[1]戴锋,沈学强,龚冠亦,等.可塑性夹板联合骨折合剂治疗锁骨中段骨折的临床疗效观察[J].中国中医骨伤科杂志,2025,33(10):24-28.[doi:10.20085/j.cnki.issn1005-0205.251005]
　DAI Feng,SHEN Xueqiang,GONG Guanyi,et al.Clinical Observation on the Efficacy of Moldable Splint Combined with Fracture-Healing Herbal Formula in the Treatment of Midshaft Clavicular Fractures[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(10):24-28.[doi:10.20085/j.cnki.issn1005-0205.251005]
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可塑性夹板联合骨折合剂治疗锁骨中段骨折的临床疗效观察()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年10期
页码:
24-28
栏目:
临床研究
出版日期:
2025-10-15

文章信息/Info

Title:
Clinical Observation on the Efficacy of Moldable Splint Combined with Fracture-Healing Herbal Formula in the Treatment of Midshaft Clavicular Fractures
文章编号:
1005-0205(2025)10-0024-05
作者:
戴锋1; 沈学强1; 龚冠亦1; 刘锦涛1; 俞鹏飞1; 陈华1△
1南京中医药大学附属苏州市中医医院(江苏 苏州,215000)
Author(s):
DAI Feng1; SHEN Xueqiang1; GONG Guanyi1; LIU Jintao1; YU Pengfei1; CHEN Hua1△
1Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suzhou 215000,Jiangsu China.
关键词:
骨折合剂;  锁骨中段骨折;  临床疗效观察
Keywords:
fracture-healing herbal formula;  midshaft clavicular fractures;  therapeutic effect observation
分类号:
R683.41
DOI:
10.20085/j.cnki.issn1005-0205.251005
文献标志码:
A
摘要:
目的:观察可塑性夹板联合骨折合剂治疗锁骨中段骨折的临床疗效。方法:选择2022年4月至2024年2月治疗的锁骨中段骨折患者共96例,随机分为观察组和对照组(各48例)。对照组采用可塑性夹板保守治疗,观察组在对照组的基础上口服骨折合剂,20 mL/次,3次/d,疗程为4周。观察两组患者治疗后1,3,9个月视觉模拟量表(VAS)评分,末次随访时Constant-Murley肩关节功能评分,治疗后3 d及1周血清白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α),治疗后4周血清Ⅰ型前胶原氨基端前肽(P1NP)及骨钙素(BGP),以及骨折愈合时间。结果:最终89例患者完成随访,其中观察组44例,对照组45例。临床疗效方面:观察组治疗后1个月及3个月VAS评分、末次随访时Constant-Murley肩关节功能评分、骨折愈合时间优于对照组,差异有统计学意义(P<0.05); 治疗后9个月VAS评分、骨折愈合情况两组比较差异无统计学意义(P>0.05)。实验室指标方面:观察组治疗后3 d及1周血清IL-6和TNF-α,治疗后4周血清P1NP和BGP优于对照组,差异有统计学意义(P<0.05)。结论:骨折合剂干预后可以改善锁骨中段骨折患者的早中期临床症状,促进骨折愈合,缩短骨折愈合时间,具有较好的临床疗效。
Abstract:
Objective:To observe the clinical efficacy of moldable splint combined with fracture-healing herbal formula in the treatment of midshaft clavicular fractures.Methods:A total of 96 patients with midshaft clavicular fractures treated from April 2022 to February 2024 were selected and randomly divided into observation group and control group,with 48 cases each.The control group received conservative treatment with a moldable splint,while the observation group was additionally administered fracture-healing herbal formula(20 mL per dose,three times daily)for a 4-week course.Outcome measures included visual analogue scale(VAS)scores at 1,3,and 9 months after treatment,Constant-Murley shoulder function score at final follow-up; serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels at 3 d and 1 week post-treatment; serum procollagen type 1 N-peptide(P1NP)and bone gla protein(BGP)levels at 4 weeks post-treatment; and fracture healing time.Results:Ultimately,89 patients completed follow-up(44 in the observation group,45 in the control group).In clinical efficacy:The observation group showed superior VAS scores at 1 and 3 months post-treatment,Constant-Murley shoulder function scores at final follow-up,and shorter fracture healing time compared to the control group(P<0.05).No significant difference was observed in VAS scores at 9 months or overall fracture healing rates(P>0.05).In laboratory indicators:The observation group demonstrated better serum IL-6 and TNF-α levels at 3 d and 1 week,and higher serum P1NP and BGP levels at 4 weeks post-treatment(P<0.05).Conclusion:The fracture-healing herbal formula intervention improved early-to-mid-term clinical symptoms,promoted fracture healing,and shortened healing time in patients with midshaft clavicular fractures,demonstrating favorable clinical efficacy.

