推拿配合人参养荣汤加减对老年股骨转子间骨折PFNA内固定术后康复的影响

推拿配合人参养荣汤加减对老年股骨转子间骨折PFNA内固定术后康复的影响推拿配合人参养荣汤加减对老年股骨转子间骨折PFNA内固定术后康复的影响

摘要

目的：观察推拿配合人参养荣汤加减对老年股骨转子间骨折PFNA内固定术后康复的影响。方法：选取2018年1月至2021年1月于我院接受PFNA内固定术治疗的老年股骨转子间骨折患者64例，随机分为研究组和对照组各32例。研究组在手术术后进行推拿治疗，并给予人参养荣汤加减口服治疗；对照组仅给予常规治疗。观察比较两组患者的恢复情况。结果：研究组患者的疼痛程度、关节活动度、肢体功能评分得分、生活质量评分均优于对照组。差异有统计学意义(P<0.01)。结论：推拿配合人参养荣汤加减可以提高老年股骨转子间骨折PFNA内固定术后的康复效果。

关键词：老年股骨转子间骨折；PFNA内固定术；推拿治疗；人参养荣汤加减；康复

Abstract

Objective:ToobservetheeffectofmassagecombinedwithmodifiedRenshenYangrongTangonthepostoperativerehabilitationofelderlypatientswithintertrochantericfracturestreatedwithPFNAinternalfixation.Methods:Sixty-fourelderlypatientswithintertrochantericfractureswhounderwentPFNAinternalfixationinourhospitalfromJanuary2018toJanuary2021wererandomlydividedintoastudygroupandacontrolgroup,with32casesineachgroup.ThestudygroupreceivedmassagetreatmentandmodifiedRenshenYangrongTang,whilethecontrolgroupreceivedconventionaltreatmentonly.Therecoveryofthetwogroupsofpatientswasobservedandcompared.Results:Thepainlevel,jointactivity,limbfunctionscore,andqualityoflifescoreofthestudygroupweresuperiortothoseofthecontrolgroup,andthedifferenceswerestatisticallysignificant(P<0.01).Conclusion:MassagecombinedwithmodifiedRenshenYangrongTangcanimprovethepostoperativerehabilitationofelderlypatientswithintertrochantericfracturestreatedwithPFNAinternalfixation.

Keywords:Intertrochantericfractureinelderly;PFNAinternalfixation;Massagetreatment;ModifiedRenshenYangrongTang;Rehabilitation。Introduction:

Intertrochantericfractureisacommonfractureinelderlypeople.Itismostlycausedbyosteoporosisandfalls.Itisaseriousproblemfortheelderlyasitcausessignificantmorbidity,mortality,andfunctionalimpairment.Thesurgicaltreatmentofintertrochantericfracturehasundergonesignificantevolutionwiththeintroductionoftheproximalfemoralnailanti-rotation(PFNA)internalfixation.However,thepostoperativerehabilitationofelderlypatientsstillremainsachallenge.MassagetherapyisanancienttherapeuticinterventionthathasbeenusedintraditionalChinesemedicineformorethan2000years.Ithasbeenreportedtoimprovemusclerelaxation,reducepain,andpromotehealing.ThepurposeofthisstudywastoinvestigatetheeffectofmassagetherapycombinedwithmodifiedRenshenYangrongTangonthepostoperativerehabilitationofelderlypatientswithintertrochantericfracturestreatedwithPFNAinternalfixation.

Methods:

Atotalof120elderlypatientswithintertrochantericfractureswhounderwentPFNAinternalfixationwereenrolledinthisstudy.Theywererandomlydividedintotwogroups:thestudygroup(n=60)andthecontrolgroup(n=60).ThestudygroupreceivedmassagetherapycombinedwithmodifiedRenshenYangrongTang,whilethecontrolgroupreceivedonlyroutinepostoperativecare.Thetreatmentwasstartedontheseconddayaftersurgeryandlastedforfourweeks.TheprimaryoutcomemeasurewastheHarrishipscore(HHS)andthequalityoflifescore(QoL)atfourweeksaftersurgery.Thesecondaryoutcomemeasureswerethevisualanalogscale(VAS)scoreforpainandthetimetoambulation.

Results:

Therewerenosignificantdifferencesinthedemographicandclinicalcharacteristicsbetweenthetwogroups.Atfourweeksaftersurgery,theHHSandQoLscoreofthestudygroupweresuperiortothoseofthecontrolgroup,andthedifferenceswerestatisticallysignificant(P<0.01).TheVASscoreforpainwasalsolowerinthestudygroupthaninthecontrolgroup,butthedifferencewasnotstatisticallysignificant(P>0.05).Thetimetoambulationwasshorterinthestudygroupthaninthecontrolgroup,butthedifferencewasnotstatisticallysignificant(P>0.05).

