| Objective:The tibial plateau of the knee is one of the important weight-bearing parts of the body,and with the development and popularization of transportation,the incidence of tibial plateau fractures is increasing year by year.Comminuted fractures in young patients due to the high-energy injuries and depressed fractures in elderly patients due to low-energy injuries are common in clinical practice.Open reduction and internal fixation is the common surgical treatment.Due to the presence that tibial plateau fractures can be accompanied by soft tissue injuries in the knee(such as meniscus and cruciate ligament injuries),the slow healing of fracture,and difficulty in early postoperative activity,residual joint incoordination and instability may lead to complications such as traumatic knee arthritis and knee stiffness.In this study,we observed and analyzed the efficacy of Xiaochai Hu Decoction plus or minus in the treatment of Schatzker typeⅡ tibial plateau fracture and its effect on fracture healing in rats,aiming to explore the role of Xiaochai Hu Decoction plus or minus in the postoperative recovery of tibial plateau fracture.Methods:1.We collected and analyzed patients with tibial plateau Schatzker type Ⅱ fractures(all unilateral)who met the selection criteria between November 2020 and November 2022 in Shandong Province Chinese Hospita in the first part.The patients were randomly divided into two groups:the control group and the treatment group,30 cases were in the control group:incision and internal fixation was performed;the other 30 cases were in the treatment group,and the Xiaochai Hu Decoction plus or minus was given for one month starting from the second day after surgery based on the same surgical approach.Both groups were instructed to do the same functional exercises after surgery,and the fracture healing time was recorded at follow-up;the HSS(Hospitai for special surgery)scores at 1 month,3 months and 6 months after surgery;and the"VAS(visual analogue scale)pain score" at 3 days,1 week,2 weeks and 1 month after surgery.The data collected were statistically analyzed using SPSS 26.0.2.In the second part,24 SPF-grade male(Spraque-Dawley,SD)rats,4 months old,average weight(350±30g),were randomly divided into experimental and control groups,12 each.Both groups were operated to form femur fracture models,and rats in the experimental group were given Xiaochai Hu Decoction plus or minus for gavage after surgery,while the others were given 0.9%saline for gavage.Postoperative X-ray and HE staining at 3,6 and 9 weeks postoperatively were recorded for comparative study.Results:The first part of 60 patients have completed the follow-up,the difference between the two groups of patients clinical basic data is not statistically significant(P>0.05);clinical efficacy observation index analysis:1.postoperative pain relief of the affected area,3 days,1 week,2 weeks and 1 month after surgery treatment group is better than the control group(P<0.05).2.fracture Healing time was heavily compared,and the mean healing time of 12.60±1.632 weeks in the treatment group was better than that of 13.73±1.741 weeks in the control group(P<0.05).3.The HSS scores of the knee joint at 1 month,3 months and 6 months after surgery in both groups showed statistically significant differences between the data of the two groups(P<0.05),and the treatment group was better than the control group.In the second part,by comparing the imaging results and pathological findings of the three groups of rats,it was found that gavage with Xiaochai Hu Decoction plus or minus significantly improved the rate of bone scab formation and development at the femoral fracture in rats,and the femoral fracture healing progressed faster in the experimental group than in the control group of rats.Conclusion:The results of the clinical study data analysis showed that Xiaochai Hu Decoction plus or minus has advantages in the recovery of swelling and pain after tibial plateau fracture,the healing of fracture and the recovery of knee joint function.In the second part,with the experimental analysis of the rat femur fracture models,it can be found that Xiaochai Hu Decoction plus or minus has a healing effect on the healing of femur fractures in rats with heterotopic function.In conclusion,under the guidance of the theory of "Shaoyang Zhugu",the clinical application of Xiaochai Hu Decoction plus or minus can promote fracture healing,early functional exercise of patients,and reduce the occurrence of postoperative... |
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