补肾断续汤结合髓内钉固定植骨术治疗胫骨中下段骨折不愈合

摘要

目的 探讨补肾断续汤结合髓内钉固定植骨术治疗胫骨中下段骨折不愈合临床疗效.方法 研究对象选取我院2012年7月-2015年7月收治胫骨中下段骨折不愈合患者共110例,以随机区组法分为对照组(55例)和治疗组(55例),分别采用髓内钉固定植骨术单用治疗和在此基础上加用补肾断续汤辅助治疗;比较两组患者临床疗效,X线片骨折线消失时间、骨折愈合时间,治疗前后Lysholm评分,HSS评分,BMP-2,IGF-1,IGF-2,及VEGF水平等.结果 治疗组患者临床疗效显著优于对照组(P＜0.05);治疗组患者X线片骨折线消失时间和骨折愈合时间均显著短于对照组(P＜0.05);治疗组患者治疗后Lysholm评分和HSS评分均显著高于对照组、治疗前(P＜0.05);同时治疗组患者治疗后BMP-2,IGF-1,IGF-2,及VEGF水平均显著高于对照组、治疗前(P＜0.05).结论 补肾断续汤结合髓内钉固定植骨术治疗胫骨中下段骨折不愈合可有效加快骨折愈合进程,提高膝关节功能,并有助于改善实验室相关指标水平.%Objective To investigate the clinical effects ofBushen Duanxu Decoction combined with intramedullary nail fixation and bone graft operation in the treatment of nonunion of middle and distal tibial fractures.1The 110 patients with nonunion of middle and distal tibial fractures were chosen in the period from July 2012 to July 2015 in our hospital and randomly divided into both group including control group (55 patients) with intramedullary nail fixation and bone graft operation used alone and treatment group (55 patients) with Bushen Duanxu Decoction on the basis of control group;and the clinical efficacy,the disappearance time of fracture line,the fracture healing time,the Lysholm score,the HSS score,the levels of BMP-2,IGF-1,IGF-2 and VEGF of both groups were compared.Results The clinical efficacy of treatment group was significantly better than control group(P＜0.05).The disappearance time of fracture line and the fracture healing time of treatment group was significantly shorter than control group (P＜0.05).The Lysholm score and the HSS score after treatment of treatment group was significantly better than control group and before treatment (P＜0.05).The levels of BMP-2,IGF-1,IGF-2 and VEGF after treatment of treatment group were significantly better than control group (P＜0.05).Conclusion Bushen Duanxu Decoction combined with intramedullary nail fixation and bone graft operation in the treatment of nonunion of middle and distal tibial fractures can efficiently accelerate the fracture healing process,higher the knee function and be helpful to improve the level of laboratory related indicators.