夹板外固定结合中药治疗老年人桡骨远端骨折的临床对照试验

目的：探讨自拟益肾壮骨方对老年人桡骨远端骨折患者骨折愈合及腕关节功能的影响。方法：小夹板外固定结合中药治疗90例原发性骨质疏松性桡骨远端骨折患者，男28例，女62例；年龄61～91岁，平均63岁。按AO分型属A型或B1型，Colles骨折80例，Smith骨折7例，Barton骨折3例。手法复位小夹板外固定后，随机将患者分为中药组、西药组及对照组，每组30例。中药组予益肾壮骨方水煎服，日l剂，2次／日；西药组予密钙息50单位肌注．2次／周，同时口服钙尔奇D（1片／次，口服，1次／日）和α-骨化醇（每次0．5μg，口服，1次／日），2组均用药2个月。对照组未予任何特殊抗骨质疏松药物。患者于治疗后第4、6、8、12周后摄腕部正侧位X线片，了解骨折愈合情况并进行对比，2个月后进行腕关节功能评估并进行疗效对比。结果：骨折愈合时间，中药组平均（7．12±2．32）周及西药组平均（9．25±3．05）周，短于对照组平均（11．57±1．93）周，差异有统计学意义（P〈0．05），中、西药组相比差异有统计学意义（P〈0．05）。腕关节功能恢复方面，中、西药及对照组优良率分别为93.3％、86．7％、60％，中、西药组优于对照组（P〈0．05）。经Ridit分析，药物组疗效优于对照组。结论：自拟益肾壮骨方能明显促进骨折愈合，缩短骨折愈合时间，且优于西药，同时能显著促进腕关节功能的恢复。

Clinical randomized controlled trial on splint external fixation combined with Chinese herbs in treating distal radius fractures of elderly patients

Objective ：To explore the effects of Yishen Zhuanggu decoction （ 益肾壮骨方, YSZGD） on the fracture healing and function of wrist joint in osteoporotic distal radius fractures （ODRF） of elderly patients. Methods：Ninety patients of ODRF were treated with splint external fixation and YSZGD,including 28 males and 62 females ,with an average age of 63 years （ranged ,61 to 91 years）. According to AO classification,all the patients were classified as type A or BI. Among the patients, 80 patients had a type of Colles fracture,7 patients were with a type of Smith fracture,and 3 patients had a type of Barton fracture. They were randomly divided into three groups included TCM ,Western medicine and control group （30 cases each group）after the fractures were fixed manually by splint. Patients in TCM group took YSZGD orally ,one potion and two time each day;the patients in Western medicine group treated with Calcitonin （50 units,intramuscular, 2 times each week）, Cahrate D （ 1 tablets ,taken orally ,one time each day）and Alfacalcidol Soft Capsules（0.5 μg,taken orally ,one time each day） ;and the patients in control group took no medicine. X-ray examination on the fractured wrist was taken at the 4,6,8,12th weeks after treating to observe ,the fracture healings, the evaluation of wrist function and comparision of curative effects were taken at the 2nd month. Results ：The fracture healing time in TCM group was 7.12±2.32 weeks and that in the Western medicine group was 9.25±3.05 weeks,showing significant differences between them （P〈0.05） ,and that in the control group was 11.57±1.93 weeks which was longer than that in the two medicine groups （P〈0.05） ;According to Dienst wrist rating system,the excellent and good rates of three groups were 93.3%,86.7%and 60% respectively which showing significant differences between medicine groups and control group （P〈0.05） ,and the curative effects of medicine groups were more excellent than that of control group through Ridit analys