Li Hanjing, Wang Biao, Chen Chuanyuan
Department of Traditional Chinese Medicine, Fuzhou Second Hospital Affiliated to Xiamen University Fuzhou, Fujian Province, China.
Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University Fuzhou, Fujian Province, China.
Am J Transl Res. 2021 Jul 15;13(7):8372-8378. eCollection 2021.
To determine the efficacy of acupuncture around the greater tuberosity of the femur (AGTF) combined with acupuncture at Xuehai acupoint for postoperative pain in elderly patients with intertrochanteric fracture.
A total of 97 elderly patients with intertrochanteric fracture treated by proximal femoral nail antirotation (PFNA) were enrolled and randomly assigned into an observation group (Obs group, n=48) and a control group (Con group, n=49). The Obs group was treated by aspirin and AGTF combined with acupuncture at Xuehai acupoint for analgesia, while the Con group was treated by aspirin alone for analgesia. Both groups were treated for 7 consecutive days. The two groups were compared in pain degree (visual analog scale (VAS) score) after operation and hip joint function (Harris score), daily living ability (modified Barthel index (MBI) score), bone metabolism-related indexes, and inflammatory factors before and after treatment.
At 1-7 d after operation, both groups had gradually lower VAS scores, and at 5 and 7 d after operation, the Obs group had a lower VAS score than the Con group (both P<0.05). Additionally, at 2 months after operation, both groups had higher Harris scores and MBI scores, and the scores of the Obs group were both higher than those of the Con group (both P<0.05). At 7 d after operation, both groups showed a decrease in serum beta collagen degradation products (β-CTx) and an increase in procollagen type I amino-terminal propeptide (PINP) (both P<0.05), but the differences between the two groups in β-CTx and PINP were insignificant (P>0.05). Moreover, at 7 d after operation, both groups showed a decrease in C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α), and the two levels in the Obs group were lower than those in the Con group (both P<0.05).
For elderly patients with intertrochanteric fracture, AGTF combined with acupuncture at the Xuehai acupoint can more effectively relieve their postoperative pain and postoperative inflammation and more strongly promote their postoperative recovery of hip joint function.
探讨股骨大转子周围针刺（AGTF）联合血海穴针刺对老年股骨转子间骨折患者术后疼痛的疗效。
选取97例行股骨近端抗旋髓内钉（PFNA）治疗的老年股骨转子间骨折患者，随机分为观察组（Obs组，n = 48）和对照组（Con组，n = 49）。Obs组采用阿司匹林联合AGTF及血海穴针刺镇痛，Con组单纯采用阿司匹林镇痛。两组均连续治疗7天。比较两组术后疼痛程度（视觉模拟评分（VAS））、髋关节功能（Harris评分）、日常生活能力（改良Barthel指数（MBI）评分）、治疗前后骨代谢相关指标及炎症因子。
术后1 - 7天，两组VAS评分均逐渐降低，术后5天和7天，Obs组VAS评分低于Con组（均P < 0.05）。此外，术后2个月，两组Harris评分和MBI评分均升高，Obs组评分均高于Con组（均P < 0.05）。术后7天，两组血清β-胶原降解产物（β-CTx）均降低，I型前胶原氨基端前肽（PINP）均升高（均P < 0.05），但两组β-CTx和PINP差异无统计学意义（P > 0.05）。而且，术后7天，两组C反应蛋白（CRP）和肿瘤坏死因子-α（TNF-α）均降低，Obs组这两个指标低于Con组（均P < 0.05）。
对于老年股骨转子间骨折患者，AGTF联合血海穴针刺能更有效地缓解术后疼痛和炎症，更有力地促进髋关节功能的术后恢复。
