世界中医药

目的：观察骨康胶囊辅助治疗老年不稳定性桡骨远端骨折的效果，以探讨中医药在这类患者外科治疗中的辅助作用。方法：选取2014年2月至2016年6月在骨科住院治疗的老年不稳定性桡骨远端骨折68例，按随机数字表法分为观察组和对照组，各34例，2组患者均接受掌侧锁定钢板内固定治疗，对照组患者术后予以碳酸钙片口服治疗，1.5 g/次，3次/d，观察组患者则在对照组患者的基础上予以骨康胶囊口服治疗，4粒/次，3次/d，2组患者均连续服用2个月。分别于术前、术后1个月、术后2个月检测2组患者血清抗酒石酸酸性磷酸酶5b（TRACP5b）、I型前胶原羧基端肽（PICP）、骨钙素（BGP）等骨代谢生化指标，同时详细记录2组患者术后肿胀消退时间、骨折愈合时间、住院时间，并于术后6个月时评价患者骨折复位质量和腕关节功能恢复情况。结果：与对照组患者比较，术后1个月、2个月时观察组患者血清TRACP5b水平均明显降低，血清PICP、BGP均明显升高，差异均有统计学意义（P<0.05）；观察组患者术后肿胀消退时间、骨折愈合时间、住院时间均明显短于对照组患者，差异均有统计学意义（P<0.05）；术后6个月时常规拍摄腕关节正侧位X线片，2组患者掌倾角、尺偏角、桡骨高度比较，差异均有统计学意义（P<0.05）；术后6个月时，观察组患者腕关节功能恢复优良率为79.41%（27/34），对照组患者为64.71%（22/34），组间差异无统计学意义（P>0.05）。结论：骨康胶囊辅助治疗老年不稳定性桡骨远端骨折的效果显著，有效改善患者骨代谢状态，促进术后肿胀消退和骨折愈合。

English Summary:

To observe the effects of Gukang capsule treatment for elderly patients with unstable distal radius fractures, in order to investigate the auxiliary effect of traditional Chinese medicine on the surgical treatment of these patients. Methods:A total of 68 cases of elderly patients with unstable distal radius fractures who were admitted in our hospital from February 2014 to June 2016 were selected and randomly divided into experimental group and control group according to random number table method, with 34 cases in each group. Patients in both group received volar locking plate internal fixation treatment. Besides that, patients in control group received calcium carbonate tablet, 1.5g each time, 3 times each day, and patients in experimental group received Gukang capsule on the basis of the control group, 4 tablets each time, 3 times each day. Patients in both groups were treated for 2 months. The serum levels of serum tar-trate resistant acid phosphatase (TRACP5b), Procollagen type I C-terminal propeptide (PICP), bone gla protein (BGP) were detected before treatment and 1 month, 2 month after surgical treatment were detected, and the time of swelling subsided, fracture healing, hospitalization were recorded in detail. The fracture reduction quality and recovery of wrist function were evaluated at 6 months after surgical treatment. Results:Compared with the control group, the serum levels of TRACP5b of experimental group was significantly decreased, and the serum levels of PICP, BGP of experimental group were significantly increased at 1 month, 2 months after surgical treatment, with statistically significant difference (P<0.05); The time of swelling subsided, fracture healing, hospitalization of experimental group were significantly shorter than that of control group, with statistically significant difference (P<0.05); At 6 months after surgical treatment, there were statistically significant difference in palmar angle, ulnar deviation angle and radius height between the two groups (P<0.05); At 6 months after surgical treatment, the excellent rate of wrist function recovery was 79.41% (27/34) in experimental group, and 64.71% (22/34) in control group, without statistically significant difference (P>0.05). Conclusion:Gukang capsule treatment for elderly patients with unstable distal radius fractures has significant effects, which can effectively improve the state of bone metabolism, promote postoperative swelling subsided and fracture healing.

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