84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]何幫劍,毛強(qiáng),華江,等.恒古骨傷愈合劑在脛骨中下段骨折術(shù)后的應(yīng)用及作用機(jī)制[J].中醫(yī)正骨,2020,32(05):15-18.
　HE Bangjian,MAO Qiang,HUA Jiang,et al.Application of Osteoking to patients who received surgery for treatment of middle-lower tibial fractures and its mechanism of action[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(05):15-18.
點擊復(fù)制

恒古骨傷愈合劑在脛骨中下段骨折術(shù)后的應(yīng)用及作用機(jī)制()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年05期
頁碼:
15-18
欄目:
臨床研究
出版日期:
2020-05-20

文章信息/Info

Title:
Application of Osteoking to patients who received surgery for treatment of middle-lower tibial fractures and its mechanism of action
作者:
何幫劍; 毛強(qiáng); 華江; 童培建
(浙江省中醫(yī)院,浙江 杭州 310006)
Author(s):
HE Bangjian; MAO Qiang; HUA Jiang; TONG Peijian
Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China
關(guān)鍵詞:
脛骨骨折;  恒古骨傷愈合劑;  桃紅四物湯;  骨折愈合;  手術(shù)后并發(fā)癥;  堿性磷酸酶;  骨鈣素;  Ⅰ型前膠原羧基末端前肽
摘要:
目的:探討恒古骨傷愈合劑在脛骨中下段骨折術(shù)后的應(yīng)用價值及作用機(jī)制。方法:脛骨中下段骨折患者65例,隨機(jī)分為2組,恒古骨傷愈合劑組32例、桃紅四物湯組33例。2組患者均采用微創(chuàng)經(jīng)皮鎖定加壓鋼板內(nèi)固定手術(shù)治療,手術(shù)均由同一組醫(yī)生完成。術(shù)后第1天開始,恒古骨傷愈合劑組患者予以恒古骨傷愈合劑口服,每次25 mL,每2日1次; 桃紅四物湯組患者予以桃紅四物湯口服,每日1劑,每日早晚各1次; 共服用4周。記錄術(shù)后患肢腫脹消退時間、瘀斑消失時間及骨折愈合時間。分別于服藥前和服藥4周后,采用疼痛視覺模擬量表(visual analogue scale,VAS)對患肢疼痛情況進(jìn)行評分; 檢測患者血清中堿性磷酸酶(alkaline phosphatase,ALP)、骨鈣素(bone gla-protein,BGP)及Ⅰ型前膠原羧基末端前肽(carboxy terminal propeptide of typeⅠprocollagen,PⅠCP)含量。術(shù)后12個月,參照J(rèn)ohner-Wruhs脛骨骨折療效評價標(biāo)準(zhǔn)評價綜合療效。結(jié)果:65例患者均順利完成手術(shù)和術(shù)后治療; 均獲隨訪,隨訪時間12～26個月,中位數(shù)18個月。恒古骨傷愈合劑組,術(shù)后患肢腫脹消退時間、瘀斑消失時間及骨折愈合時間均短于桃紅四物湯組[(15.03±2.29)d,(18.52±3.51)d,t=-4.722,P=0.000;(19.09±2.96)d,(24.09±3.23)d,t=-6.497,P=0.000;(22.47±3.32)周,(26.79±2.89)周,t=-5.597,P=0.000]。服藥前,2組患者患肢疼痛VAS評分比較,差異無統(tǒng)計學(xué)意義(t=0.995,P=0.324); 服藥4周后,2組患者患肢疼痛VAS評分均較服藥前降低[(7.28±0.77)分,(2.75±0.76)分,t=26.070,P=0.000;(7.06±0.99)分,(3.18±0.85)分,t=17.913,P=0.000],且恒古骨傷愈合劑組患肢疼痛VAS評分低于桃紅四物湯組(t=-2.160,P=0.035)。服藥前,2組患者血清ALP、BGP、PⅠCP含量比較,組間差異均無統(tǒng)計學(xué)意義(t=-0.344,P=0.732; t=0.653,P=0.561; t=0.283,P=0.778); 服藥4周后,2組患者血清ALP、BGP含量較服藥前增加、PⅠCP含量較服藥前降低[恒古骨傷愈合劑組:(74.88±6.43)單位·L-1,(128.91±10.10)單位·L-1,t=-26.581,P=0.000;(2.26±0.39)μg·L-1,(3.76±0.50)μg·L-1,t=-11.789,P=0.000;(121.06±10.49)μg·L-1,(67.13±6.23)μg·L-1,t=23.366,P=0.000; 桃紅四物湯組:(75.45±7.12)單位·L-1,(112.33±7.86)單位·L-1,t=-20.542,P=0.000;(2.20±0.37)μg·L-1,(3.15±0.49)μg·L-1,t=-9.010,P=0.000;(120.27±11.90)μg·L-1,(77.33±7.74)μg·L-1,t=16.951,P=0.000],且恒古骨傷愈合劑組血清ALP、BGP含量高于桃紅四物湯組(t=7.395,P=0.000; t=4.987,P=0.000)、PⅠCP含量低于桃紅四物湯組(t=-5.844,P=0.000)。術(shù)后12個月參照上述療效評價標(biāo)準(zhǔn),恒古骨傷愈合劑組優(yōu)19例、良11例、可2例,桃紅四物湯組優(yōu)16例、良9例、可8例,恒古骨傷愈合劑組的綜合療效優(yōu)于桃紅四物湯組(Z=-6.377,P=0.000)。結(jié)論:恒古骨傷愈合劑用于脛骨中下段骨折的術(shù)后治療,可緩解患肢疼痛,促進(jìn)術(shù)后患肢腫脹消退、瘀斑消失及骨折愈合,綜合療效優(yōu)于桃紅四物湯; 其作用機(jī)制可能與提高患者血清中ALP、BGP含量、降低血清中PⅠCP含量,調(diào)節(jié)骨代謝有關(guān)。
Abstract:
Objective:To explore the applied values and mechanism of action of Osteoking(OK)in patients who recevied surgery for treatment of middle-lower tibial fractures.Methods:Sixty-five patients with middle-lower tibial fractures were selected and randomly divided into OK group(32 cases)and Taohong Siwu Tang(桃紅四物湯,THSWT)group(33 cases).The patients in the 2 groups were treated with minimally invasive percutaneous locking compression plate internal fixation by the same group of surgeons.From postoperative day 1,the patients in