| Objective : To treat the middle and distal tibial fracture of the adult by the combination of traditional Chinese medicine Xin Shang Dipsacus Decoction combined with MIPPO technique,to observe the improvement of clinical manifestations and characteristics,the healing rate of fractures and the healing time of fractures after treatment,and to objectively evaluate the clinical efficacy of Xin Shang Dipsacus Decoction addition and subtraction and the operability of clinical application,observe the pharmacological effects of Xin Shang Dipsacus Decoction,and provide new ideas and treatment methods for promoting the healing of the middle and distal tibial fracture.Methods:From November 2017 to November 2018,62 patients with fractures of the middle and distal tibia of the Department of Orthopaedics,Department of Orthopaedics,Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine,were selected and met the inclusion criteria and exclusion criteria.A total of 62 patients with middle and distal tibia fractures who met the inclusion criteria in the Department of Orthopaedic Surgery of Shanxi Hospital of Integrated Traditional Chinese and Western Medicine were randomly assigned to the control group.The 31 patients were included in the control group and the latter 31 were included in the treatment group.Both groups of patients were treated with MIPPO technique.Both groups were given routine treatment after operation(intraoperative routine infusion of anti-inflammatory therapy,dexamethasone,mannitol intravenous infusion,once/day,3 days of use,at the same time,appropriate rehydration,hemostasis and other symptomatic treatments were given,and the suture was removed two weeks after the operation.)and regular rehabilitation training.The treatment group was given orally on the first day after surgery with the traditional Chinese medicine Xin Shang Dipsacus Decoction.The method of administration: one dose per day(200ml),Water decoction,morning and evening,continuous medication for 8 weeks,regular review of blood routine,urine routine,ECG,liver and kidney function.The control group was not given prescription.The patient's general data(sex,age,fracture type,fracture site,etc.)and Olerud-Molander's calf fracture function score,VAS pain scores were recorded.The Olerud-Molander calf fracture function score,fracture healing time and healing rate,osteophyte formation time,VAS pain score,complication rate andpostoperative clinical efficacy were compared between the treatment group and the control group..X-ray were reviewed in our hospital at 4th week,8th week,12 th week,and 16 th week after operation.The data of follow-up items were recorded in detail,and the data were statistically analyzed by SPSS21.0 statistical software.Results:1.The preoperative general data of the treatment group and the control group included gender,age,cause of injury,type of fracture AO,fractured limb and site.After statistical analysis,the difference between the two groups was not statistically significant(P>0.05),Both the treatment group and the control group were followed up.2.The scores of Olerud-Molander's calf fracture function before and after surgery were compared between the two groups.Both the treatment group and the control group were able to improve the functional score after surgery.The two groups were preoperatively,4 weeks after the operation,and 16 weeks after the operation,The scores of the group were statistically analyzed.There was no significant difference between the two groups(P>0.05).The joint scores of the treatment group and the control group at the8 th and 12 th week after surgery were statistically analyzed.The difference between the two groups was statistical.Significance(P<0.05).The VAS scores of the two groups were compared before and after surgery.The VAS scores of the two groups were significantly improved.The VAS scores of the treatment group and the control group were statistically analyzed.The difference between the two groups was statistically significant(P<0.05).There was no statistically significant difference between the two groups at the 8th week,12 th week and 16 th week after operation(P>0.05).The fracture healing rate of the two groups was compared.The fracture healing rate of the treatment group and the control group was statistically analyzed at the 12 th week after operation.The difference was statistically significant(P<0.05);the 4th week after the operation At 8 weeks and 16 weeks,the scores of the two groups were statistically analyzed.There was no significant difference between the two groups(P>0.05).3.The fracture healing time of the two groups was compared.The healing time of the treatment group was statistically analyzed.At 12.19±2.48 weeks,the healing time of the control group was 14.39±3.06 weeks.The difference was statistically significant(P<0.05).The treatment group was superior to the control group in reducing the healing time of thefracture.Compared with the time of occurrence,the time of onset of osteophytes in the treatment group was 5.02±0.94 weeks,and the control group was 6.39±1.06 weeks.The difference was statistically significant(P<0.05),and the treatment of osteophyte formation was promoted.The group was superior to the control group;the incidence of postoperative complications was compared between the two groups.The statistical analysis showed that the incidence of the treatment group was 0%,and that of the control group was 6.4%.There was no significant difference between the two groups(P>0.05).The clinical efficacy of the two groups was statistically analyzed.The excellent rate was 96.7% in the treatment group and 93.5% in the control group.The difference was statistically significant(P<0.05).The clinical effect was better in the treatment group than the control group.group.4.The patients in the treatment group and the control group received grade A healing after operation.No adverse reactions occurred in the treatment group during and after the drug administration.Conclusion:1.The treatment of Xin Shang Dipsacus Decoction combined with MIPPO technique in the treatment of middle and distal tibial fractures can significantly promote the formation of osteophytes at the fracture end,reduce the healing time of fractures,accelerate the good healing of fractures,and effectively improve the clinical manifestations and characteristics of patients.2.Post-operative use of prescription Xin Shang Dipsacus Decoction can reduce the incidence of postoperative complications,The new prescription of Xin Shang Dipsacus Decoction has high safety.There is no obvious adverse reaction after taking the patient,which is worth promoting. |
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