补肾活血法对血流动力学不稳定性桡骨远端骨折愈合的影响

目的探讨中医补肾活血法对血流动力学不稳定性骨质疏松桡骨远端骨折愈合的影响。方法选择2018年8月～2019年8月我院收治的96例血流动力学不稳定性桡骨远端骨折患者,随机分为对照组和观察组,每组各48例。对照组给予骨折复位、稳定固定和康复锻炼指导;观察组在骨折复位、稳定固定和康复锻炼同时,口服补肾活血汤剂,4周为1疗程。骨折复位后两组均随访8周,并定期行X线复查,观察两组骨折愈合评分系统(RUSS)、视觉模拟疼痛评分(VAS)变化,比较两组消肿和骨折愈合时间以及腕关节功能Gartland-Werley量表评分。结果观察组骨折复位2周、4周、6周后RUSS评分均高于对照组,VAS评分显著低于对照组,差异有统计学意义(P0.05);两组复位8周后RUSS评分和VAS评分比较,差异无统计学意义(P0.05);观察组消肿时间(4.92±1.15)d、骨折愈合时间(5.17±1.08)周分别短于对照组的(6.37±1.63)d、(5.83±1.20)周,差异有统计学意义(P0.05);观察组末次随访时Gartland-Werley评分(6.37±1.09)分低于对照组的(7.92±1.31)分;腕关节功能恢复优良率87.50%(42/48)高于对照组的70.83%(34/48),差异均有统计学意义(P0.05)。结论补肾活血法能有效促进血流动力学不稳定性桡骨远端骨折的骨折愈合,减轻肿胀疼痛,缩短骨折愈合时间,改善腕关节功能,临床应用价值显著。

Impacts of kidney-reinforcing and blood-activating traditional Chinese medicine on fracture healing in patients with distal radius fractures complicated with unstable haemodynamics

Objective To investigate the impacts of kidney-reinforcing and blood-activating(KRBA) traditional Chinese medicine on fracture healing in patients with distal radius fractures complicated with unstable haemodynamics.Methods A total of 96 patients with distal radius fractures complicated with unstable haemodynamics admitted in our hospital from August 2018 to August 2019 were randomly divided into the control group and the observation group,with 48 in each group.Reduction,stable fixation and rehabilitation were performed for patients in the two groups.Those in the observation group additionally received KRBA decoction.Each course of treatment lasted for 4 weeks.A 8-week follow-up was conducted and regular X-ray was reexamined.Radius union scoring system(RUSS) scores and visual analogue scale(VAS) scores in the two groups were recorded.The detumescence time,time to fracture healing and Gartland-Werley scores for assessing wrist function were compared between the two groups.Results RUSS scores were higher and VAS scores were lower in the observation group than those in the control group at 2,4 and 6 weeks after reduction,with statistically significant differences(P<0.05).There were no significant differences in the two scores between the two groups at 8 weeks after reduction(P>0.05).Besides,the detumescence time and the time to fracture healing in the observation group(4.92±1.15 days and 5.17±1.08 weeks,respectively) were shorter than those in the control group(6.37±1.63 days and 5.83±1.20 weeks,respectively),with statistically significant differences(P<0.05).The Gartland-Werley score at the end of the follow-up in the observation group(6.37±1.09) was lower than that in the control group(7.92±1.31),with a higher recovery rate of wrist function(87.50%,or 42/48) than the control group(70.83%,or 34/48),with statistically significant differences(P<0.05).Conclusion The KRBA method effectively facilitated fracture healing,relieved swelling and pain,shorten fracture healing time and improved wrist function in patients with distal radius fractures complicated with unstable haemodynamics,presenting significant clinical values.