OK group were treated with oral application of OK,once every 2 days for consecutive 4 weeks,25 mL at a time; while the patients in THSWT group were treated with oral application of THSWT,one dose a day in the morning and evening respectively for consecutive 4 weeks.The postoperative swelling subsidence time,ecchymoses extinction time and fracture healing time of affected limbs were recorded.The affected limb pain was evaluated by using visual analogue scale(VAS)and the serum contents of alkaline phosphatase(ALP),bone gla-protein(BGP)and carboxy terminal propeptide of typeⅠprocollagen(PⅠCP)were detected before medication and after 4-week medication respectively.The total clinical curative effects were evaluated according to Johner-Wruhs therapeutic effect evaluation standard of tibial fracture at 12 months after surgery.Results:The surgeries and postoperative treatments were finished successfully in all patients,and all patients in the 2 groups were followed up for 12-26 months with a median of 18 months.The postoperative swelling subsidence time,ecchymoses extinction time and fracture healing time of affected limbs were shorter in OK group compared to THSWT group(15.03+/-2.29 vs 18.52+/-3.51 days,t=-4.722,P=0.000; 19.09+/-2.96 vs 24.09+/-3.23 days,t=-6.497,P=0.000; 22.47+/-3.32 vs 26.79+/-2.89 weeks,t=-5.597,P=0.000).There was no statistical difference in pain VAS scores between the 2 groups before medication(t=0.995,P=0.324).The pain VAS scores decreased after 4-week medication compared to pre-medication in the 2 groups(7.28+/-0.77 vs 2.75+/-0.76 points,t=26.070,P=0.000; 7.06+/-0.99 vs 3.18+/-0.85 points,t=17.913,P=0.000),and was lower in OK group compared to THSWT group(t=-2.160,P=0.035).There was no statistical difference in serum contents of ALP,BGP and PⅠCP between the 2 groups before medication(t=-0.344,P=0.732; t=0.653,P=0.561; t=0.283,P=0.778).The serum contents of ALP and BGP increased,while the serum content of PⅠCP decreased after 4-week medication compared to pre-medication(OK group:74.88+/-6.43 vs 128.91+/-10.10 unit/L,t=-26.581,P=0.000; 2.26+/-0.39 vs 3.76+/-0.50 μg/L,t=-11.789,P=0.000; 121.06+/-10.49 vs 67.13+/-6.23 μg/L,t=23.366,P=0.000; THSWT group:75.45+/-7.12 vs 112.33+/-7.86 unit/L,t=-20.542,P=0.000; 2.20+/-0.37 vs 3.15+/-0.49 μg/L,t=-9.010,P=0.000; 120.27+/-11.90 vs 77.33+/-7.74 μg/L,t=16.951,P=0.000),and the serum contents of ALP and BGP were higher and the serum content of PⅠCP was lower in OK group compared to THSWT group(t=7.395,P=0.000; t=4.987,P=0.000; t=-5.844,P=0.000).The total clinical curative effects were evaluated according to Johner-Wruhs therapeutic effect evaluation standard of tibial fracture at 12 months after surgery.Nineteen patients obtained an excellent result,11 good and 2 fair in OK group; while 16 patients obtained an excellent result,9 good and 8 fair in THSWT group.The OK group surpassed the THSWT group in total clinical curative effects(Z=-6.377,P=0.000).Conclusion:OK can relieve the pain and promote swelling subsidence,ecchymoses extinction and fracture healing in patients who recevied surgery for treatment of middle-lower tibial fractures,and its clinical curative effects is better than that of THSWT.Its mechanisms of action may be that it can regulate the bone metabolism through increasing the serum contents of ALP and BGP and decreasing the serum content of PⅠCP.

