摘要
目的:观察分期辨证口服中药联合股骨近端防旋髓内钉(PFNA)内固定术治疗老年股骨粗隆间骨折的临床疗效。方法:选取86例老年股骨粗隆间骨折患者,随机分为研究组和对照组各43例。对照组行单纯PFNA内固定术治疗;研究组在对照组的基础上联合分期辨证口服中药治疗。比较2组术中情况、围手术期并发症发生情况、术后1、3、7 d视觉疼痛模拟评分法(VAS)评分、住院时间、各时间点髋关节Harris评分和骨密度(BMD)值。结果:2组手术时间、术中出血量、透视次数比较,差异均无统计学意义(P>0.05)。研究组住院时间短于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率为14.29%,低于对照组35.00%,组间比较,差异有统计学意义(P<0.05)。术前及术后1 d,2组VAS评分比较,差异无统计学意义(P>0.05);术后1、3、7 d,2组VAS评分均较术前降低(P<0.05),且研究组术后3、7 d VAS评分均低于对照组(P<0.05)。术后当天,2组Harris评分比较,差异无统计学意义(P>0.05);术后3、6、12个月,研究组相同时间点Harris评分均高于对照组(P<0.05)。术前及术后3、6个月,2组BMD值比较,差异均无统计学意义(P>0.05);术后12个月,研究组BMD值高于对照组(P<0.05)。结论:分期辨证口服中药治疗老年股骨粗隆间骨折,能降低围手术期并发症发生率,减轻疼痛,缩短住院时间,并可加速髋关节功能恢复,改善骨骼强度。
Objective: To observe the clinical effect of the therapy of oral administration of Chinese medicine based on staging syndrome differentiation combined with proximal femoral nail antirotation(PFNA)internal fixation on senile intertrochanteric fracture. Methods: A total of 86 senile patients with femoral intertrochanteric fracture were selected and randomly divided into the study group and the control group,with 43 cases in each group. The control group was treated with simple PFNA internal fixation,and the study group was additionally treated with oral administration of Chinese medicine based on staging syndrome differentiation on the basis of the treatment of the control group. The intraoperative conditions and perioperative complications,the scores of Visual Analogue Scale(VAS) for pain on the first,the third and the seventh day after surgery, hospitalization time, Harris hip scores at each time point and bone mineral density(BMD) values in both groups were compared. Results: There was no significant difference being found in the comparisons of operation time,intraoperative blood loss and fluoroscopy times between the two groups(P>0.05). The hospitalization time in the study group was shorter than that in the control group,the difference being significant(P<0.05). The incidence of postoperative complications was 14.29%in the study group,lower than that of 35.00% in the control group,the difference being significant(P<0.05). On the day before surgery and the first day after surgery,there was no significant difference being found in the comparison of the VAS scores between the two groups(P>0.05);on the first,the third and the seventh day after surgery,the VAS scores in the two groups were decreased when compared with those before surgery(P<0.05),and the VAS scores in the study group on the third and the seventh day after surgery were lower than those in the control group(P<0.05). On the day of the operation,there was no significant difference being found in the comparison of the Harris hip scores between the two groups(P>0.05);after 3,6 and 12 months of surgery,the Harris scores in the study group were higher than those in the control group at the same time point(P<0.05). Before surgery and 3 and 6 months after surgery,there was no significant difference being found in the comparison of BMD values between the two groups(P>0.05);12 months after surgery,the BMD value in the study group was higher than that in the control group(P<0.05). Conclusion: The therapy of Chinese medicine decoction based on staging syndrome differentiation for senile intertrochanteric fracture can reduce the incidence of perioperative complications,relieve the pain,shorten the hospitalization time,accelerate the recovery of hip function,and improve the strength of bone.
作者
李克南
陈柯
王兴源
陈勤
田可为
范克杰
LI Ke'nan;CHEN Ke;WANG Xingyuan;CHEN Qin;TIAN Kewei;FAN Kejie
出处
《新中医》
CAS
2023年第6期78-83,共6页
New Chinese Medicine
基金
河南省中医药科学研究专项课题(20-21ZY2253)
河南省中医药科学研究专项课题(2018ZY2160)。
关键词
股骨粗隆间骨折
分期辨证
PFNA内固定
术后康复
髋关节Harris评分
Femoral intertrochanteric fracture
Staging syndrome differentiation
PFNA internal fixation
Postoperative rehabilitation
Harris hip score
作者简介
李克南(1983-),男,主治中医师,E-mail:laomianli@163.com;通信作者:陈柯(1969-),男,主任中医师,E-mail:115946827@qq.com。
