| ObjectiveThe purpose of this study is to observe the changes of serum inflammatory mediators and clinical manifestations of iflammation in the early stage of olecranon fracture through the intervention of clearing heat,removing blood stasis and dredging collaterals,and to explore the effect of clearing heat.,removing blood stasis and dredging collaterals on the early inflammatory response after olecranon fracture,so as to explore a safe and effective method to reduce post-traumatic inflammatory response and prevent complications of elbow fracture(e.g heterotopic ossification).MethodsAccording to the inclusion and exclusion criteria,72 patients with closed olecranon fracture of ulna who wore hospitalized from April 2018 to March 2019 in Orthopedic Department of Foshan Hospital of Traditional Chinese Medicine were selected and randomized into experimontal group and control group.On the first day aft.er admission,the two groups were t.reated with splint external fixation,yellow water external application,oral Qushangpian and other basic treatments.Blood samples were taken to examine patient’s hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-alpha(TNF-alpha).Meanwhile,pain score and swelling of elbow joints were assessed.On the second day after admission,the oxperimental group was givon basic treatment and prescription cclearing heat,removing blood stasis and dredging collaterals.The control group maintained basic treatment.All patients were reexamined on the 4th and 7th day of admission to evaluate the above indicators,and the adverse reactioris during treatment were recorded.ResultsThere was no significant difference in baseline data of average age,sex composition,time from injury to admission and Mayo classification of olecranon fracture between the experimental group and the control group(P>0.05).The baseline data between the two groups were balanced and comparable.There was no significant difference in NRS pain score,the difference between affected limbs and healthy side circumference before treatment between the two groups(P<0.05).The NRS score dcecrased with time in both groups,and there were significant differerices at all time points(P<0.05).The difference of limb circumference increased first and then decreased,and there were significant differences at all time poirits(P<0.05).However,the difference between the two groups was significant on the 4th day of admission and the 7th day of admission.NRS pain score and limb circumference difference in the treatment group were significantly lower than those in the control group(P<0.01).There was no significant difference in TNF-a,IL-6 and hs-CRP values between t.he two groups before treat.ment(P>0.05).TNF-alpha increased first and then decreased,and the experimental group was lower than the control group at all time points between the two groups,the difference was significamt(P<0.05).Compared with the control group,IL-6 decreased gradually with time,and there were significant differences at each time point.The experimental group was lower than the control group on the 4th and 7th day of treatment(P<0.05).There were significant differences in hs-CRP between groups atdifferent time points(P<0.05).The experimental group was lower than the control group on the 4th and 7th day(P<0.05).There was a significant difference in blood stasis and heat score between the two groups after treatment(p<0.05).ConclusionEarly application of clearing away heat,removing blood stasis and dredging collaterals method after fracture can effectively reduce the level of inflammatory mediators such as IL-6 and TNF-alpha,reduce limb pain and swelling,with less adverse reactions.It shows that clearing away heat,removing blood stasis and dredging collaterals can safely and effectively alleviate the inflammatory reaction after olecranon fracture,alleviate the pain of patients and shorten the preoperative detumescence time. |
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