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[1]盛紅楓,張培祥,張魁,等.益腎活血方口服治療脛骨下段骨折術(shù)后骨折不愈合[J].中醫(yī)正骨,2017,29(11):60-62,68.
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益腎活血方口服治療脛骨下段骨折術(shù)后骨折不愈合()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年11期
頁碼:
60-62,68
欄目:
學(xué)術(shù)探討
出版日期:
2017-11-20

文章信息/Info

作者:
盛紅楓張培祥張魁陸建偉
浙江省立同德醫(yī)院,浙江 杭州 310012
關(guān)鍵詞:
脛骨骨折 骨折不愈合 益腎活血方 骨密度 骨鈣素 骨保護(hù)素 Ⅰ型膠原N末端肽 抗酒石酸酸性磷酸酶5b
摘要:
目的:觀察自擬益腎活血方口服治療脛骨下段骨折術(shù)后骨折不愈合的臨床療效。方法:2012年1月至2016年12月,采用自擬益腎活血方口服治療脛骨下段骨折術(shù)后骨折不愈合患者30例,男14例、女16例。年齡31~63歲,中位數(shù)43歲。橫斷形骨折10例,斜形骨折6例,粉碎性骨折14例。所有患者首次治療時均行切開復(fù)位解剖鋼板內(nèi)固定術(shù)。病程9~14個月,中位數(shù)10個月。觀察患者治療前后骨密度(bone mineral density,BMD)、血清骨鈣素(bone gla protein,BGP)、血清骨保護(hù)素(osteoprotegerin,OPG)、血清Ⅰ型膠原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)變化情況,并于治療開始后6個月參照《中醫(yī)骨傷學(xué)》中骨折愈合的療效標(biāo)準(zhǔn)評價療效。結(jié)果:治療開始后1、3、6個月BMD分別由治療前(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分別由治療前(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分別由治療前(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型膠原NTX由治療前(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由治療前(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。治療開始后6個月參照《中醫(yī)骨傷學(xué)》中骨折愈合的療效標(biāo)準(zhǔn)評價療效,臨床愈合23例、好轉(zhuǎn)5例、無效2例。結(jié)論:采用自擬益腎活血方口服治療脛骨下段骨折術(shù)后骨折不愈合,可以提高患者骨密度,促進(jìn)骨形成和骨吸收,有利于骨折愈合,療效確切; 但因病例數(shù)有限,還需進(jìn)行多中心大樣本前瞻性研究加以證實。

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更新日期/Last Update: 2018-04-02