中医辨证分期配合内外用药治疗不稳定型股骨粗隆间骨折的临床研究

Clinical Research of Applying Traditional Chinese Medicine Syndrome Differentiation by Stages Combined with Drug Treatment Inside and Outside in the Treatment of Unstable Intertrochanteric Fractures

目的:观察与分析中医辨证分期内外用药配合治疗不稳定型股骨粗隆间骨折的临床效果。方法:选取我院自2014年6月~2015年6月收治的90例不稳定型股骨粗隆间骨折患者,采取随机数字表法分为对照组与观察组,每组各45例,对照组仅给予股骨近端防旋髓内钉治疗,观察组在对照组基础上加用中医辨证分期内外用药配合治疗,对比两组Harris评分、VAS疼痛评分、肿胀程度及并发症发生率。结果:观察组与对照组相比髋关节功能优良率较高,差异具有统计学意义(P<0.05)。两组治疗后与治疗前相比VAS评分降低,观察组治疗后与对照组治疗后相比VAS评分降低更加显著,差异具有统计学意义(P<0.05)。观察组肿胀程度明显低于对照组,差异具有统计学意义(P<0.05)。两组肺部感染、尿路感染、深静脉血栓、固定松动发生率相比均无明显差异(P>0.05)。结论:在股骨近端防旋髓内钉基础上加用中医辨证分期内外用药配合治疗不稳定型股骨粗隆间骨折的临床效果显著,促进改善了患肢的活动功能,且未增加不良反应,安全性较高。

Objective: To explore and analyze the clinical effect of traditional Chinese medicine syndrome differentiation stage,both inside and outside type medicine cooperate for the treatment of unstable intertrochanteric fractures. Methods: Our hospital from June 2014 to June 2015 treated 90 cases of unstable intertrochanteric fracture patients,taking a random number table method was divided into controlled group and observation group,45 cases in each group and the controlled group only for proximal femoral intramedullary nail treatment,the observation group added with TCM syndrome differentiation stage,both inside and outside with drug treatment on the basis of control group,compared two groups of Harris score,VAS pain score,swelling degree and the incidence of complications. Results: The observation group and the controlled group compared with the function of hip joint was higher,the difference was statistically significant( P<0. 05). The two groups after treatment compared with before treatment to reduce VAS score,the observation group after treatment compared with the controlled group after treatment,VAS score reduced more significantly,statistically significant difference( P<0. 05). Swelling in the observation group was significantly lower than the controlled group,the difference statistically significant( P < 0. 05). Two groups of pulmonary infection,urinary tract infection,deep vein thrombosis,loose fixed rate compared with no significant difference( P>0. 05). Conclusion: In the proximal femur prevent rotation intramedullary nailing combined with traditional Chinese medicine based on syndrome differentiation stage,both inside and outside type medicine combined treatment for unstable intertrochanteric fractures has significant clinical effect,can promote to improve the activity of limb function,and do not increase adverse reactions,higher security.