摘要
目的:探讨腰五针加扶正强督灸联合全髋关节置换术(THA)治疗老年股骨粗隆间骨折(IFF)患者的疗效以及对骨代谢、关节功能的改善作用。方法:纳入2020年1月—2022年1月在我院就诊的老年IFF患者98例,按照随机数字表法分入治疗组与对照组,每组均49例。两组均经同一组医生采取THA治疗;对照组术后采取抗凝、抗感染等常规措施;治疗组于对照组治疗的基础上在术后1 d予腰五针加扶正强督灸治疗。两组连续治疗12周。比较两组IFF患者的下床行走时间、术后负重时间、骨代谢指标、髋关节功能评分、髋关节功能疗效。结果:治疗组患者的下床行走时间、术后负重时间均低于对照组(P<0.01);术前,两组患者的血清骨钙素和腰椎正位(L2-4)骨密度水平差异无统计学意义(P>0.05);术后12周,治疗组的血清骨钙素和腰椎正位(L2-4)骨密度水平明显高于对照组(P<0.01);术前,两组患者的Harris评分差异无统计学意义(P>0.05);术后4、8、12周,治疗组患者的Harris评分明显高于对照组(P<0.01);术后12周,治疗组的髋关节功能改善优良率为83.67%,较对照组的65.31%显著增加,差异有统计学意义(P<0.05)。结论:在运用THA治疗老年IFF的同时辅以腰五针加扶正强督灸治疗有助于缩短患者康复病程,提高骨代谢水平,促进髋关节功能的恢复,提高治疗效果。
Objective To investigate the curative effect of waist-five acupuncture plus Fuzheng Qiangdu moxibustion combined with total hip arthroplasty(THA)in the treatment of elderly patients with intertrochanteric fracture(IFF)and the improvement of bone metabolism and joint function.Methods A total of 98 elderly patients with IFF who were treated in our hospital from January 2020 to January 2022 were enrolled in this study.They were divided into treatment group and control group according to the random number table method,with 49 cases in each group.Both groups were treated with THA by the same group of doctors;the control group was treated with routine measures such as anticoagulation and anti-infection after operation;the treatment group was treated with waist five acupuncture plus Fuzhengqiangdu moxibustion on the basis of the control group 1 day after operation.The two groups were treated continuously for 12 weeks.The time of getting out of bed and walking,postoperative weight-bearing time,bone metabolism indexes,hip joint function score and hip joint function efficacy were compared between the two groups of IFF patients.Results The time of getting out of bed and walking and postoperative weight-bearing time in the treatment group were significantly lower than those in the control group(P<0.01).There were no significant differences(P>0.05);12 weeks after operation,the serum osteocalcin and lumbar vertebrae(L2-4)bone mineral density in the treatment group were significantly higher than those in the control group(P<0.01).There were no significant differences in Harris score between the two groups(P>0.05);the Harris score in the treatment group was significantly higher than that in the control group at 4 weeks,8 weeks and 12 weeks after operation(P<0.01);12 weeks after operation,The excellent and good rate of hip function improvement in the treatment group was 83.67%,which was significantly higher than that in the control group(65.31%)(P<0.05).Conclusion The use of THA in the treatment of elderly patients with IFF and supplemented by waist five acupuncture plus strengthening the body and strengthening the governor moxibustion can help shorten the course of rehabilitation,improve the level of bone metabolism,promote the recovery of hip joint function and improve the therapeutic effect.
作者
谈志俊
陈二海
张濒
史法见
TAN Zhi-jun;CHEN Er-hai;ZHANG Bin(Department of Orthopedics,the Fourth Arfiliated Hospital of Nanjing Medical University,Nanjing(210000),China)
出处
《中国中西医结合外科杂志》
CAS
2023年第3期327-331,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
2019年高层次卫生人才“六个一工程”拔尖人才科研项目(LGY201970)。
关键词
股骨粗隆间骨折
腰五针
督灸
全髋关节置换术
骨代谢
关节功能
Intertrochanteric fracture
Yaowu acupuncture
Du meridian moxibustion
total hip replacement
bone metabolism
joint function
作者简介
通信作者:史法见,E-mail:sdfwzx730@163.com。