参考文献/References:

[1] WALTON B,MEIJER K,MELANCON K,et al.A cost analysis of internal fixation versus nonoperative treatment in adult midshaft clavicle fractures using multiple randomized controlled trials[J].J Orthop Trauma,2015,29(4):173-180.
[2] 唐佩福.锁骨骨折治疗方法的选择与思考[J].中国骨伤,2015,28(2):97-100.
[3] 曹发奇,刘梦非,周武,等.2023美国骨科医师学会临床实践指南:锁骨骨折的治疗概要[J].临床外科杂志,2024,32(1):52-54.
[4] 姜锋,王晓,张明辉,等.组合外固定架治疗成人锁骨中1/3不稳定骨折[J].中国骨伤,2013,26(12):1033-1036.
[5] MCKEE M D,PEDERSEN E M,JONES C,et al.Deficits following nonoperative treatment of displaced midshaft clavicular fractures[J].J Bone Joint Surg:Am Vol,2006,88(1):35-40.
[6] LAZARIDES S,ZAFIROPOULOS G.Conservative treatment of fractures at the middle third of the clavicle:the relevance of shortening and clinical outcome[J].J Shoulder Elb Surg,2006,15(2):191-194.
[7] 王亦璁,姜保国.骨与关节损伤[M].5版.北京:人民卫生出版社,2017:717-728.
[8] 朱兴涛,孙轶韬,孙一夫,等.锁骨中段骨折分型及可塑性夹板治疗的临床观察[J].中国骨伤,2022,35(3):258-264.
[9] WEAVERS H,MARTIN P.The cell biology of inflammation:from common traits to remarkable immunological adaptations[J].J Cell Biol,2020,219(7):e202004003.
[10] SHWE S,WITCHEY L,LAHHAM S,et al.Retrospective analysis of eFAST ultrasounds performed on trauma activations at an academic level-1 trauma center[J].World J Emerg Med,2020,11(1):12-17.
[11] 顾伟伟,许恒,江国荣,等.高效液相色谱法同时测定骨折合剂中6种化学成分的含量[J].中南药学,2017,15(2):210-213.
[12] 孙智珺,叶阳梅.芍药苷联合SYK抑制剂干预NAFLD细胞脂肪沉积和炎症[J].中药材,2024,47(3):735-739.
[13] 乔磊,邸振宇,乔曼,等.紫丁香苷对前交叉韧带横断诱导的大鼠骨关节炎的影响[J].局解手术学杂志,2022,31(1):10-15.
[14] 柳燕,窦昌贵.蚤休合剂镇痛抗炎活血作用实验研究[J].时珍国医国药,2005,16(8):736-737.
[15] WAGNER J M,SCHMIDT S V,DADRAS M,et al.TNF-α modulation via Etanercept restores bone regeneration of atrophic non-unions[J].Bone,2020,141:115569.
[16] 田浩然,柴雷子,宋财,等.锁骨中段骨折两种内固定的比较[J].中国矫形外科杂志,2023,31(8):678-682.
[17] 张浩泉,张港,舒勋章,等.锁定钢板经皮微创内固定治疗锁骨骨折[J].临床骨科杂志,2022,25(6):829-832.
[18] 刘锦涛,戴宇祥,姜宏,等.吴门伤科锁骨夹板联合骨折合剂治疗锁骨中段骨折的临床评价[J].中国中医急症,2020,29(12):2100-2103.
[19] YAO F,CHEN W,GU W W,et al.Osteoblast biospecific extraction conjugated with HPLC analysis for screening bone regeneration active components from moutan cortex[J].Comb Chem High Throughput Screen,2024,27(6):834-844.
[20] 马奇翰,孟祥奇,俞鹏飞.骨折合剂干预治疗青壮年戈登Ⅳ型股骨颈骨折临床研究[J].吉林中医药,2012,32(6):598-599.
[21] KREGE J H,LANE N E,HARRIS J M,et al.PINP as a biological response marker during teriparatide treatment for osteoporosis[J].Osteoporosis Int,2014,25(9):2159-2171.
[22] CHI P J,HUNG S Y,HSIAO F T,et al.Serum osteocalcin concentration as an independent biomarker of osteoporosis in patients with chronic kidney disease[J].Clin Nephrol,2022,98(1):1-9.
[23] BANJABI A A,KANNAN K,KUMOSANI T A,et al.Association of blood heavy metal levels with osteocalcin abnormality and incidence of osteoporosis in Saudi subjects[J].Braz J Biol,2021,83:e248828.
(收稿日期:2025-05-01)

备注/Memo

备注/Memo:
基金项目:江苏省中医药科技发展计划项目(ZD202326)
苏州市姑苏卫生人才科研项目(GSWS2022084)
苏州市“科教兴卫”青年科技项目(KJXW2023047)
苏州市科技局课题(SKJY2021135)
苏州市卫健委课题(GSWS2022084)
第七批全国老中医药专家学术经验继承工作项目(国中医药人教函〔2022〕76号)
△通信作者 E-mail:chen20168@sina.com
更新日期/Last Update: 2025-10-10