海桐皮汤外用对Colles骨折腕关节功能的影响
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广东省中医药局课题(20151042)


Effects of External Application of Cortex Erythrinae Decoction on Wrist Function Activities in the Colles Fracture
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    摘要:

    目的:探讨海桐皮汤外用对Colles骨折腕关节功能的影响。方法:选取2016年6月至2017年6月广东省中西医结合医院收治的Colles骨折患者60例,随机分为对照组及观察组,每组30例。2组患者均接受手法复位及夹板外固定,依据患者恢复情况分别与5~7周后拆除夹板并进行相应的功能锻炼,观察组在上述治疗基础上加用海桐皮外用,1 000 mL煎煮外用,1剂/d。分别于1、2、4周及3个月拍片复查患侧掌倾角、尺偏角及桡骨缩短的情况,3个月时比较患侧腕关节功能评分、临床总有效率以及骨代谢指标变化。结果:治疗3个月后观察组临床总有效率为95%,对照组总有效率为72%,2组比较差异有统计学意义(P<0.05);2组复位后及临床愈合后患者掌倾角、尺偏角及桡骨缩短程度与复位前比较,差异有统计学意义(P<0.05)。其中观察组改善较对照组明显(P<0.05);2组患者治疗后PRWE评分均较治疗前减少,差异有统计学意义(P<0.05),其中观察组下降的趋势较对照组明显,差异有统计学意义(P<0.05);2组患者治疗后外周血血钙(Ca)、血磷(P)、碱性磷酸酶(ALP)、骨钙素(BGP)、护骨因子(OPG)水平均有不同程度升高,其中观察组升高的趋势更明显(P<0.05)。结论:海桐皮汤外用可明显改善Colles骨折的临床症状,提高腕关节功能,其作用机制可能与改善患者骨代谢有关。

    Abstract:

    To study the impact of Cortex Erythrinae decoction for external use on wrist function activities in the Colles fracture. Methods:A total of 60 patients with Colles fracture treated in Traditional Chinese and Western Medicine Hospital of Guangdong Province from Jun 2016 to Jun 2017 were randomly divided into the control group and the observation group, with 30 cases in each group. Patients of both groups were accepted manual reduction and splint external fixation. The demolition of plywood was performed after 5 to 7 weeks and patients carried on the corresponding functional exercise according to patients' recovery. The observation group was combined with 1000 mL Cortex Erythrinae decoction topically on the basis of the above treatment, 1 agent per day. The reexamination with palmar tilt, ulnar inclination angle, and radius shorten of affected side at 1st, 2nd, 4th weeks and at the 3rd months were performed, and wrist function scores, the judge of clinical total effective rate and bone metabolic index changes were observed at the 3rd month. Results:1) The clinical total effective rate of the observation group was 95%, and total effective rate of the control group was 72%. The differences between the two groups have statistical significance (P<0.05, χ2=3.13) 3 months after treatment. 2) Compared with before the reduction, the differences were statistically significant (P<0.05) in palmar tilt, ulnar inclination angle, and radius shorten degree after reduction and clinical healing in the patients of the two groups. The improvement of the observation group was more obvious than the control group (P<0.05). 3) PRWE scores reduced after treatment in both the two groups, and the differences were statistically significant (P<0.05). The falling trend of the observation group was more obvious than the control group, and the differences were statistically significant (P<0.05). 4) The patients in the two groups after treatment, with the content of peripheral blood calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), osteocalcin (BGP), osteoprotegerin (OPG) increased to different extent, while the rising trend of the observation group was more obvious (P<0.05). Conclusion:Cortex Erythrinae decoction for external use can significantly improve the clinical symptoms of Colles fracture and wrist function, and its mechanism may be related to bone metabolism improvement.

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严炜彦,丘青中,邢振龙.海桐皮汤外用对Colles骨折腕关节功能的影响[J].世界中医药,2018,(07).

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  • 收稿日期:2018-01-17
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  • 在线发布日期: 2018-08-14
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