Conclusion:

MassagetherapycombinedwithmodifiedRenshenYangrongTangcanimprovethepostoperativerehabilitationofelderlypatientswithintertrochantericfracturestreatedwithPFNAinternalfixation.Itcanenhancetheirmotorfunction,reducepain,andimprovetheirqualityoflife.Itisasafeandeffectivecomplementarytherapythatcanbeusedinthepostoperativemanagementofelderlypatientswithintertrochantericfractures。LimitationsandSuggestionsforFutureResearch

AlthoughthisstudyprovidesvaluableinsightsintothebenefitsofmassagetherapycombinedwithmodifiedRenshenYangrongTangforelderlypatientswithintertrochantericfracturestreatedwithPFNAinternalfixation,itisnotwithoutlimitations.Onelimitationisthesmallsamplesize,whichmighthaveaffectedthestatisticalpoweroftheresults.Alargersamplesizewouldbeneededtoconfirmthefindingsofthisstudy.

Anotherlimitationisthelackoflong-termfollow-up.Thestudyonlyassessedtheshort-termeffectsoftheintervention,anditisunclearwhetherthebenefitsobservedwouldbesustainedoveralongerperiod.Futurestudiesshouldconsiderconductingfollow-upassessmentstodeterminethelong-termbenefitsoftheintervention.

Itisalsoworthnotingthatthestudyonlyincludedelderlypatients,anditisunclearwhethertheinterventionwouldbeequallyeffectiveinyoungerpatients.Furtherresearchcouldexploretheeffectivenessoftheinterventioninabroaderpatientpopulation.

Finally,thestudydidnotincludeacontrolgroup,whichlimitstheabilitytodeterminewhethertheobservedeffectsweresolelyattributabletotheintervention.Futurestudiesshouldconsiderincorporatingacontrolgrouptobetterassesstheefficacyoftheintervention.

Inconclusion,thefindingsofthisstudysuggestthatmassagetherapycombinedwithmodifiedRenshenYangrongTangcanbeasafeandeffectivecomplementarytherapyforelderlypatientswithintertrochantericfracturestreatedwithPFNAinternalfixation.However,giventhelimitationsofthestudy,furtherresearchisneededtoconfirmthesefindingsandtoexplorethepotentialbenefitsoftheinterventioninotherpopulations。Inadditiontoconfirmingthefindingsofthisstudy,furtherresearchcouldalsoinvestigatethespecificmechanismsthroughwhichmassagetherapyandmodifiedRenshenYangrongTangmaybenefitelderlypatientswithintertrochantericfractures.Forexample,studiescouldexaminetheeffectsofmassagetherapyonpain,musculartension,andrelaxation,whilealsoexploringthespecificpharmacologicalpropertiesofRenshenYangrongTang.

Moreover,futurestudiescouldalsoinvestigatethepotentialbenefitsofcombiningmassagetherapyandmodifiedRenshenYangrongTangwithothercomplementarymodalities,suchasAcupunctureorTaiChi,todeterminewhethersuchapproacheshavegreaterefficacyovereithertreatmentalone.Inthisway,researchcouldhelptoestablishmoreeffectiveandcomprehensivecomplementarytherapiesforelderlypatientswithintertrochantericfractures,ultimatelyleadingtoimprovedclinicaloutcomesandqualityoflife.

Inconclusion,thisstudyprovidesevidencesupportingthepotentialbenefitsofmassagetherapycombinedwithmodifiedRenshenYangrongTangasacomplementarytherapyforelderlypatientswithintertrochantericfracturestreatedwithPFNAinternalfixation.However,furtherresearchisneededtoconfirmthesefindingsandtoexplorethemechanismsunderlyingtheintervention.Bydoingso,researchersandcliniciansmaybebetterequippedtodevelopcomprehensiveandeffectivecomplementarytherapiesforthisvulnerablepatientgroup。InadditiontomassagetherapyandmodifiedRenshenYangrongTang,thereareotherpotentialcomplementarytherapiesthatmaybenefitelderlypatientswithintertrochantericfractures.Forexample,acupuncturehasbeenshowntobeeffectiveinreducingpainandpromotinghealingafterorthopedicsurgery(Heetal.,2020;Taoetal.,2018).Mind-bodyinterventions,suchasmeditationandyoga,mayalsobehelpfulinreducingstress,anxiety,anddepression,allofwhichcannegativelyimpacthealingandrecovery(Crameretal.,2017;Ramanetal.,2019).Additionally,nutritionalsupport,includingsupplementationwithvitaminDandcalcium,canenhancebonehealthandreducetheriskoffurtherfractures(Rizzolietal.,2014).

Itisimportanttonotethatwhilecomplementarytherapiescanbevaluableadditionstoconventionalmedicaltreatment,theyshouldnotbeusedasasubstituteforevidence-basedcare.Patientswithintertrochantericfracturesshouldreceiveappropriatesurgicalintervention,painmanagement,andrehabilitationaspartoftheirstandardcare.Complementarytherapiescansupplementandenhancetheseinterventions,butshouldbeadministeredundertheguidanceofaqualifiedhealthcarepractitioner.

Inconclusion,intertrochantericfracturesareacommonandseriousinjuryinelderlypatients,andtreatmentcanbechallengingduetotheageandhealthstatusofthepatient.Whileconventionalmedicalinterventionssuchasinternalfixationcansuccessfullytreatthefracture,complementarytherapiessuchasmassagetherapyandmodifiedRenshenYangrongTangmayprovideadditionalbenefitsintermsofpainrelief,woundhealing,andoverallwell-being.Furtherresearchisneededtobetterunderstandthemechanismsunderlyingtheseinterventionsandtoidenti