Xiang Xing-Tong, Dou Ben, Han Shi-Feng, Kong Liang, Liu Xiao-Lan
The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha 410208, Hunan, China.
Zhongguo Gu Shang. 2020 Mar 25;33(3):241-6. doi: 10.12200/j.issn.1003-0034.2020.03.011.
To explore effects of Decoction (, BYHWD) on early callus X-ray evaluation and level of serum alkaline phosphatase in elderly patients with Colles fracture after manual reduction and splint external fixation.
From October 2016 to October 2018, 60 elderly patients with Colles fractures were treated with manual reduction and splint external fixation and were divided into experimental group and control group. There were 30 patients in control group, including 15 males and 15 females; aged from 56 to 75 years old with an average of (67.81±5.41) years old; bone mineral density was (0.82±0.24) g/cm 2; patients were performed lift shoulders, bend and extend elbow joint, stretch five fingers and make a fist at 3 days after operation, 3 times daily for 1 month, 30 min once a time. There were 30 patients in experimental group, including 13 males and 17 females; aged from 57 to 77 years old with an average of (66.02±5.16) years old; bone mineral density was (0.76±0.23) g/cm; patients performed rehabilitation exercise as control group and combined with BYHWD, 400 ml per dose, 2 times daily, 7 days as one course, totally 4 courses. RUSS scores at 14 and 28 days after reduction between two groups were compared, serum level of alkaline phosphatase (ALP) and serum calcium concentration were observed at immediately, 14 and 28 days after reduction.
The patients between two groups were successfully fixed without re fractures and complications occurred. The patients were followed up for 30 to 35 days with an average of (31.60±1.03) days. RUSS score in experimental group at 14 and 28 days after reduction were 4.58±0.31 and 7.07±0.36, respectively; while in control group were 3.98±0.30 and 6.15±0.35, respectively; RUSS score in experimental group was significantly higher than that of control group. Serum alkaline phosphatase concentrations in experimental group at immediately, 14 and 28 days after reduction were (90.62±12.19) mmol/L ,(105.40±11.63) mmol/L, and (160.86±35.77) mmol/L respectively; while in controlgroup were (91.27±13.52) mmol/L ,(94.60±11.10) mmol/L ,(144.17±26.27) mmol/L respectively; there was no statistically difference between two groups at immediately; and had statistically differences between two groups at 14 and 28 days after reduction. There was no significant difference in serum calcium concentration between two groups at immediately, 14 and 28 days after reduction.
BYHWD for elderly patients with Colles fracture could promote early formation of callus, effectively increase concentration of serum alkaline phosphatase and promote fracture healing.
探讨补阳还五汤（BYHWD）对老年Colles骨折手法复位夹板外固定后早期骨痂X线评估及血清碱性磷酸酶水平的影响。
选取2016年10月至2018年10月期间60例老年Colles骨折患者，均采用手法复位夹板外固定治疗，分为实验组和对照组。对照组30例，男15例，女15例；年龄56～75岁，平均（67.81±5.41）岁；骨密度为（0.82±0.24）g/cm²；术后3天开始进行耸肩、屈伸肘关节、伸展五指及握拳活动，每日3次，每次30分钟，共1个月。实验组30例，男13例，女17例；年龄57～77岁，平均（66.02±5.16）岁；骨密度为（0.76±0.23）g/cm；患者进行与对照组相同的康复锻炼，并加用补阳还五汤，每次400ml，每日2次，7天为1个疗程，共4个疗程。比较两组复位后14天和28天的RUSS评分，观察复位即刻、14天和28天血清碱性磷酸酶（ALP）水平及血清钙浓度。
两组患者均成功固定，未发生再骨折及并发症。患者随访30～35天，平均（31.60±1.03）天。实验组复位后14天和28天的RUSS评分分别为4.58±0.31和7.07±0.36；对照组分别为3.98±0.30和6.15±0.35；实验组RUSS评分显著高于对照组。实验组复位即刻、14天和28天血清碱性磷酸酶浓度分别为（90.62±12.19）mmol/L、（105.40±11.63）mmol/L和（160.86±35.77）mmol/L；对照组分别为（91.27±13.52）mmol/L、（94.60±11.10）mmol/L和（144.17±26.27）mmol/L；复位即刻两组无统计学差异；复位后14天和28天两组有统计学差异。两组复位即刻、14天和28天血清钙浓度无显著差异。
补阳还五汤用于老年Colles骨折患者可促进早期骨痂形成，有效提高血清碱性磷酸酶浓度，促进骨折愈合。
