黄罡

【摘要】 目的：探究分析化瘀接骨湯结合手术切开复位内固定治疗胫骨中下段粉碎性骨折的临床效果。方法：选择2017年12月-2018年11月于笔者所在医院接受治疗的86例胫骨中下段粉碎性骨折患者为研究对象，按照就诊顺序号将其分为手术组与联合组，每组43例。手术组接受手术切开复位内固定治疗，联合组接受化瘀接骨汤结合手术切开复位内固定治疗。比较两组疼痛程度、疼痛消失时间、肿胀消失时间，并观察两组骨痂生长时间、骨折愈合时间及临床疗效。结果：联合组VAS评分低于手术组，疼痛消失时间、肿胀消失时间均短于手术组，差异均有统计学意义（P<0.05）;联合组治疗12、24周后骨痂生长评分均高于手术组，骨折愈合时间短于手术组，差异均有统计学意义（P<0.05）;联合组患者总优良率为93.02%，高于手术组的76.74%，差异有统计学意义（P<0.05）。结论：化瘀接骨汤结合手术切开复位内固定用于胫骨中下段粉碎性骨折治疗，能够减轻术后疼痛感，缩短疼痛、肿胀消失时间，促进骨痂生长与骨折愈合，效果明显，值得临床推广使用。

【关键词】 化瘀接骨汤; 切开复位; 内固定; 胫骨中下段粉碎性骨折

doi：10.14033/j.cnki.cfmr.2019.27.068 文献标识码 B 文章编号 1674-6805（2019）27-0-03

Analysis of the Effect of Huayu Jiegu Decoction Combined with Open Reduction and Internal Fixation in Treatment of Comminuted Fracture of Middle and Lower Tibia/HUANG Gang.//Chinese and Foreign Medical Research，2019，17（27）：-153

【Abstract】 Objective：To explore and analyze the clinical effect of Huayu Jiegu Decoction combined with open reduction and internal fixation in treatment of comminuted fracture of middle and lower tibia.Method：A total of 86 patients with comminuted fracture of the middle and lower tibia who were treated in our hospital from December 2017 to November 2018 were selected as the study subjects.They were divided into the operation group and the combination group according to the order of visits，with 43 cases in each group.The operation group received open reduction and internal fixation，and the combined group received Huayu Jiegu Decoction combined with open reduction and internal fixation.The degree of pain，time of pain disappearance and time of swelling disappearance were compared between the two groups，and the growth time of callus，healing time of fracture and clinical efficacy of the two groups were observed.Result：The VAS score of the combined group was lower than that of the operation group，and the pain and swelling disappearance time of the combined group were significantly shorter than that of the operation group，the differences were significant（P<0.05）.The callus growth score after 12 and 24 weeks in the combined group was higher than that in the operation group，and the healing time of fracture in the combined group was shorter than that in the operation group，the differences were significant（P<0.05）.The total excellent and good rate of the combined group was 93.02%，which was significantly higher than that of the operation group（76.74%），the difference was significant（P<0.05）.Conclusion：Huayu Jiegu Decoction combined with open reduction and internal fixation for the treatment of comminuted fracture of the middle and lower tibia can reduce the pain after operation，shorten the time of pain and swelling disappearance，promote callus growth and fracture healing，the effect is obvious，and it is worthy of clinical application.

【Key words】 Huayu Jiegu Decoction; Open reduction; Internal fixation; Comminuted fracture of middle and lower tibia

First-authors address：Quanzhou Hospital of Traditional Chinese Medicine，Quanzhou 362000，China

临床研究证明，胫骨在遭受巨大冲击力时，中下段部位可发生粉碎性骨折，且此类骨折往往来自胫骨上、下干骺端的滋养动脉受损，游离骨折段的血供明显减少，多伴有血管及软组织严重损伤，复位难度极大[1-2]。临床常采用切开复位内固定手术治疗此类骨折，效果较好，可促进骨折愈合，但该手术容易造成血运破坏及骨膜过度剥离，产生二次创伤，且手术对软组织损伤无明显治疗效果[3]。中医学认为，创伤后可导致瘀滞脉络，气血逆乱，离经之血溢脉外而瘀于肌腠，进而出现肿胀、疼痛等情况，因此，中医治疗骨折之法多以活血化瘀、接骨续筋为主。有研究指出，中医在缩短疼痛肿胀时间、骨折愈合时间方面效果显著，对症的药物治疗有助于加速骨折愈合，提高治疗效果[4]。……