參考文獻(xiàn)/References:

[1] WENNERGREN D,BERGDAHL C,EKELUND J.Epidemiology and incidence of tibia fractures in the Swedish Fracture Register[J].Injury,2018,49(11):2068-2074.
[2] HU L C,XIONG Y,MI B B,et al Comparison of intramedullary nailing and plate fixation in distal tibial fractures with metaphyseal damage:a meta-analysis of randomized controlled trials[J].J Orthop Surg Res,2019,14(1):30.
[3] 袁鑫,武羽潔,角建林,等.彝藥恒古骨傷愈合劑的藥理作用和臨床應(yīng)用[J].中國現(xiàn)代應(yīng)用藥學(xué),2019,36(3):372-376.
[4] RüEDI T P,BUCKLEY R E,MORAN C G.骨折治療的AO原則[M].危杰,劉璠,吳新寶,等譯.2版.上海:上海科學(xué)技術(shù)出版社,2010:5.
[5] 黃桂成,王擁軍.中醫(yī)骨傷科學(xué)(新世紀(jì)第四版)[M].北京:中國中醫(yī)藥出版社,2016:7.
[6] JOHNER R,WRUHS O.Classification of tibial shaft fractures and correlation with results after rigid internal fixation[J].Clin Orthop Relat Res,1983,(178):7-25.
[7] 常文利,張英澤,陳偉.脛骨中下段骨折不愈合原因的研究進(jìn)展[J].中國骨與關(guān)節(jié)雜志,2017,6(9):713-716.
[8] ANDALIB A,SHEIKHBAHAEI E,ANDALIB Z,et al.Effectiveness of minimally invasive plate osteosynthesis(MIPO)on comminuted tibial or femoral fractures[J].Arch Bone Jt Surg,2017,5(5):290-295.
[9] 魏英俊,徐克武,蔣宜偉,等.脛骨骨折內(nèi)固定術(shù)后感染的相關(guān)危險因素[J].中醫(yī)正骨,2018,30(5):37-39.
[10] 朱小龍,徐衛(wèi)星,盛紅楓,等.微創(chuàng)鎖定加壓鋼板內(nèi)固定治療脛骨中下段骨折[J].中醫(yī)正骨,2019,31(3):60-62.
[11] 殷兵,張奇,張英澤.脛骨骨不連的手術(shù)治療進(jìn)展[J].中國矯形外科雜志,2010,18(20):1701-1703.
[12] LI J L.Effect of ossotide injection on the bone metabolism and bone mineral density in patients with femoral intertrochanteric fracture[J].J Hainan Med Univers,2016,22(20):70-73.
[13] 錢雪豐,曹平,劉拴,等.仙靈骨葆輔助外科治療老年婦女Colles骨折的愈合時間、鈣磷含量及骨代謝的評估[J].海南醫(yī)學(xué)院學(xué)報,2017,23(2):281-284.
[14] 任保紅,張志忠,謝鵬.骨康膠囊對老年橈骨遠(yuǎn)端骨折患者術(shù)后愈合的影響[J].中南醫(yī)學(xué)科學(xué)雜志,2018,46(2):183-185.
[15] VAN BAARDEWIJK L J,VAN DER ENDE J,LISSENBERG-THUNNISSEN S,et al.Circulating bone morphogenetic protein levels and delayed fracture healing[J].Int Orthop,2013,37(3):523-527.
[16] 王建年.骨康膠囊輔助外科治療后老年橈骨遠(yuǎn)端骨折患者的骨折愈合、微循環(huán)狀態(tài)以及骨代謝的評估[J].海南醫(yī)學(xué)院學(xué)報,2016,22(19):2294-2297.
[17] 趙超,張本政,馮和林.中醫(yī)藥干預(yù)骨折愈合過程的機(jī)制及實驗研究進(jìn)展[J].河北中醫(yī),2017,39(12):1904-1907.
[18] 陳弘林,涂來勇,趙疆,等.用于骨折延遲愈合和骨折不愈合的中藥湯劑的用藥規(guī)律研究[J].中醫(yī)正骨,2018,30(12):37-39.
[19] 高淑蘭,周芳,亢孝弟,等.化瘀止痛散在橈骨遠(yuǎn)端骨折治療中的療效觀察[J].中國醫(yī)院藥學(xué)雜志,2014,34(3):224-226.
[20] 李秀秀,金中義,金福厚.桃紅四物湯促進(jìn)骨折愈合的實驗研究進(jìn)展[J].云南中醫(yī)中藥雜志,2015,36(10):79-81.

