李英周+叶锋+杨永博++陈园升++陈建良

[摘要]目的 探討补阳还五汤加味预防性治疗肘部损伤术后骨化性肌炎的效果。方法 选取我院2012年8月～2016年3月收治的69例肘部损伤患者作为观察对象，其中32例患者应用中药治疗（中药治疗组），另外37例患者不服用任何药物（对照组），所有患者术后4周，3、12个月门诊随访，均复查患者肘关节正侧位X线片及检查血碱性磷酸酶（ALP）。同时评定肘关节功能参照mayo肘关节功能评分标准（MEPS）。结果 中药治疗组平均随访时间（16.0±3.9）个月。X线示：骨化性肌炎1例（3.2%）；对照组平均随访（17.0±2.8）个月。X线示：骨化性肌炎5例（14.5%）；对照组的肘关节骨化性肌炎发生率明显高于药物治疗组（P<0.05）。术后4周，中药治疗组的ALP含量明显低于对照组，差异有统计学意义（P<0.05），术后3、12个月，两组的ALP含量差异无统计学意义（P>0.05）。治疗后3、12个月，中药治疗组的mayo肘关节功能评分明显高于对照组，差异有统计学意义（P<0.05）。结论 对肘部损伤术后患者常规应用中医药干预安全有效，对肘关节骨化性肌炎的预防起到了一定的作用。

[关键词]补阳还五汤；预防性治疗；肘部损伤；骨化性肌炎

[中图分类号] R685.2 [文献标识码] A [文章编号] 1674-4721（2017）09（a）-0136-03

Clinical effect of Modified Buyang Huanwu Decoction preventively treating myositis ossificans after elbow injury surgery

LI Ying-zhou YE Feng YANG Yong-bo CHEN Yuan-sheng CHEN Jian-liang

Department of Orthopedics，Shangyu Hospital of Traditional Chinese Medicine in Shaoxing City of Zhejiang Province，Shangyu 312300，China

[Abstract]Objective To investigate the effect of Modified Buyang Huanwu Decoction preventively treating myositis ossificans after elbow injury surgery.Methods 69 patients with elbow injuries treated in our hospital from August 2012 to March 2016 were selected as the observation object，among them，32 cases accepted the traditional Chinese medicine treatment （Chinese medicine treatment group） while the remaining 37 patients had no medication （control group）.All the patients were followed up at post-operative 4 weeks，3 months and 12 months and underwent elbow joint anteroposterior and lateral X-ray examination and serum alkaline phosphatase （ALP）.Meanwhile，the elbow function was assessed according to the Mayo Elbow Performance Score （MEPS）.Results The average follow-up time of Chinese medicine treatment group was （16.0±3.9） months，X-ray showed 1 case of myositis ossificans （3.2%），and the average follow-up time of the control group was （17.0±2.8） months and the X-ray showed 5 cases of myositis ossificans （14.5%），and the incidence of elbow joint myositis ossificans of control group was significantly higher than the Chinese medicine treatment group （P<0.05）.ALP content of Chinese medicine treatment group at post-operative 4 weeks was significantly lower than that of the control group，with statistically significant difference （P<0.05），and ALP content of Chinese medicine treatment group at post-operative 3 months and 12 months had no significant difference compared with that of control group，without no statistical difference （P>0.05）.After 3 months and 12 months treatment，elbow joint function score in Chinese medicine treatment group was obviously higher than that of control group，and there was a statistical difference （P<0.05）.Conclusion It is safe and effective for the patients with elbow injuries to be treated with traditional Chinese medicine，which plays a certain role in the prevention of elbow myositis ossificans.endprint

[Key words]Buyang Huanwu Decoction；Preventive treatment；Elbow injuries；Myositis ossificans

骨化性肌炎是一种以局部组织纤维化、软骨或骨性化生为主要特征的组织反应性病变。它的发生多与外伤性血肿有关，常由于剧烈运动或外伤可引起肌肉破裂，出血和血肿形成，最终引起受累肌肉相应关节僵直和残废。骨化性肌炎最常见于肘关节损伤中，据研究报道认为肘关节发生骨化性肌炎的概率高达20%[1]，严重影响肘关节的活动。目前多数学者认为治疗应以预防为主[2-3]，一旦局部形成骨化，就只有等成熟后才能进行手术切除，否则会引起复发[4]。为进一步探讨预防性治疗创伤性肘关节骨化性肌炎，本研究采用补阳还五汤加味进行预防性治疗肘部损伤术后骨化性肌炎，取得了良好的临床效果，现报道如下。……