微创植骨联合健脾益肾汤对胫骨中下段骨折不愈合患者炎症细胞因子的影响

目的:观察微创植骨联合健脾益肾汤治疗胫骨中下段骨折不愈合的疗效及对炎症细胞因子的影响。方法:70例胫骨中下段骨折不愈合患者随机分为观察组和对照组,两组均为35例。对照组给予微创植骨后应用外固定架固定治疗,并给予碳酸钙胶囊每次2粒,每日2次。观察组在对照组治疗基础上给予健脾益肾汤。观察两组患者经治疗后骨痂评分、骨折愈合时间、疼痛程度以及血液炎症因子的变化,并采用Johner-Wruhs评分系统评估患者骨折愈合和下肢功能恢复情况。结果:观察组术后3个月的骨痂评分(3.72±0.59)分,高于明显高于对照组的(2.14±0.67)分(P0.05),且骨折愈合时间为(5.83±0.96)周,明显少于对照组(6.72±1.34)周(P0.05);两组患者在术后1个月和3个月疼痛程度评分均较入院时降低,且观察组为(2.17±1.09)分患者疼痛改善较对照组(3.98±1.21)分更明显(P0.05);2组术后1个月血清C反应蛋白、肿瘤坏死因子-α以及白细胞介素-6水平均较治疗前显著降低,且观察组明显低于对照组;经过6个月康复,观察组骨折愈合和下肢功能恢复(94.3%)情况优于对照组(80.0%)。结论:健脾益肾汤结合微创植骨治疗胫骨中下段骨折不愈合临床疗效肯定,可减轻术后炎症反应,促进患者肌肉及关节功能恢复。

Effect of Minimally Invasive Bone Graft plus Jianpi Yishen Decoction on Inflammatory Cytokines of Patients with Unhealed Middle and Lower Tibial Fractures

Objective:To investigate the effect of minimally invasive bone graft combined with Jianpi Yishen Decoction on inflammatory cytokines of patients with unhealed middle and lower tibial fractures.Methods:Seventy cases patients were selected as the research objects and were divided into observation group and control group,with 35 cases in each group.The control group was treated with external fixation after minimally invasive bone grafting,and 2 capsules of calcium carbonate were given twice a day.The observation group was treated with Jianpi Yishen Decoction based on the treatment of the control group.The bone scab score,fracture healing time,pain and blood inflammatory factors of both groups before and after treatment were observed.The Johner-Wruhs scoring system was used to evaluate the fracture healing and lower extremity functional recovery conditions of the two groups.Results:The callus score of the observation group was 3.72 ± 0.59 points,which was significantly higher than that of the control group (2.14 ± 0.67) (P ＜ 0.05).The fracture healing time (5.83 ± 0.96) of the observation group was significantly less that (6.72 ± 1.34) of the observation group (P ＜ 0.05).The pain scores of the two groups 1 month and 3 months after operation were significantly lower than those before treatment,and the improvement of pain of the control group of was significantly obvious than that of the control group (P ＜ 0.05).The serum C-reactive protein,tumor necrosis factor-α and interleukin-6 levels in the two groups were significantly lower than those in the control group at 1 month after operation (P ＜ 0.05).The recovery of fracture healing and lower limb function of the observation group was better than that of the control group (P ＜ 0.05).Conclusion:minimally invasive bone graft combined with Jianpi Yishen Decoction has significant effect on inflammatory cytokines of patients with unhealed middle and lower tibial fractures,with clinical curative effect.The treatment can reduce the postoperative inflammatory reaction and promote the recovery of muscle and joint function of patients,which is worthy of wider clinical application.