[1]盛红枫,张培祥,张魁,等.益肾活血方口服治疗胫骨下段骨折术后骨折不愈合[J].中医正骨,2017,29(11):60-62,68.
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益肾活血方口服治疗胫骨下段骨折术后骨折不愈合()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年11期
页码:
60-62,68
栏目:
学术探讨
出版日期:
2017-11-20

文章信息/Info

作者:
盛红枫; 张培祥; 张魁; 陆建伟
浙江省立同德医院,浙江 杭州 310012
关键词:
胫骨骨折;  骨折; 不愈合;  益肾活血方;  骨密度;  骨钙素;  骨保护素;  Ⅰ型胶原N末端肽;  抗酒石酸酸性磷酸酶5b
摘要:
目的:观察自拟益肾活血方口服治疗胫骨下段骨折术后骨折不愈合的临床疗效。方法:2012年1月至2016年12月,采用自拟益肾活血方口服治疗胫骨下段骨折术后骨折不愈合患者30例,男14例、女16例。年龄31～63岁,中位数43岁。横断形骨折10例,斜形骨折6例,粉碎性骨折14例。所有患者首次治疗时均行切开复位解剖钢板内固定术。病程9～14个月,中位数10个月。观察患者治疗前后骨密度(bone mineral density,BMD)、血清骨钙素(bone gla protein,BGP)、血清骨保护素(osteoprotegerin,OPG)、血清Ⅰ型胶原N末端肽(N-terminal telopeptide,NTX)及血清抗酒石酸酸性磷酸酶5b(tartrate resistant acid phosphatase 5b,TRACP5b)变化情况,并于治疗开始后6个月参照《中医骨伤学》中骨折愈合的疗效标准评价疗效。结果:治疗开始后1、3、6个月BMD分别由治疗前(0.900±0.047)g·cm-2升至(0.919±0.042)g·cm-2、(0.952±0.041)g·cm-2、(0.964±0.046)g·cm-2,血清BGP分别由治疗前(4.53±0.29)μg·L-1升至(4.77±0.31)μg·L-1、(4.98±0.27)μg·L-1、(5.06±0.33)μg·L-1,血清OPG分别由治疗前(5.38±0.29)μg·L-1升至(5.62±0.27)μg·L-1、(6.02±0.25)μg·L-1、(6.05±0.24)μg·L-1,血清Ⅰ型胶原NTX由治疗前(4.38±0.30)μg·L-1升至(4.49±0.32)μg·L-1、(4.72±0.28)μg·L-1、(4.68±0.31)μg·L-1,血清TRACP5b由治疗前(6.39±0.29)μg·L-1升至(6.55±0.25)μg·L-1、(6.72±0.17)μg·L-1、(6.68±0.19)μg·L-1。治疗开始后6个月参照《中医骨伤学》中骨折愈合的疗效标准评价疗效,临床愈合23例、好转5例、无效2例。结论:采用自拟益肾活血方口服治疗胫骨下段骨折术后骨折不愈合,可以提高患者骨密度,促进骨形成和骨吸收,有利于骨折愈合,疗效确切; 但因病例数有限,还需进行多中心大样本前瞻性研究加以证实。

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更新日期/Last Update: 2018-04-02