益气温肾汤联合鲑降钙素注射液治疗跟骨骨折术后骨萎缩临床研究

目的 评价益气温肾汤联合鲑降钙素注射液治疗跟骨骨折患者术后骨萎缩的临床疗效.方法 将符合入选标准的120例跟骨骨折术后骨萎缩患者采用随机数字表法分为2组,每组60例.对照组在常规对症处理基础上皮下注射鲑降钙素注射液,联合组在对照组基础上加用益气温肾汤治疗.2组均连续治疗6周.采用双能X线骨密度检测仪检测患侧肢体局部骨密度值,采用踝与后足功能评分评价踝关节功能的恢复情况,观察并记录患者治疗前后临床症状、体征的变化,评价临床疗效.结果 治疗后,联合组疼痛[(2.8±1.1)分比(3.6±1.1)分,t=4.129]、压痛[(1.0±0.5)分比(1.4±0.7)分,t=3.297]、肤色改变[(1.5±0.8)分比(2.0±0.6)分,t=3.117]评分低于对照组(P<0.05),肿胀程度[(112.5±11.8)cm3比(122.5±13.6)cm3,t=3.816]低于对照组(P<0.05)、骨密度值[(0.762±0.020)g/cm2比(0.722±0.023)g/cm2,t=3.803]高于对照组(P<0.05).联合组愈显率为90.0%(54/60)、对照组为70.0%(42/60),2组比较差异有统计学意义(χ2=7.500,P=0.006).联合组踝关节功能优良率为83.3%(50/60)、对照组为70.0%(42/60),2组比较差异有统计学意义(χ2=4.444,P=0.035).结论 益气温肾汤联合皮下注射鲑降钙素注射液可缓解跟骨骨折术后骨萎缩患者的疼痛、肿胀等症状、改善骨密度、促进骨折愈合,有利于患者骨折康复及踝关节功能的恢复.

Clinical study of Yiqi-Wenshen decoction combined with salmon calcitonin injection for the patients with bone atrophy after calcaneal fracture

Objective To evaluation of curative effect of Yiqi-Wenshen decoction combined with salmon calcitonin subcutaneous injection for the patients with postoperative bone atrophy after calcaneal fracture.Methods According to the inclusion criteria, 120 patients with calcaneal fracture were randomly divided into 2 groups, 60 in each group. The control group received the subcutaneous injection of salmon calcitonin, and the combined group received the control group treatment plus Yiqi-Wenshen decoction. Both groups were treated for 6 weeks. The X-ray was used to detecte the local bone density of limbs, and the foot function scores of ankle function and the changes of clinical symptoms and signs before and after treatment were observed.Results After treatment, joint pain (2.8 ± 1.1vs. 3.6 ± 1.1,t=4.129), tenderness (1.0 ± 0.5vs. 1.4 ± 0.7,t=3.297), the color change of (1.5 ± 0.8vs. 2.0 ± 0.6,t=3.117) score in the combined group were significantly lower than those in the control group (P<0.05). The degree of swelling (112.5 ± 11.8 cm3vs. 122.5 ± 13.6 cm3,t=3.816) in the combined group was significantly lower than that in control group (P<0.05). The bone mineral density (0.762 ± 0.020 g/cm2vs. 0.722 ± 0.023 g/cm2,t=3.803,P<0.05) in the combined group was significantly higher than that in the control group. The effect rate of the combined group was 90% (54/60), and the control group was 70%. There was significant difference between 2 groups (χ2=7.500,P=0.006). The effect rate of ankle joint function of the combined group was 83.3% (50/60), and the control group was 70% (42/60). There was significant difference between 2 groups (χ2=4.444,P=0.035).Conclusions The Yiqi-Wenshen decoction combined with subcutaneous injection of salmon calcitonin could relieve the pain, swelling and other symptoms of the patients with bone atrophy after calcaneal fractures, and could benefit the recovery of ankle joint function.