补肾活血汤联合康复训练对不同创伤下肢骨折患者术后骨密度的影响

摘要

目的 探讨补肾活血汤联合康复训练对不同创伤下肢骨折患者术后骨密度的影响.方法 将102例下肢创伤性骨折患者按住院时间分为试验组48例,对照组54例,并根据创伤类型将每组患者分为开放性骨折和闭合性骨折.两组均给予常规手术治疗,在此基础上试验组术后采用补肾活血汤联合康复训练,对照组仅予以康复训练,观察24周.分别于术前和术后不同时间点测定两组患者的骨密度、血浆D-二聚体和C反应蛋白水平,并采用简化版运动功能评分法评定运动功能,统计并发症发生情况.结果 试验组术后4周及8周骨密度显著高于对照组(P＜0 .05) ,术后不同时间点血浆D-二聚体和CRP水平及术后并发症发生率显著低于对照组(P＜0 .05或0 .01) ,简化版运动功能评分法评分显著高于对照组(P＜0 .01).开放性骨折患者与闭合性骨折患者骨密度及并发症发生率比较差异无统计学意义(P＞0 .05) ,手术前后闭合性骨折患者血浆D-二聚体和C反应蛋白水平均显著低于开放性骨折患者(P＜0 .05) ,术后4周和8周简化版运动功能评分法评分显著高于开放性骨折患者(P＜0 .01) .结论 补肾活血汤联合康复训练可以有效促进下肢开放性和闭合性骨折患者术后骨密度及运动功能的恢复,减少并发症的发生.%Objective To investigate the effect Bushen Huoxue decoction combined with rehabilitation training on postoperative bone mineral density in patients w ith different traumatic low er extremity frac- tures .Methods 102 patients with traumatic fractures of the lower extremities were divided into the exper- imental g roup (48 cases) and the control group (54 cases).Each g roup of patients w ere divided into open fractures and closed fractures according to bed type .Both g roups w ere given routine surgical treatment . On the basis of this ,the experimental g roup w as treated w ith Bushen Huoxue Decoction com bined w ith re- habilitation training .T he control group w as only given rehabilitation training for 2 months and follow ed up for 24 w eeks .Bone mineral density ,plasma D-dimer and CRP levels of the tw o g roups w ere measured at different time points before and af ter surgery ,and motor function w as assessed by FM A .T he complica- tions were followed up .Results The bone mineral density of the experimental group was significantly higher than that of the control group at 4 and 8 w eeks after operation ( P＜0 .05 ).Plasma D-dimer and CRP levels and postoperative co mplications at different time points af ter surgery w ere significantly low er than those of the control g roup ( P＜0 .05 or 0 .01) ,the FM A score w as significantly higher than the con- trol group ( P＜0 .01 ).T here w as no significant difference in the bone mineral density and co mplication rate betw een patients w ith open fracture and closed fracture ( P＞0 .05 ).T he plasma D-dimer and CRP levels in patients w ith closed fracture before and after surgery w ere significantly low er than those in open fractures ( P＜0 .05).T he FM A score w as signifi- cantly hig her than that of open fracture patients at 4 w eeks and 8 w eeks after surgery ( P＜ 0 .05 ). Conclusion Bushen Huoxue decoction com bined w ith rehabilitation training can effectively promote the recovery of postoperative bone density and motor function in patients w ith open and closed fractures of low er ex tremities ,and reduce the occurrence of complications .