補(bǔ)骨顆粒配合小夾板治療骨質(zhì)疏松性Colles骨折
發(fā)布時間：2018-08-02 10:13
【摘要】：目的:運(yùn)用"補(bǔ)骨顆粒"對老年骨質(zhì)疏松性colles骨折進(jìn)行疊加治療,觀察其治療效果,驗證其有效性,為骨質(zhì)疏松性colles骨折患者提供一個便捷安全的有效防治方法,為其臨床推廣提供有效依據(jù)。方法:在2015年5月至2016年11月期間納入67例在廣州中醫(yī)藥大學(xué)附屬湛江市第二中醫(yī)醫(yī)院治療的骨質(zhì)疏松性colles骨折患者,將這67例患者按隨機(jī)數(shù)字表法分為兩組,治療組34例,對照組33例,治療期間,治療組4例患者脫落,對照組3例脫落。治療前,兩組患者在性別、年齡、骨密度基線資料經(jīng)統(tǒng)計學(xué)比較,P0.05,無統(tǒng)計比較意義。對照組B組采用三聯(lián)抗骨質(zhì)疏松用藥治療:口服碳酸鈣D3,每日一次,一次一片;口服骨化三醇片,每日一次,一次一片;鮭魚降鈣素注射液,50IU/d,肌肉注射2周后改為每周1次。治療組A患者在對照組的基礎(chǔ)上于骨折1周后加服用本院中藥配方補(bǔ)骨顆粒,方藥組成:骨碎補(bǔ)1包(10g)、三七2包(3g)、鹿角霜1包(10g)、黃芪1包(10g)、肉蓯蓉1包(10g)、千斤拔1包(10g)、熟地1包(10g)、當(dāng)歸1包(10g)、白芍1包(10g),(中藥顆粒為廣東一方制藥有限公司生產(chǎn))水沖服,每日1劑,分2次服。兩組中患者無移位骨折或不完全骨折不需要整復(fù),僅用小夾板固定2-4周即可。有移位的骨折均采用手法復(fù)位,拍片檢查,如骨折對位欠佳或棉墊位置不當(dāng),及時糾正,前臂保持中立位掛于胸前。堅持握拳鍛煉。視患者骨折愈合情況,一般4周后拆除夾板。各組患者治療期均為3個月,臨床追蹤調(diào)查期為3個月,按照要求在相應(yīng)時間點(diǎn)即治療期間1月、2月、3月如實記錄兩組患者相關(guān)評分?jǐn)?shù)據(jù):疼痛、功能狀態(tài)、握力、主觀感受、客觀評價、并發(fā)癥、骨折愈合情況。禁止所有患者在治療期間使用除了試驗藥物之外的藥物。運(yùn)用SPSS18.0統(tǒng)計軟件對取得的臨床數(shù)據(jù)進(jìn)行統(tǒng)計分析,數(shù)據(jù)以均數(shù)土標(biāo)準(zhǔn)差用(x±s)表示,用t檢驗分析計量資料,X2檢驗分析計數(shù)資料,秩和檢驗分析等級資料,重復(fù)測量設(shè)計采用方差分析,當(dāng)P0.05時認(rèn)為兩組數(shù)據(jù)之間存在顯著性差異,當(dāng)P0.05時兩組數(shù)據(jù)之間無顯著性差異。結(jié)果:①治療組中采用"補(bǔ)骨顆粒"疊加治療,臨床療效及患者臨床癥狀的改善比對照組明顯,且不良反應(yīng)事件發(fā)生率較對照組低,無明顯毒副作用。②治療組30例患者中15例患者痊愈,13例患者好轉(zhuǎn),總有效率為93.33%,對照組中9例痊愈,15例好轉(zhuǎn),總有效率為86.66%。經(jīng)統(tǒng)計學(xué)分析比較,P0.05,兩組在療效方面比較存在統(tǒng)計學(xué)比較意義。經(jīng)過治療后兩組患者在Green O'Brien腕關(guān)節(jié)評分、BMD值與治療前比較都有積分有較明顯提高,腫脹評分較治療前有明顯降低,合并癥發(fā)生方面,對照組明顯較對照組高。兩組患者臨床癥狀經(jīng)治療后均有改善,且兩組治療后各種指標(biāo)評分治療組優(yōu)于對照組,經(jīng)過統(tǒng)計學(xué)比較P0.05,存在顯著性差異。③兩組患者在治療后均有不良反應(yīng)事件發(fā)生,治療組發(fā)生率為13%,對照組為40%。治療過程中均為未發(fā)現(xiàn)肝腎功能損害事件,治療組中僅有4例對中藥產(chǎn)生了胃腸道反應(yīng),而對照組有5位患者出現(xiàn)胃腸道反應(yīng)、1例過敏反應(yīng)、6例便秘,經(jīng)停藥后癥狀可消失。經(jīng)X2檢驗兩組不良反應(yīng)事件發(fā)生率有統(tǒng)計學(xué)意義。結(jié)論:"補(bǔ)骨顆粒"在治療骨質(zhì)疏松性colles骨折(肝腎虧虛夾瘀型或氣血虧虛夾淤型)臨床試驗中能取得較好的臨床效果,并且安全有效,能有效地緩解患者臨床癥狀,值得在臨床中推廣。
[Abstract]:Objective: to apply the "Bu Gu Granule" to the elderly osteoporotic Colles fractures, to observe the therapeutic effect, to verify its effectiveness, to provide a convenient and safe effective prevention and control method for the patients with osteoporotic Colles fracture, and to provide effective basis for its clinical application. Methods: 67 cases were included in the period from May 2015 to November 2016. The patients with osteoporotic Colles fracture treated by Guangzhou University of Chinese Medicine affiliated Zhanjiang second Chinese medicine hospital were divided into two groups according to the random digital table method, 34 cases in the treatment group and 33 in the control group. During the treatment, 4 cases in the treatment group fell off and 3 cases in the control group fell off. Before treatment, the baseline data of sex, age and bone mineral density were in the two groups. Statistical comparison, P0.05, no statistical significance. The control group B group of anti osteoporosis drug treatment: oral calcium carbonate D3, once a day, once a tablet, oral ossification three alcohol tablets, once a day, a tablet, Salcatonin Injection, 50IU/d, muscle injection 2 weeks after 1 times a week. The treatment group of A patients in the control group basis. 1 weeks after the fracture, add the traditional Chinese medicine formula supplementing bone granules, prescription: 1 packages (10g), 37 2 packets (3G), 1 packs of staghorn cream (10g), 1 bags of astragalus (10g), 1 packs (10g), 1 packets of Angelica (10g), 1 (10g) of Radix Paeoniae (10g), and daily 1 The two groups were divided into 2 times. No displaced fracture or incomplete fracture in the two groups did not need to be restored, only a small splint was fixed for 2-4 weeks. The displaced fractures were treated by manipulative reduction and flaps, such as the improper position of the fracture and the improper position of the cotton pad, the forearm kept on the neutral position in the chest. 