Clinical Efficacy of Modified Bushen Huoxuetang Combined with LCP in Treatment of Nonunion of Limb Long Bone Shaft Fracture
10.13422/j.cnki.syfjx.20201231
- VernacularTitle:补肾活血汤加减配合LCP治疗四肢长骨骨干骨折不愈合的临床观察
- Author:
Rong FAN
1
;
Yu-jin LIU
1
;
Man-mo BAI
1
;
Chang LI
1
;
Jian HUANG
2
Author Information
1. Sanya Traditional Chinese Medicine （TCM） Hospital，Sanya 572220，China
2. Haikou TCM Hospital，Haikou 570216，China
- Publication Type:Research Article
- Keywords:
fracture nonunion;
kidney deficiency and blood stasis;
Bushen Huoxuetang;
microcirculation;
osteogenic differentiation factor;
bone metabolism
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2021;27(7):80-85
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the clinical efficacy of modified Bushen Huoxuetang combined with autologous bone grafting and locking compression plate （LCP） in treating nonunion of long bone fractures， and the effect on microcirculation， osteogenic differentiation factor and bone metabolism index. Method:A total of 70 patients were randomly divided into control group and observation group by random number table， with 35 cases in each group. Patients in both groups received LCP. Patients in control group got Dieda Shenggu granule， 10 g/time， 1 time/day. Patients in observation group got Bushen Huoxuetang， 1 dose/day. The course of treatment lasted for 3 months， and 3-month follow-up data were recorded. On a weekly basis， the main symptoms， such as pain， tenderness， longitudinal percussion pain and swelling were checked， and the time of disappearing of main symptoms and signs were compared. On a weekly basis， a X-ray examination was performed for callus formation and fracture line， and the fracture healing time was recorded. Before and after treatment， Fugl-Meyer （FMA） was scored， and levels of fibrinogen （FIB）， whole blood viscosity （BV） （high shear， low shear）， plasma viscosity （PV）， platelet aggregation rate （PAR）， D-Dimer （D-D）， bone morphogenetic protein-2 （BMP-2）， BMP-7， insulin-like growth factor-1 （IGF-1）， vascular endothelial growth factor （VEGF）， transforming growth factor-β1 （TGF-β1）， osteocalcin （BGP）， osteoprotegerin （OPG）， procollagen type Ⅰ N-terminal propeptideserum amino pro peptide （PINP）， serum type 1 collagen cross-linked C-terminal peptide （S-CTX） and serum tartrate resistant acid phosphatase （TRACP） of type I procollagen were detected， and the safety was evaluated. Result:Disappearance time of symptoms and signs and fracture healing time in observation group were all lower than those in control group （P<0.01）. At the third month after treatment， and during the three-month follow-up， scores of callus and FMA （upper and lower limbs） in observation group were all higher than those in control group （P<0.01）. Levels of D-D， FIB， PAR， BV and PV （high-cut and low-cut）， BMP-2， BMP-7， IGF-1， VEGF， TGF-β1， S-CTX and TRACP were all lower than those in control group （P<0.01）， whereas levels of BGP， OPG and PINP were higher than those in control group （P<0.01）. The curative effect of fracture healing was better than that of control group （Z=1.977， P<0.05）. And the limb function recovery was superior to that in control group （Z=1.970， P<0.05）. Conclusion:Based on autogenous bone and LCP， modified Bushen Huoxuetang can promote the fracture healing， shorten the course of disease， and promote the recovery of limb function， with a good clinical efficacy. It can improve microcirculation， promote the expression of osteogenic differentiation factor， regulate bone metabolism， and play a role in promoting fracture healing， with a safety in clinical use.
