患者分为对照组49例,研究组49例。对照组给予胫骨结节远端单平面截骨术,研究组给予续筋接骨汤联合胫骨结节远端单平面截骨术。对比两组患者治疗前后髌股关节退变情况,治疗前后髌骨高度,疼痛程度指数,肿胀程度,氧化应激指标,生活质量评分及骨密度水平。结果:治疗后研究组患者K-L分级评分、Iwano分级评分明显低于对照组患者,差异有统计学意义(P<0.05);治疗后研究组患者CDI指数、BPI指数高于对照组患者,ISI指数低于对照组患者,差异有统计学意义(P<0.05);治疗后研究组患者疼痛程度视觉模拟评分法(VAS)评分及肿胀程度明显低于对照组患者,差异有统计学意义(P<0.05);治疗后研究组氧化物歧化酶(SOD)、谷性甘肽过氧化物酶(GSH-Px)水平、ADL评分明显高于对照组,丙二醛(MDA)水平低于对照组,差异有统计学意义(P<0.05);治疗后,研究组Ward三角区、股骨大转子区、腰椎区骨密度水平高于对照组,差异有统计学意义(P<0.05)。结论:续筋接骨汤联合胫骨结节远端单平面截骨术可以有效避免胫骨骨折合并胫骨结节骨骺炎患者髌股关节退变,改善患者的髌骨高度及肿胀程度,进一步调节患者氧化应激指标,减轻治疗过程中的疼痛程度,改善患者骨密度水平,从而提高患者生活质量,值得临床推广应用。

Objective To Effect of Xujin Jiegu decoction combined with distal tibial tubercle single plane osteotomy on patellar height,quality of life score and bone mineral density in patients with patellofemoral joint degeneration.Methods A total of 98 patients with tibial fracture complicated with tibial tuberous epiphysitis admitted to our hospital from January 2021 to December 2022 were selected and divided into control group(49 cases)and study group(49 cases)according to numerical random table method.The control group was given the distal tibial tubercle single plane osteotomy,and the study group was given the Xujin Jiegu decoction combined with the distal tibial tubercle single plane osteotomy.The patellofemoral joint degeneration of the two groups before and after treatment was compared.The patellar height before and after treatment was compared between the two groups.The VAS index of pain degree before and after treatment was compared between the two groups.The swelling degree of the two groups before and after treatment was compared.The indexes of oxidative stress were compared between the two groups.The quality of life scores of the two groups were compared.Bone mineral density was compared between the two groups.Results After treatment,the K-L grading score and Iwano grading score of the study group patients were significantly lower than those of the control group patients(P<0.05).After treatment,the CDI index and BPI index of the study group patients were significantly higher than those of the control group patients,while the ISI index was significantly lower than that of the control group patients(P<0.05).After treatment,the VAS score of pain in the study group patients was significantly lower than that in the control group patients(P<0.05).After treatment,the swelling length of the study group patients was significantly lower than that of the control group patients.After treatment,the levels of SOD and GSH-Px indicators in the study group were significantly higher than those in the control group,and the MDA index was significantly lower than that in the control group(P<0.05).The ADL score of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the BMD levels in Ward triangle,femoral greater trochanter and lumbar spine in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Xujin Jiegu decoction combined with distal tibial tubercle single plane osteotomy can effectively avoid the tibial fracture merge tibial tubercle epiphyseal inflammation in patients with patellofemoral joint degeneration,improve patients with patellar height and swelling degree,further regulating oxidative stress indicators patients,alleviate the pain degree in the process of treatment,improve the level of patients with bone density,thus improve the treatment of patients with life,worthy of clinical popularization and application.