目的 探讨筋骨疗伤膏联合补肾接骨汤对老年下肢骨折患者术后肿胀及典型Wnt/β-链蛋白(Canonical Wnt/β-catenin pathway，Wnt/β-catenin)信号通路的影响。方法 收集2021年1月—2022年7月在医院骨外科进行诊治的下肢骨折患者92例，随机数字法分为试验组(46例)及对照组(46例)。所有受试者予以切开复位内固定术，对照组术后接受常规康复手段和热水泡脚，试验组在对照组的基础上予以筋骨疗伤膏联合补肾接骨汤。对比两组临床恢复情况、肿胀程度、疼痛评分、血液流变学指标、Wnt/β-catenin信号通路血清蛋白水平、骨痂生长情况及不良反应。数据结果应用统计学软件SPSS 19。0加以处理。结果 与对照组相比，试验组完全负重锻炼、骨折愈合时间缩短，骨折延迟愈合率较低(P＜0。05)。与治疗前相比，两组治疗后肿胀程度、疼痛评分均明显降低(P＜0。05)，与对照组相比，试验组患者肿胀程度、疼痛评分较低(P＜0。05)。与治疗前相比，两组治疗后β-catenin升高，β-Ⅰ型胶原羧基端肽(β isomer of C-terminal telopeptide of type Ⅰ collagen，β-CTX)及总 Ⅰ 型胶原氨基端延长肽(total type Ⅰ collagen amino terminal extender peptide，T-PINP)水平均明显降低(P＜0。05)，与对照组相比，试验组β-catenin水平较高，β-CTX及T-PINP水平较低(P＜0。05)。与治疗前相比，两组骨痂量评分、骨痂密度评分均明显升高(P＜0。05)，与对照组相比，试验组治疗后骨痂量评分、骨痂密度评分较高(P＜0。05)。与对照组相比，试验组并发症发生率较低(P＜0。05)。结论 通过筋骨疗伤膏联合补肾接骨汤可减轻老年下肢骨折患者的肿胀及疼痛程度，改善血液微循环，其治疗机制可能与调节Wnt/β-catenin信号通路具有密切相关性。
Effect of Jinju Jiangnan Ointment(筋骨疗伤膏)Combined with Bushen Jiegu Decoction(补肾接骨汤)on Postoperative Swelling and Wnt/β-catenin Signaling Pathway in Elderly Patients with Lower Extremity Fracture
Objective To investigate the effect of Jinju Jiangnan Ointment(筋骨疗伤膏)combined with Bushen Jiegu Decoc-tion(补肾接骨汤)on postoperative swelling and Wnt/β-catenin(Canonical Wnt/β-catenin pathway)signaling pathway in the elderly patients with lower extremity fracture.Methods From January 2021 to July 2022,92 patients with lower limb fractures who were treated in the Department of Orthopedics of the hospital were collected and randomly divided into experimental group(46 cases)and control group(46 cases).All subjects were treated with open reduction and internal fixation.The control group received conventional rehabilitation methods and hot foot soaking feet after operation,and the experimental group was treated with Jingu Jiangnan Ointment combined with Bushen Jiegu Decoction on the basis of the control group.The clinical recovery,swelling degree,pain score,hemorheology index,serum protein level of Wnt/β-catenin signaling pathway,callus growth and adverse reac-tions were compared between the two groups.Statistical software SPSS 19.0 was used to process the data.Results Compared with those of the control group,the fully weight-bearing exercise and fracture healing time was shorter and fracture healing rate was lower in the experimental group(P＜0.05).Compared with those before treatment,the swelling degree and pain score of the two groups were significantly decreased after treatment(P＜0.05).Compared with those of the control group,the swelling degree and pain score of the experimental group were lower(P＜0.05).Compared with those before treatment,the levels of β-catenin were increased,and the levels of β isomer of C-terminal telopeptide of type Ⅰ collagen(β-CTX)and total type Ⅰ collagen amino terminal extender peptide(T-PINP)were significantly decreased in the two groups after treatment(P＜0.05).Compared with those of the control group,the levels of β-catenin in the experimental group were higher,and the levels of β-CTX and T-PINP were lower(P＜0.05).Compared with those before treatment,the callus volume score and callus density score of the two groups were significantly increased(P＜0.05).Compared with those of the control group,the callus volume score and callus den-sity score of the experimental group were higher after treatment(P＜0.05).Compared with that of the control group,the inci-dence of complications in the experimental group was lower(P＜0.05).Conclusion Jinju Jiangnan Ointment combined with Bushen Jiedu Decoction can reduce the swelling and pain degree of the elderly patients with lower limb fracture,improve blood microcirculation,and its treatment mechanism may be regulated.Wnt/β-catenin signaling pathway is closely related.
Jiangu healing Ointment(筋骨疗伤膏膏)Bushen Jiedu Decoction(补肾接骨汤)lower limb fractures in the eld-erlypostoperative swellingWnt/β-catenin signaling pathway
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