相似文獻(xiàn)/References:

[1]肖善富,張喜善,于鳳珍.髕下小切口鋼絲紐扣式內(nèi)固定治療脛骨髁間隆突骨折[J].中醫(yī)正骨,2015,27(11):34.
[2]葛波涌,王玉波,王明太,等.交鎖髓內(nèi)釘內(nèi)固定治療脛骨干骨折的臨床研究[J].中醫(yī)正骨,2015,27(10):8.
　GE Boyong,WANG Yubo,WANG Mingtai,et al.Clinical study on the internal fixation with interlocking intramedullary nail for the treatment of tibial shaft fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(05):8.
[3]全先輝,萬春友,劉磊,等.Taylor空間支架外固定治療脛腓骨開放性骨折[J].中醫(yī)正骨,2015,27(10):30.
[4]何 濤.有限切開植骨鋼板內(nèi)固定治療 SchatzkerⅡ、Ⅲ型脛骨平臺骨折[J].中醫(yī)正骨,2015,27(09):22.
[5]何忠,黃宗權(quán),王強(qiáng),等.脛骨中下段螺旋形骨折合并后踝裂紋骨折的診治體會[J].中醫(yī)正骨,2015,27(09):28.
[6]王慶東,李付彬,徐向峰,等.關(guān)節(jié)鏡下可吸收螺釘內(nèi)固定治療兒童脛骨髁間嵴骨折[J].中醫(yī)正骨,2015,27(12):52.
[7]李楠,李鋒.脛骨平臺骨折的手術(shù)治療進(jìn)展[J].中醫(yī)正骨,2015,27(12):78.
[8]張一鳴,張學(xué)民,陸洲.經(jīng)皮解剖型鎖定鋼板固定治療脛骨遠(yuǎn)端骨折[J].中醫(yī)正骨,2015,27(02):47.
[9]陳利軍,田野,劉文剛,等.非典型膝關(guān)節(jié)外傷后脛骨近端隱匿性骨折的影像診斷[J].中醫(yī)正骨,2015,27(06):26.
[10]徐俊峰,王翔宇.切開復(fù)位鎖定加壓鋼板內(nèi)固定治療高能量損傷Pilon骨折[J].中醫(yī)正骨,2015,27(06):54.

備注/Memo

備注/Memo:
(收稿日期:2019-11-06 本文編輯:楊雅)通訊作者:華江 E-mail:[email protected]
更新日期/Last Update: 2020-08-15