| 引用本文:蔡雅楠，梁嘉樑.七厘散治疗踝关节骨折对踝关节功能和等速肌力的影响[J].世界中医药,2019,(04):. |
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| 七厘散治疗踝关节骨折对踝关节功能和等速肌力的影响 |
| Effects of Qili Powder in the Treatment of Ankle Joint Fracture on Ankle Joint Function and Determination of Isokinetic Muscle Strength |
| 投稿时间：2018-03-31 |
| DOI：10.3969/j.issn.1673-7202.2019.04.032 |
| 中文关键词: 七厘散 踝关节骨折 Kofoed评分 AOFAS评分 白细胞介素-6 肿瘤细胞因子-α 等速肌力 临床疗效 |
| English Keywords:Qili Powder Ankle fracture Kofoed AOFAS IL-6 TNF-α Isokinetic muscle strength Clinical efficacy |
| 基金项目:陕西省卫生厅卫生科研基金项目(16D42) |
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| 中文摘要: |
| 目的：观察七厘散治疗踝关节骨折患者的临床疗效，并分析其对踝关节相关指标和功能的影响。方法：选取2016年1月至2017年12月宝鸡市中医医院收治的踝关节骨折患者80例作为研究对象，通过抽取随机数字法将其纳入观察组和对照组，每组40例。对照组使用经皮微创空心螺钉内固定术治疗，观察组在手术治疗同时结合七厘散口服，分别在治疗前、治疗后和4个月随访后，对患者的踝关节功能（Kofoed、AOFAS评分）、临床症状（肿痛消失时间、骨折愈合时间和完全负重时间）、等速肌力、血清Ca2+、碱性磷酸酶（ALP）、白细胞介素-6（IL-6）和肿瘤细胞因子-α（TNF-α）水平进行分析。结果:在治疗后及4个月后随访时，2组患者的Kofoed评分、AOFAS评分均较治疗前明显提高，差异有统计学意义（P<0.05），且观察组优于对照组，差异有统计学意义（P<0.05）;在治疗后及4个月随访后，2组患者的血清IL-6及TNF-α水平明显降低，且观察组优于对照组，差异有统计学意义（P<0.05）。2组在治疗后及随访后的Ca2+、ALP水平较治疗前明显升高，差异有统计学意义（P<0.05）;且观察组显著高于对照组，差异有统计学意义（P<0.05）。在随访4个月后，观察组患者的平均肿痛消失时间、骨折愈合时间和完全负重时间均明显优于对照组，差异有统计学意义（P<0.05）。在4个月随访后，观察组患者背伸、趾屈、内外翻时，其力矩加速能、相对峰力矩值、耐力与对照组比较明显增高，差异有统计学意义（P<0.05）。结论：踝关节骨折手术患者结合服用七厘散，可以有效改善相关临床症状，疼痛、肿胀及骨折愈合时间等均明显缩短，踝关节功能及肌力明显好转，这可能与七厘散活血化瘀，促进骨折修复，清除炎性反应递质等作用有关。 |
| English Summary: |
| To observe the clinical efficacy of Qili Powder in the treatment of ankle fracture，and to analyze its effects on the ankle joint related indexes and functions.Methods:A total of 80 patients with ankle fracture treated in Baoji Hospital of Chinese Medicine from January 2016 to December 2017 were selected.They were randomly divided into the treatment group and the control group，with 40 cases in each group.The control group was treated with percutaneous cannulated screw fixation，while the treatment group received the same procedure combined with the Qili Powder.The patients' ankle joint function(Kofoed，AOFAS score)，clinical symptoms(time of swelling disappearance，fracture healing and full weight-bearing)，isokinetic muscle strength，serum Ca2+，ALP，IL-6 and TNF-α level before，after and 4 months' follow-up after the treatment were assessed respectively，and the comparative analysis was performed.Results:1）After，and in the 4 months' follow-up after treatment，the Kofoed and AOFAS scores of both group were significantly improved compared with before treatment(P<0.05)，and the treatment group had greater improvement than the control group(P<0.05);2）After the treatment and in the follow-up 4 months after，patients of both group had significantly decreased serum IL-6 and TNF-α levels，and the treatment group had greater decrease than the control group(P<0.05).3）After treatment and in the follow-up，the Ca2+ and ALP levels of 2 groups were higher than those before treatment(P<0.05); and that of the treatment group was significantly higher than the control group(P<0.05).4）In the follow-up after 4 months，the average time of disappearance of pain and swelling，fracture healing and full weight-bearing of patients in the treatment group was significantly shorter than that of the control group(P<0.05).5）In the 4 months of follow-up，during dorsiflexion，flexion，varus and valgus，patients in the treatment group had significantly increased torque acceleration energy，relative peak torque，endurance when compared to the control group(P<0.05).Conclusion:Ankle fracture surgery，combined with Qili Powder，can effectively improve the clinical symptoms，pain，swelling and fracture healing time，and significantly improve ankle joint function and muscle strength，which may be contributed by the functions of invigorating blood and dissolving stasis，boosting fracture healing，and removing of inflammatory factors，etc. |
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