桃红四物汤加味对老年股骨粗隆间骨折术后康复的影响
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R274.12

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Effect of Modified Taohong Siwu Decoction on Rehabilitation After Surgery of Intertrochanteric Fracture in Senile
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    摘要:

    目的:观察桃红四物汤加味对老年股骨粗隆间骨折术后患者疼痛、髋关节功能、血液流变学指标 及炎症因子的影响。方法:选取66例老年股骨粗隆间骨折患者,按随机数字表法分为对照组与试验组各33例。 治疗过程中对照组剔除2例,试验组剔除1例,最终纳入研究对照组31例、试验组32例。2组均行防旋股骨近 端髓内钉(PFNA) 内固定术治疗。对照组术后给予常规西药及康复锻炼治疗,试验组在对照组基础上予以桃 红四物汤加味治疗。2组均随访至术后6个月。比较2组临床疗效、髋关节功能、疼痛程度、血液流变学指标 水平、炎症因子水平及并发症发生率。结果:术后6个月,试验组总有效率93.75%,高于对照组70.97%(P< 0.05)。术后8周,2组Harris评分均较术后1 d升高(P<0.05),视觉模拟评分法(VAS) 评分均较术后1 d降 低(P<0.05);试验组Harris评分高于对照组(P<0.05),VAS评分低于对照组(P<0.05)。术后8周,2组血 沉、红细胞比容、血浆黏度水平均较术后1 d降低(P<0.05),试验组血沉、红细胞比容、血浆黏度水平均低 于对照组(P<0.05)。术后8周,2组血清白细胞介素(IL) -8、IL-6及肿瘤坏死因子(TNF) -α水平均较术 后1 d降低(P<0.05),试验组血清IL-8、IL-6、TNF-α水平均低于对照组(P<0.05)。随访6个月,试验组并 发症发生率12.50%,低于对照组35.48%(P<0.05)。结论:桃红四物汤加味可改善老年股骨粗隆间骨折术后 患者的髋关节功能,缓解临床症状,降低并发症发生率,作用机制与其可调节血液流变学指标、炎症因子表达 有关。

    Abstract:

    Abstract: Objective: To observe the effects of modified Taohong Siwu Decoction on pain, hip joint function,hemorheology indexes and inflammatory factors of senile patients after surgery of intertrochanteric fracture. Methods:A total of 66 cases of senile patients with intertrochanteric fracture were selected and divided into the control group and the trial group according to the random number table method , with 33 cases in each group. During the treatment,two cases in the control group and one case in the trial group were excluded, and finally 31 and 32 cases were respectively included in the control group and the trial group. The two groups were given proximal femoral nail antirotation (PFNA) internal fixation for treatment; the control group was treated with routine western medicine and rehabilitation exercises after surgery,and the trial group was additionally treated with modified Taohong Siwu Decoction based on the treatment of the control group. The two groups were followed up for six months after surgery. The clinical effects,hip joint function, pain degree, levels of hemorheology indexes and inflammatory factors, and incidence of adverse reactions were compared between the two groups. Results:After six months of follow-up,the total effective rate was 93.75% in the trial group,higher than that of 70.97% in the control group (P<0.05). Eight weeks after surgery,the Harris scores in the two groups were increased when compared with those one day after surgery (P<0.05), and the Visual Analogue Scale (VAS) scores were decreased when compared with those one day after surgery (P<0.05); the Harris score in the trial group was higher than that in the control group (P<0.05),and the VAS score was lower than that in the control group (P<0.05). Eight weeks after surgery,the levels of erythrocyte sedimentation rate,hemotocrit and plasma viscosity in the two groups were decreased when compared with those one day after surgery (P<0.05),and the levels of above three indexes in the trial group were lower than those in the control group (P<0.05). Eight weeks after surgery,the levels of serum interleukin (IL) -8,IL-6 and tumor necrosis factor (TNF) - α in the two groups were decreased when compared with those one day after surgery (P<0.05), and the levels of serum IL-8,IL-6 and TNF-α in the trial group were lower than those in the control group (P<0.05). During the six months of follow-up,the incidence of complications was 12.50% in the trial group,lower than that of 35.48% in the control group (P<0.05). Conclusion:The modified Taohong Siwu Decoction can improve the hip joint function of senile patients after surgery of intertrochanteric fracture, mitigate the clinical symptoms and decrease the incidence of complications,whose mechanism is related to the regulation of hemorheology indexes and expression of inflammatory factors.

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易观俊,罗军,柴重喜.桃红四物汤加味对老年股骨粗隆间骨折术后康复的影响[J].新中医,2024,56(12):37-41

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  • 在线发布日期: 2024-06-28
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