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投稿时间：2024-10-10 网络发布日期：2025-09-19
投稿时间：2024-10-10 网络发布日期：2025-09-19
中文摘要: 目的 探讨桃红四物汤联合针灸对气虚血瘀证股骨粗隆间骨折患者术后髋关节功能改善的价值及疗效的影响因素分析。方法 选取西安市红会医院2022年1月至2023年6月收治的股骨粗隆间骨折（气虚血瘀证）患者138例，按随机数字表法分为针灸组、汤药组和联合组，各46例。患者均给予常规内固定治疗，针灸组在此基础上进行针灸治疗，汤药组在此基础上给予桃红四物汤，联合组此基础上给予针灸及桃红四物汤联合治疗，均随访3个月。采用Harris髋关节（HHS）评分及Parker-Palmer活动度（PPMS）评分评估患者髋关节功能，比较3组临床疗效及髋关节功能，多因素logistic回归分析股骨粗隆间骨折（气虚血瘀证）患者疗效的影响因素。结果 3组治疗后1个月HHS及PPMS评分高于治疗前（P＜0.05），治疗后3个月HHS及PPMS评分高于治疗后1个月（P＜0.05），且联合组治疗后1个月及治疗后3个月HHS及PPMS评分均高于汤药组及针灸组（P＜0.05）。联合组优良率高于汤药组及针灸组（P＜0.05）；经logistic回归分析发现，高龄、单纯针灸或桃红四物汤治疗、卧床时间长、术前美国麻醉医师协会（ASA）分级高、术前HHS评分低、术前PPMS评分低是股骨粗隆间骨折患者疗效不佳的危险因素（P＜0.05）。结论 针灸与桃红四物汤配合能够显著改善股骨粗隆间骨折（气虚血瘀证）患者髋关节功能，年龄、单纯针灸或桃红四物汤治疗、卧床时间、术前ASA分级、术前HHS评分、术前PPMS评分可影响患者的疗效。
Abstract:Objective To investigate the value of Taohong Siwu Decoction combined with acupuncture in improving postoperative hip joint function in patients with intertrochanteric fracture (Qi deficiency and blood stasis syndrome), and to analyze the factors influencing therapeutic efficacy. Methods A total of 138 patients with intertrochanteric fracture (Qi deficiency and blood stasis syndrome) treated in Xi’an Honghui Hospital from January 2022 to June 2023 were selected and divided into acupuncture group (46 cases), decoction group (46 cases) and combined group (46 cases), using random number toble method. All patients underwent conventional internal fixation treatment. The acupuncture group received additional acupuncture therapy, the decoction group was given Taohong Siwu Decoction, and the combination group received both acupuncture and Taohong Siwu Decoction. All patients were followed up for 3 months. Hip joint function was assessed using the Harris Hip Score (HHS) and Parker-Palmer Mobility Score (PPMS). Clinical efficacy and hip joint function were compared among the three groups. Multivariate logistic regression analysis was conducted to identify factors influencing therapeutic efficacy. Results At 1-month post-treatment, HHS and PPMS scores in all three groups were higher than those before treatment, and at 3 months post-treatment, the scores were increased compared to 1-month post-treatment (P＜0.05). The combination group showed significantly higher HHS and PPMS scores at both 1- and 3-months post-treatment compared to the decoction group and acupuncture group (P＜0.05). The excellent-good rate in the combined group was higher than the other two groups (P＜0.05). Logisticregression analysis revealed that advanced age, treatment with acupuncture or Taohong Siwu Decoction alone, prolonged bed rest, high preoperative American Society of Anesthesiologists (ASA) grade, low preoperative HHS and PPMS scores were risk factors for poor therapeutic efficacy (P＜0.05). Conclusion The combination of acupuncture and Taohong Siwu Decoction significantly improves hip joint function in patients with intertrochanteric fracture (Qi deficiency and blood stasis syndrome). A monotherapy (acupuncture or decoction alone), bed rest, preoperative ASA grade, and preoperative HHS and PPMS scores can affect patient’s therapeutic efficacy.
keywords: Intertrochanteric fracture Qi deficiency and blood stasis syndrome Taohong Siwu Decoction Acupuncture Hip joint function
文章编号： 中图分类号：R683.42 文献标志码：A
基金项目:西安市卫生健康委员会卫生科研项目（2024yb25）
附件
| 作者 | 单位 |
| 李良 | 西安交通大学附属红会医院康复医院疼痛科,陕西 西安 710064 |
| 王敏 | 西安交通大学附属红会医院康复医院疼痛科,陕西 西安 710064 |
| 董博 | 西安交通大学附属红会医院康复医院神经脊柱科,陕西 西安 710064 |
引用文本：
李良,王敏,董博.桃红四物汤联合针灸对气虚血瘀证股骨粗隆间骨折患者术后髋关节功能的影响[J].中国临床研究,2025,38(9):1411-1415.
李良,王敏,董博.桃红四物汤联合针灸对气虚血瘀证股骨粗隆间骨折患者术后髋关节功能的影响[J].中国临床研究,2025,38(9):1411-1415.