【摘要】：目的:通過臨床研究,觀察補腎活血湯對腎虛血瘀型老年股骨轉子間骨折患者術后康復的臨床療效。方法:選取常州市中醫(yī)醫(yī)院2015年8月～2016年2月收治的52例老年股骨轉子間骨折患者按入院先后順序,采用隨機數字表分組法分為觀察組(26例)和對照組(26例),所有患者均由同一組醫(yī)師行閉合復位后股骨近端防旋髓內釘固定術(PFNA),術后常規(guī)予抗血栓、預防感染及口服鈣片等營養(yǎng)支持治療。觀察組在常規(guī)治療基礎上加服自擬補腎活血湯,每日一劑,療程為24周。觀察對比兩組患者治療前、術后特定時間的血清鈣(Ca)、磷(P)、堿性磷酸酶(ALP)、疼痛、骨密度(BMD)、髖關節(jié)功能Harris評分。結果:兩組骨代謝生化指標(Ca、P、ALP)組間比較,術前及術后1、2周均無統(tǒng)計學差異(P0.05)。兩組患者治療前VAS評分、腰椎BMD值接近(P0.05),術后1周兩組VAS評分無統(tǒng)計學差異(P0.05),術后2周觀察組VAS評分明顯優(yōu)于對照組(P0.05);術后12周兩組腰椎BMD值無統(tǒng)計學差異(P0.05),術后24周觀察組腰椎BMD值明顯優(yōu)于對照組(P0.05);兩組術前及術后2、12、24周髓關節(jié)功能Harris評分比較,術前及術后2周、12周無統(tǒng)計學差異(P0.05),術后24周,有統(tǒng)計學差異(P0.05),觀察組優(yōu)于對照組。兩組術后24周髖關節(jié)功能Harris評分,觀察組優(yōu)良率為88.46%,對照組優(yōu)良率為65.38%,組間比較(P0.05),觀察組優(yōu)于對照組。結論:口服補腎活血湯治療老年股骨轉子間骨折療效肯定,能減輕骨折患者術后疼痛癥狀,改善骨代謝,增強BMD,促進髖關節(jié)功能的恢復。
[Abstract]:Objective: to observe the clinical effect of Bushen Huoxue decoction on postoperative rehabilitation of senile patients with intertrochanteric fracture of femur due to kidney deficiency and blood stasis. Methods: 52 elderly patients with intertrochanteric fracture of femur were selected from Changzhou Hospital of traditional Chinese Medicine from August 2015 to February 2016. According to the order of admission, they were divided into observation group (n = 26) and control group (n = 26). All the patients were treated by the same group of doctors after closed reduction and intramedullary nail fixation of the proximal end of femur with antithrombotic therapy, prevention of infection, oral calcium tablets and other nutritional support therapy after (PFNA),. On the basis of routine treatment, the observation group was treated with Bushen Huoxue decoction once a day for 24 weeks. The pain of serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP),) and bone mineral density (BMD),) hip function Harris score were observed and compared between the two groups before and after treatment. Results: there was no significant difference in bone metabolism biochemical index (Ca,P,ALP) between the two groups before and 1 week after operation (P0.05). The VAS score of the two groups before treatment, lumbar BMD value was close (P0.05), there was no significant difference in the VAS score between the two groups at 1 week after operation (P0.05). The VAS score in the observation group was significantly better than that in the control group at 2 weeks after operation (P0.05). There was no significant difference in lumbar BMD between the two groups at 12 weeks after operation (P0.05). The BMD value of lumbar spine in observation group was significantly better than that in control group at 24 weeks after operation (P0.05). There was no significant difference in Harris score between the two groups before and after 2 weeks (P0.05) and 24 weeks after operation (P0.05), and the observation group was superior to the control group. The Harris score of hip function was 88.46 in the observation group and 65.38in the control group 24 weeks after operation. The comparison between the two groups (P0.05) showed that the observation group was superior to the control group. Conclusion: oral Bushen Huoxue decoction is effective in treating senile femoral intertrochanteric fracture. It can relieve postoperative pain symptoms, improve bone metabolism and enhance BMD, to promote hip joint function recovery in elderly patients with femoral intertrochanteric fracture.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R274.9

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