摘要
目的研究探讨复元活血汤加减治疗对四肢骨折术后患者炎症因子、免疫功能及骨代谢指标的影响。方法将74例四肢骨折术后患者按随机数字表法分为2组,对照组37例术后予西医常规治疗,治疗组37例在对照组基础上联合复元活血汤加减治疗。2组均治疗7天后,比较2组治疗前后炎症因子指标[包括白细胞介素2(IL-2)、IL-10、降钙素原(PCT)及肿瘤坏死因子α(TNF-α)]、免疫功能指标(包括T淋巴细胞亚群CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+))及骨代谢指标[包括活性骨碱性磷酸酶(BALP)百分率、骨钙素(OC)及Ⅰ型胶原C-末端肽交联(S-CTX)]水平变化情况,比较2组治疗后肿胀消除时间及总住院天数情况,比较2组术后并发症发生情况。结果与本组治疗前比较,2组治疗后IL-2及IL-10水平均升高(P<0.05),PCT及TNF-α水平均降低(P<0.05),且治疗组治疗后IL-2及IL-10水平均高于对照组(P<0.05),PCT及TNF-α水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均升高(P<0.05),且治疗组治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均高于对照组(P<0.05)。与本组治疗前比较,2组治疗后活性BALP百分率、OC及S-CTX水平均升高(P<0.05),且治疗组治疗后BALP百分率、OC及S-CTX水平均高于对照组(P<0.05)。治疗组肿胀消除时间(6.27±0.61)天,总住院天数(11.49±1.41)天,对照组肿胀消除时间(9.11±0.39)天,总住院天数(17.00±0.47)天,治疗组治疗后肿胀消除时间及总住院天数均少于对照组(P<0.05)。治疗组并发症总发生率2.70%(1/37),对照组并发症总发生率21.62%(8/37),治疗组并发症总发生率低于对照组(P<0.05)。结论复元活血汤治疗四肢骨折术后疗效确切,可通过调节炎症因子水平,抑制炎性反应,提高机体免疫力,调节骨代谢,从而促进骨折愈合,促进伤口恢复,减少并发症的发生。
Objective To explore the effects of modified FuyuanHuoxue Decoction on postoperative inflammatory factors,immune function and bone metabolism index in patients with limb fracture.Methods Seventy-four patients undergoing limb fracture surgery were randomly assigned into the treatment group(n=37)and the control group(n=37).All patients were managed by conventional Western medicine,and those in the treatment group were additionally treated with modified FuyuanHuoxue Decoction.A 7-day treatment was performed to compare inflammatory factors(interleukin-2[IL-2],IL-10,procalcitonin[PCT],tumor necrosis factor-α[TNF-α]),immune function indexes(T lymphocyte subsets CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)),bone metabolism indexes(percentage of bone alkaline phosphatase[BALP]activity,bone-gla-protein[OC],carboxy-terminal telopeptide of type I collagen[sCTx]),detumescence time,length of hospital stay,postoperative complications.Results After treatment,IL-2 and IL-10 in groups were increased(P<0.05),while PCT and TNF-αwere decreased(P<0.05).The difference in IL-2 and IL-10,and PCT and TNF-αbetween groups was statistically significant(all P<0.05).CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in groups were increased(P<0.05),which were higher in the treatment group than in the control group(P<0.05).BALP,OC and sCTx in groups were increased(P<0.05),which in the treatment group were common compared with the control group(P<0.05).The detumescence time and length of hospital stay in the treatment group were shorter than those in the control group([6.27±0.61]days vs[9.11±0.39]days,[11.49±1.41]days vs[17.00±0.47]days,P<0.05).The total incidence of complications was 2.70%(1/37)in the treatment group,lower than that of 21.64%(8/37)in the control group(P<0.05).Conclusion For patients undergoing limb fracture surgery,modified FuyuanHuoxue Decoction has definite curative effect,which can promote fracture healing,wound recovery and reduce complications by regulating inflammatory factors,inhibiting inflammatory response,improving immunity and regulat
作者
靳胜利
马世云
马志永
JIN Shengli;MA Shiyun;MA Zhiyong(Department of Orthopedics,Cangzhou Central Hospital,Cangzhou,Hebei 061000;Department of Orthopedics,Xianxian People's Hospital,Xianxian,Hebei 062250)
出处
《河北中医》
2023年第7期1077-1080,共4页
Hebei Journal of Traditional Chinese Medicine
基金
2016年沧州市科学技术研究与发展指导计划项目(编号:162302123)。
关键词
骨折
四肢
术后加速康复
中药疗法
复元活血汤
Fracture
Limbs
Enhanced recovery after surgery
Traditional Chinese medicine therapy
FuyuanHuoxue Decoction