4 weeks later, the splints were removed. The treatment period of each group was 3 months, and the clinical follow-up period was 3 months. In accordance with the requirements at the corresponding time point, January, February, March, two groups of patients were recorded: pain, functional state, grip strength, subjective feeling, objective evaluation, complications and fracture healing. During the treatment, the drugs were used in addition to the experimental drugs. The statistical analysis of the acquired clinical data was carried out using the SPSS18.0 statistical software. The data were represented by the standard deviation of the average number of soil (x + s), the measurement data were analyzed by the t test, the X2 test and analysis count data, the rank sum test analysis grade data, the repeated measurement design using variance analysis, when P0.05 There was a significant difference between the two groups of data. There was no significant difference between the two groups of data when P0.05. Results: (1) the treatment group was treated with the superposition of "bone filling Granule", the clinical effect and the improvement of the clinical symptoms of the patients were more obvious than the control group, and the incidence of adverse events was lower than the control group, and there was no obvious side effect in the treatment group. 30 cases in the treatment group. Of the patients, 15 patients recovered, 13 patients improved, the total effective rate was 93.33%, 9 cases in the control group were cured, 15 cases improved, the total effective rate was compared with 86.66%., P0.05, two groups in the curative effect comparison of statistical significance. After treatment, two groups of patients in the Green O'Brien wrist joint score, BMD value compared with before treatment before the treatment compared to all The scores were significantly improved, the swelling score was significantly lower than before the treatment, the incidence of complications, the control group was significantly higher than the control group. The two groups of clinical symptoms were improved after treatment, and the two groups after treatment of various indicators in the treatment group were better than the control group, after statistical comparison P0.05, there were significant differences. (3) the two groups of patients were treated. The incidence of adverse reaction occurred after treatment, the rate of treatment group was 13%, the control group was not found liver and kidney function damage during 40%. treatment, only 4 cases in the treatment group had gastrointestinal reaction to Chinese medicine, while 5 patients in the control group had gastrointestinal reaction, 1 cases of hypersensitivity, 6 cases of constipation, and the symptoms could disappear after the drug withdrawal. X2 The incidence of two groups of adverse events was statistically significant. Conclusion: "Bu Gu Granule" can achieve good clinical effect in the treatment of osteoporotic Colles fracture (liver kidney deficiency deficiency and stasis type or qi blood deficiency syndrome type). It is safe and effective and can effectively relieve the clinical symptoms of patients. It is worth popularizing in clinical practice.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R274.1
本文編號：2159106
[Abstract]:Objective: to apply the "Bu Gu Granule" to the elderly osteoporotic Colles fractures, to observe the therapeutic effect, to verify its effectiveness, to provide a convenient and safe effective prevention and control method for the patients with osteoporotic Colles fracture, and to provide effective basis for its clinical application. Methods: 67 cases were included in the period from May 2015 to November 2016. The patients with osteoporotic Colles fracture treated by Guangzhou University of Chinese Medicine affiliated Zhanjiang second Chinese medicine hospital were divided into two groups according to the random digital table method, 34 cases in the treatment group and 33 in the control group. During the treatment, 4 cases in the treatment group fell off and 3 cases in the control group fell off. Before treatment, the baseline data of sex, age and bone mineral density were in the two groups. Statistical comparison, P0.05, no statistical significance. The control group B group of anti osteoporosis drug treatment: oral calcium carbonate D3, once a day, once a tablet, oral ossification three alcohol tablets, once a day, a tablet, Salcatonin Injection, 50IU/d, muscle injection 2 weeks after 1 times a week. The treatment group of A patients in the control group basis. 