【摘要】 目的：探讨中药三期内治法辅治SandersⅡ～Ⅲ型跟骨骨折的效果。方法：按照1∶1试验设计原则和随机信封法将2020年1月—2021年6月长沙市中医医院收治的80例SandersⅡ～Ⅲ型跟骨骨折患者均分为对照组、分期组，各40例。对照组给予切开复位内固定治疗，分期组在对照组基础上给予中药三期内治法。比较两组功能优良率、疼痛和肿胀视觉模拟评分法（VAS）评分、术前等待手术时间、切口愈合时间、下床活动时间、患肢负重时间、骨折愈合时间、骨代谢[骨碱性磷酸酶（BALP）、骨钙素（BGP）、Ⅰ型前胶原N-端前肽（PINP）、抗酒石酸酸性磷酸酶（TRAP）、Ⅰ型胶原交联羧基末端肽（CTX）]、微循环[血管内皮细胞生长因子（VEGF）、角化细胞生长因子（KGF）、碱性成纤维细胞生长因子（bFGF）]、不良反应。结果：分期组优良率为95.00%，高于对照组的80.00%(P<0.05)；分期组术前3 d、术后1 d、术后3 d疼痛和肿胀VAS评分低于对照组（P<0.05）；分期组术前等待手术时间、切口愈合时间、下床活动时间、患肢负重时间、骨折愈合时间短于对照组（P<0.05）；分期组治疗后BALP、BGP、PINP高于对照组，TRAP、CTX低于对照组（P<0.05）；分期组治疗后VEGF、KGF、bFGF高于对照组（P<0.05）。结论：中药三期内治法辅治SandersⅡ～Ⅲ型跟骨骨折，能有效缓解疼痛和肿胀，改善骨代谢和微循环，促进康复进程，提高功能重建效果，安全可靠。更多还原

【Abstract】 Objective: To investigate the effect of the three-stage internal treatment method of traditional Chinese medicine to supplement the treatment of Sanders type II-III heel fractures. Methods: According to the principle of 1: 1 trial design and the randomized envelope method, 80 patients with Sanders type II-III heel fractures admitted to Changsha Hospital of Traditional Chinese Medicine from January 2020 to June 2021 were divided into a control group and a staging group, with 40 cases in each group. The control group was given incisional reduction and internal fixation treatment, on the basis of which the staging group was given Chinese medicine three stage internal treatment. The excellent functional rate, visual analog scoring method(VAS) score of pain and swelling, preoperative waiting time for surgery, incision healing time, time to get out of bed, weightbearing time of the affected limb, fracture healing time, bone metabolism [bone alkaline phosphatase(BALP), osteocalcin(BGP), type I precollagen N-terminal prepeptide(PINP), anti-tartrate acid phosphatase(TRAP), type I collagen cross-linked carboxy-terminal peptide(CTX) ], microcirculation [vascular endothelial growth factor(VEGF), keratinocyte growth factor(KGF), basic fibroblast growth factor(bFGF) ], adverse reactions. Results: The excellent and good rate of staging group was 95.00%, which was higher than 80.00% of control group(P<0.05). The VAS scores of pain and swelling at 3 d before operation, 1 d after operation and 3 d after operation in staging group were lower than those in control group(P<0.05). The preoperative waiting time, incision healing time, ambulation time, limb weight bearing time and fracture healing time in the staging group were shorter than those in the control group(P<0.05). After treatment, BALP, BGP and PINP in staging group were higher than those in control group, TRAP and CTX were lower than those in control group(P<0.05). After treatment,VEGF, KGF and bFGF in staging group were higher than those in control group(P<0.05). Conclusion: The three-stage internal treatment method of Chinese medicine supplemented with Sanders Ⅱ-Ⅲ heel fracture can effectively relieve pain and swelling, improve bone metabolism and microcirculation, promote the rehabilitation process, and enhance the functional reconstruction effect, which is safe and reliable.更多还原