马骨续筋胶囊对肱骨近端骨折髓内钉固定术后临床症状及骨代谢的影响

doi:10.11958/20251611

摘要/Abstract

摘要：

目的观察马骨续筋胶囊对肱骨近端骨折髓内钉固定术后临床症状及骨代谢的影响。方法选取行肱骨近端髓内钉固定术治疗的82例肱骨近端骨折患者，随机分为2组，每组41例。以术后给予常规消肿止痛对症治疗的为常规组，术后在常规组基础上给予马骨续筋胶囊（口服2粒/次，3次/d，连续8周）治疗的为试验组。比较2组肩关节周径差、肩关节疼痛评分、Neer肩关节功能评分、骨痂生长评分变化；酶联免疫吸附试验检测2组患者的血清骨钙素（BGP）、N端骨钙素（N-MID）、骨形态发生蛋白2（BMP-2），分光光度法检测血钙水平，统计2组并发症和不良反应发生情况。结果 2组术后第3、5、7、14天肩关节周径差均低于术后第1天，试验组术后第3、5、7、14天肩关节周径差均小于常规组（P<0.01）。2组术后第3、5、7、14天，第4、8周肩关节疼痛评分均较术后第1天降低，且试验组低于常规组（P<0.01）。2组术后4周、8周血清BGP、N-MID、BMP-2及血钙水平均较术前升高，且试验组高于常规组（P<0.05）。2组术后4周、8周Neer评分均较术前升高（P<0.05）。试验组术后4周、8周Neer评分、骨痂生长评分高于常规组（P<0.05）。常规组术后骨折延迟愈合2例，软组织感染1例；试验组未发生并发症。2组均无不良反应发生。结论马骨续筋胶囊可促进肱骨近端骨折髓内钉固定术后肿胀消退，减轻肩关节疼痛，改善骨代谢，促进肩关节功能恢复。

关键词: 骨折固定术，髓内, 肩关节, 疼痛, 肱骨近端骨折, 马骨续筋胶囊, 骨代谢

Abstract:

Objective To observe the effect of Magu Xujin capsule on clinical symptoms and bone metabolism after intramedullary nail fixation of proximal humerus fracture. Methods Eighty-two patients with proximal humeral fractures treated with intramedullary nailing were randomly divided into two groups, with 41 cases in each group. The conventional group was given routine anti-swelling and pain-relieving symptomatic treatment after surgery, while the experimental group was given Magu Xujin capsules (2 capsules each time, 3 times a day, for 8 consecutive weeks) on the basis of the conventional group. Changes in shoulder joint circumference difference, shoulder joint pain score, Neer shoulder joint function score and callus growth score were compared between the two groups. The serum levels of osteocalcin (BGP), N-terminal osteocalcin (N-MID), bone morphogenetic protein 2 (BMP-2) and blood calcium were detected by enzyme-linked immunosorbent assay. The occurrence of complications and adverse reactions was analyzed in the two groups. Results Changes of shoulder joint circumference difference at 3, 5, 7 and 14 days after surgery were lower than those at 1 day after surgery in both groups, and changes of the shoulder joint circumference difference were smaller in the experimental group at 3, 5, 7 and 14 days after surgery than those in the conventional group (P<0.01). The shoulder joint pain scores in both groups at 3, 5, 7 and 14 days after surgery and at 4 and 8 weeks were lower than those at 1 day after surgery, and the score was lower in the experimental group than that in the conventional group (P<0.01). The serum levels of BGP, N-MID, BMP-2 and blood calcium in both groups at 4 and 8 weeks after surgery were higher than those before surgery (P<0.05), and the levels in the experimental group were higher than those in the conventional group (P<0.05). The Neer scores in both groups at 4 and 8 weeks after surgery were higher than those before surgery (P<0.05). The Neer score and callus growth score at 4 and 8 weeks after surgery were higher in the experimental group than those in the conventional group (P<0.05). In the conventional group, there were two cases of delayed fracture healing and one case of soft tissue infection after surgery. No adverse reactions occurred in either group. Conclusion Magu Xujin capsules can promote the reduction of swelling after intramedullary nail fixation surgery for proximal humeral fractures, alleviate shoulder joint pain, improve bone metabolism and promote the recovery of shoulder joint function.

Key words: fracture fixation, intramedullary, shoulder joint, pain, proximal humeral fracture, Magu Xujin capsule, bone metabolism

中图分类号:

R683.413

图/表 6

参考文献 23

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组别	n	第1天	第3天	第5天	第7天	第14天	F
常规组	41	35.21±3.36	25.56±2.26^A	18.89±3.12^A	11.77±2.08^A	5.85±1.41^A	91.039^＊＊
试验组	41	34.97±4.02	21.33±2.07^A	13.23±2.12^A	9.45±1.44^A	5.23±1.33^A	99.634^＊＊
t		0.281	8.858^＊＊	9.591^＊＊	5.856^＊＊	2.080^＊

组别	n	第1天	第3天	第5天	第7天	第14天	F
常规组	41	35.21±3.36	25.56±2.26^A	18.89±3.12^A	11.77±2.08^A	5.85±1.41^A	91.039^＊＊
试验组	41	34.97±4.02	21.33±2.07^A	13.23±2.12^A	9.45±1.44^A	5.23±1.33^A	99.634^＊＊
t		0.281	8.858^＊＊	9.591^＊＊	5.856^＊＊	2.080^＊

组别	n	第1天	第3天	第5天	第7天	第14天	第4周	第8周	F
常规组	41	6.25±0.73	5.74±0.64^A	4.86±0.43^A	4.11±0.36^A	3.05±0.29^A	2.23±0.25^A	1.56±0.24^A	167.391^＊＊
试验组	41	6.17±0.74	5.08±0.59^A	4.17±0.39^A	3.36±0.34^A	2.34±0.25^A	1.64±0.22^A	1.02±0.21^A	180.020^＊＊
t		0.436	4.817^＊＊	7.684^＊＊	9.838^＊＊	12.198^＊＊	11.700^＊＊	10.822^＊＊

组别	n	第1天	第3天	第5天	第7天	第14天	第4周	第8周	F
常规组	41	6.25±0.73	5.74±0.64^A	4.86±0.43^A	4.11±0.36^A	3.05±0.29^A	2.23±0.25^A	1.56±0.24^A	167.391^＊＊
试验组	41	6.17±0.74	5.08±0.59^A	4.17±0.39^A	3.36±0.34^A	2.34±0.25^A	1.64±0.22^A	1.02±0.21^A	180.020^＊＊
t		0.436	4.817^＊＊	7.684^＊＊	9.838^＊＊	12.198^＊＊	11.700^＊＊	10.822^＊＊

组别	n	第1天	第3天	第5天	第7天	第14天	第4周	第8周	F
常规组	41	7.36±0.85	6.14±0.77^A	5.21±0.64^A	4.87±0.46^A	3.74±0.43^A	2.91±0.37^A	2.13±0.25^A	77.294^＊＊
试验组	41	7.41±0.79	5.60±0.69^A	4.77±0.53^A	4.11±0.42^A	3.12±0.38^A	2.24±0.31^A	1.48±0.23^A	90.011^＊＊
t		0.274	3.382^＊＊	3.475^＊＊	7.828^＊＊	6.972^＊＊	8.895^＊＊	12.019^＊＊