Clinical Observation And Systematic Evaluation Of Chinese Medicine Fumigation Combined With Functional Exercise In The Treatment Of Joint Stiffness After Distal Radius Fractur

Objective:1.The clinical efficacy of fumigation and washing granules combined with functional exercise in the treatment of wrist joint stiffness after distal radius fracture was analyzed retrospectively.2.Using meta-analysis method to study the clinical efficacy and medication rule of Chinese herbal fumigation combined with functional exercise in the treatment of wrist joint stiffness after distal radius fracture,so as to provide evidence-based medical evidence for Chinese herbal fumigation combined with functional exercise in the treatment of wrist joint stiffness.Materials and methods:1.From September 2020 to December 2022,a total of 58 patients with RJS who were treated by manual reduction and external fixation with small splints in DRF from the Department of Orthopaedics and the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were taken as the research object,and were divided into observation group and control group according to different treatment methods.Among them,there were 28 people in the observation group,9 male patients and 19 female patients,who were given the combined functional exercise of fumigating and washing granules in the hospital;There were 30 people in the control group,13 males and 17 females,who only exercised wrist function.The treatment cycle of the observation group and the control group was 4 weeks.Observe and compare the pain,function and flexion and extension of wrist joint between the two groups before and after treatment,and the pain,function and flexion and extension of wrist joint between the two groups after treatment.Finally,SPSS26.0 software was used for statistical analysis.2.Comprehensively search the main literature databases at home and abroad: China Knowledge Network(CNKI),WANFANG DATA,Weipu Chinese Sci-tech Journal Database(CQVIP)and China Biomedical Literature Database(CBM);Search major foreign databases:Pubmed,Cochrane Library and Embase.Searching the related literatures about the treatment of wrist joint stiffness after distal radius fracture by fumigation and washing with traditional Chinese medicine from the establishment of the database to January 2023,two researchers independently screened the literatures according to the pre-established literature inclusion criteria,evaluated the quality of the screened literatures by using the offset risk assessment tool ROB2.0 recommended by Cochrane Collaborative Network,extracted the data according to the pre-established data extraction table,analyzed the data by using Re Vman5.40 software,and drew relevant forest maps and funnel maps.If the heterogeneity is different,the relevant literature is analyzed in subgroups,and the sensitivity of the research results is analyzed.Results:1.The scores of wrist pain,function and range of flexion and extension in the observation group and the control group were higher than those before treatment,and the difference was statistically significant(P﹤0.05).After treatment,the wrist pain,function and range of flexion and extension in the observation group were significantly higher than those in the control group,with statistical significance(P﹤0.05).2.Meta-analysis: This study included 12 articles with 1141 patients.The results showed that the clinical total effective rate was OR = 1,95% CI = [4.22,9.39],Z = 9.01(P ﹤ 0.00001);The wrist function score showed that SMD = 3.12,95% CI = [2.46,3.78],Z = 9.25(P ﹤0.00001);The score of grip strength showed: SMD = 2.35,95% CI = [2.13,2.57],Z = 21.02(P ﹤ 0.00001);Wrist pain score showed that SMD = 3.03,95% CI = [2.13,3.94],Z = 6.56(P ﹤ 0.00001);The wrist flexion and extension activity score showed: SMD = 2.94,95% CI= [2.61,3.26],Z = 17.74(P ﹤ 0.00001);The results of wrist movement showed: SMD =2.15,95% CI = [0.89,3.40],Z = 3.35(P ﹤ 0.00001).Conclusion:1.Fumigating and washing granules combined with functional exercise and single functional exercise can effectively relieve wrist pain and improve function and flexion and extension activities,but the former is obviously better than the latter.2.Traditional Chinese medicine fumigation combined with functional exercise and single functional exercise can effectively treat wrist joint stiffness after distal radius fracture,but the former has obvious advantages over the latter in terms of overall clinical efficacy,wrist joint function recovery,wrist joint pain relief,expansion of flexion and extension range,and improvement of grip strength of affected limbs.