1 weeks after the fracture, add the traditional Chinese medicine formula supplementing bone granules, prescription: 1 packages (10g), 37 2 packets (3G), 1 packs of staghorn cream (10g), 1 bags of astragalus (10g), 1 packs (10g), 1 packets of Angelica (10g), 1 (10g) of Radix Paeoniae (10g), and daily 1 The two groups were divided into 2 times. No displaced fracture or incomplete fracture in the two groups did not need to be restored, only a small splint was fixed for 2-4 weeks. The displaced fractures were treated by manipulative reduction and flaps, such as the improper position of the fracture and the improper position of the cotton pad, the forearm kept on the neutral position in the chest. 4 weeks later, the splints were removed. The treatment period of each group was 3 months, and the clinical follow-up period was 3 months. In accordance with the requirements at the corresponding time point, January, February, March, two groups of patients were recorded: pain, functional state, grip strength, subjective feeling, objective evaluation, complications and fracture healing. During the treatment, the drugs were used in addition to the experimental drugs. The statistical analysis of the acquired clinical data was carried out using the SPSS18.0 statistical software. The data were represented by the standard deviation of the average number of soil (x + s), the measurement data were analyzed by the t test, the X2 test and analysis count data, the rank sum test analysis grade data, the repeated measurement design using variance analysis, when P0.05 There was a significant difference between the two groups of data. There was no significant difference between the two groups of data when P0.05. Results: (1) the treatment group was treated with the superposition of "bone filling Granule", the clinical effect and the improvement of the clinical symptoms of the patients were more obvious than the control group, and the incidence of adverse events was lower than the control group, and there was no obvious side effect in the treatment group. 30 cases in the treatment group. Of the patients, 15 patients recovered, 13 patients improved, the total effective rate was 93.33%, 9 cases in the control group were cured, 15 cases improved, the total effective rate was compared with 86.66%., P0.05, two groups in the curative effect comparison of statistical significance. After treatment, two groups of patients in the Green O'Brien wrist joint score, BMD value compared with before treatment before the treatment compared to all The scores were significantly improved, the swelling score was significantly lower than before the treatment, the incidence of complications, the control group was significantly higher than the control group. The two groups of clinical symptoms were improved after treatment, and the two groups after treatment of various indicators in the treatment group were better than the control group, after statistical comparison P0.05, there were significant differences. (3) the two groups of patients were treated. The incidence of adverse reaction occurred after treatment, the rate of treatment group was 13%, the control group was not found liver and kidney function damage during 40%. treatment, only 4 cases in the treatment group had gastrointestinal reaction to Chinese medicine, while 5 patients in the control group had gastrointestinal reaction, 1 cases of hypersensitivity, 6 cases of constipation, and the symptoms could disappear after the drug withdrawal. X2 The incidence of two groups of adverse events was statistically significant. Conclusion: "Bu Gu Granule" can achieve good clinical effect in the treatment of osteoporotic Colles fracture (liver kidney deficiency deficiency and stasis type or qi blood deficiency syndrome type). It is safe and effective and can effectively relieve the clinical symptoms of patients. It is worth popularizing in clinical practice.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R274.1
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