Application of Modified Huangqi Guizhi Wuwu Decoction Combined with Internal Fixation Surgery in Patients with Intertrochanteric Fracture of Femur
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维普
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目的 本研究旨在探讨加减黄芪桂枝五物汤联合内固定术在股骨粗隆间骨折患者中的应用.方法 选取2021年6月-2022年10月期间黄冈职业技术学院附属医院英山人民医院收治的104例股骨粗隆间骨折患者为研究对象,按随机数字表法分为对照组和观察组,每组各52例.对照组予内固定术治疗,观察组在对照组基础上联合加减黄芪桂枝五物汤.治疗2周后,观察比较两组患者治疗前后中医证候积分、胰岛素样生长因子(In-sulin-like growth factor,IGF-1)、骨形态发生蛋白(Bone morphogenetic proteins,BMP-2)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)、Ⅰ 型胶原羟基端肽β特殊序列(Special sequence of hydroxyl terminal pep-tide β of type Ⅰ collagen,β-CTX)、甲状腺旁腺素(Parathyroid hormone,PTH)、骨型碱性磷酸酶(Bone alkaline phos-phatase,BALP)、骨钙素(Osteocalcin,OC)、关节功能,临床疗效及并发症发生率.结果 治疗后观察组临床总有效率96.15％(50/52)明显高于对照组80.77％(42/52),差异有统计学意义(P＜0.05).治疗后两组患者股骨粗隆部位肿胀、刺痛、拒按、痛处固定、食少纳呆、疲乏、声音低弱评分均较治疗前降低,差异有统计学意义(P＜0.05);且研究组股骨粗隆部位肿胀、刺痛、拒按、痛处固定、食少纳呆、疲乏、声音低弱评分均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者IGF-1、BMP-2、VEGF、BALP、OC水平均较治疗前升高,β-CTX、PTH水平均较治疗前降低,差异有统计学意义(P＜0.05);观察组IGF-1、BMP-2、VEGF、BALP、OC水平均明显高于对照组,β-CTX、PTH水平均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者关节活动度、日常生活能力、肢体畸形、疼痛评分均较治疗前升高,差异有统计学意义(P＜0.05);且观察组关节活动度、日常生活能力、肢体畸形、疼痛评分均明显高于对照组,差异有统计学意义(P＜0.05).治疗后观察组总并发症发生率1.92％(1/52)明显低于对照组13.46％(7/52),差异有统计学意义(P＜0.05).结论 加减黄芪桂枝五物汤联合内固定术能够有效改善股骨粗隆间骨折患者临床症状,降低中医证候积分,调节IGF-1、BMP-2、VEGF、β-CTX、PTH、BALP、OC水平,改善髋关节功能,加速骨折愈合,值得临床推广使用.
Objective To investigate the application of modified Huangqi Guizhi Wuwu Decoction combined with internal fixation surgery in patients with intertrochanteric fracture of the femur.Methods A total of 104 patients with in-tertrochanteric fracture of femur admitted to The People's Hospital of Yingshan,Affiliated Hospital of Huanggang Polytech-nic College,from June 2021 to October 2022,were selected as the study objects.The patients were divided into a control group and an observation group according to the random number table method,with 52 patients in each group.The control group received internal fixation surgery,while the observation group received Huangqi Guizhi Wuwu decoction based on the control group.After 2 weeks of treatment,the traditional Chinese medicine(TCM)syndrome scores,levels of insulin-like growth factor(IGF-1),bone morphogenetic proteins(BMP-2),vascular endothelial growth factor(VEGF),special se-quence of hydroxy terminal peptide β of type Ⅰ collagen(β-CTX),parathyroid hormone(PTH),bone alkaline phosphatase(BALP),osteocalcin(OC),joint function,clinical efficacy,and incidence of complications were observed and compared between the two groups.Results After treatment,the clinical efficacy in the observation group was significantly higher at 96.15％(50/52)compared to 80.77％(42/52)in the control group,with a statistically significant difference(P＜0.05).Both groups showed significant reductions in TCM syndrome scores for swelling,stabbing pain,tenderness,fixed pain,poor appetite,fatigue,and weak voice in the intertrochanteric femur region compared to before treatment,with a statistically sig-nificant difference(P＜0.05).Moreover,the observation group had significantly lower scores in this area compared to the control group,with a statistically significant difference(P＜0.05).Levels of IGF-1,BMP-2,VEGF,BALP,and OC were significantly increased,and levels of β-CTX and PTH were significantly decreased in both groups compared to before treatment,with a statistically significant difference(P＜0.05).The observation group showed significantly higher levels of IGF-1,BMP-2,VEGF,BALP,and OC and significantly lower levels of β-CTX and PTH than the control group,with a statistically significant difference(P＜0.05).Joint mobility,daily living abilities,limb deformity,and pain scores signifi-cantly improved in both groups compared to before treatment,with a statistically significant difference(P＜0.05).Addi-tionally,the observation group showed significantly higher improvements in joint mobility,daily living abilities,limb deform-ity,and pain scores than the control group,with a statistically significant difference(P＜0.05).The overall incidence of complications in the observation group was significantly lower at 1.92％(1/52)compared to 13.46％(7/52)in the control group,with a statistically significant difference(P＜0.05).Conclusion Modified Huangqi Guizhi Wuwu Decoction com-bined with internal fixation surgery can effectively improve the clinical symptoms,reduce the TCM syndrome scores,regu-late levels of IGF-1,BMP-2,VEGF,β-CTX,PTH,BALP,and OC,improve hip joint function,and accelerate fracture healing in patients with intertrochanteric fracture of the femur.This combination therapy is worth promoting in clinical prac-tice.
Modified Huangqi Guizhi Wuwu DecoctionInternal Fixation SurgeryIntertrochanteric Fracture of Fe-murJoint Function
维普
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