和胃接骨饮对老年股骨转子间骨折内固定术后疗效影响的病例对照研究

摘要

Objective:To observe the efficacy of He wei Jie gu(和胃接骨)decoction on femoral intertrochanteric frac⁃tures after internal fixation in elderly. Methods:From January 2010 to January 2012,90 elderly patients with osteoporotic in⁃tertrochanteric fracture were randomly divided into two groups. The patients in experimental group were treated with open re⁃duction and internal fixation,He wei Jie gu decoction and Caltrate D in oral,including 18 males and 27 females with an aver⁃age age of(77.8±11.3)years old ranging from 65 to 89 years old;the time from injured to operation was 2 to 9 days with an av⁃erage of(6.6±2.1)days;according to Evans-Jensen classification,17 cases were in typeⅠ,8 in typeⅡ,15 in typeⅢ,3 in typeⅣ,2 in type V. Meanwhile,the patients in control group were treated with open reduction and internal fixation,Caltrate D in oral,including 16 males and 29 females with an average age of(81.2±9.6)years old ranging from 67 to 91 years old;the time from injury to operation was 2 to 10 days with an average of(6.8±2.6)days;according to Evans-Jensen classification,15 cases were in typeⅠ,10 in typeⅡ,14 in typeⅢ,4 in typeⅣ,2 in typeⅤ. The VAS score,hip BMD value before and after treatment,fracture healing and the Harris function score after operation were recorded and compared. Results:All patients were followed up from 3 to 9 months with an average of(5.6±2.8)months. Compared with the control group,the VAS score of the experimental group had an obviously reduction(F=98.138,P<0.01)after treatment;the hip BMD value at 3 months after treat⁃ment in the experimental group was higher than that of the control group(P<0.05);the fracture healing rate of the experimental group was higher than that of the control group(P<0.05);Harris score in 3 months of follow up in the experimental group was higher than that of the control group(t=2.542,P<0.05);all the differences between two groups were statistically significant(P<0.05). Conclusion:He wei Jie gu decoction can reduce postoperative pain and increase bone mineral density after internal fixa⁃tion of femoral intertrochanteric fracture in elderly,promote the fracture healing and functional recovery in the hip joint.%目的：观察和胃接骨饮对老年股骨转子间骨折内固定术后疗效的影响。方法：自2010年1月至2012年Ⅳ型3例，Ⅴ型2例；行内固定手术并予口服和胃接骨饮及钙尔奇D治疗，疗程3个月。对照组男16例，女29例；年龄67～91岁，平均（81.2±9.6）岁；伤后至手术时间2～10 d，平均（6.8±2.6）d；Evans-Jensen分型：Ⅰ型15例，Ⅱ型10例，Ⅲ型14例，Ⅳ型4例，Ⅴ型2例；行内固定手术并口服钙尔奇D治疗，疗程3个月。记录并比较两组患者治疗前后髋部VAS评分、骨密度（BMD）值及骨折愈合情况、髋关节Harris评分。结果：所有病例获得随访，时间3～9个月，平均（5.6±2.8）个月。与对照组比较，试验组患者术后VAS评分明显逐渐降低（F=98.138，P<0.01），且术后3个月髋部BMD值明显高于对照组（P<0.05）；试验组患者临床骨折愈合率高于对照组（P<0.05），术后3个月试验组患髋Harris评分高于对照组，两组比较差异有统计学意义（t=2.542，P<0.05）。结论：和胃接骨饮能提高老年人股骨转子间骨折内固定术后BMD值，同时减轻老年人股骨粗隆间骨折术后疼痛，促进老年人股骨转子间骨折愈合及促进术后髋关节功能恢复。