| Objective To investigate the clinical effects and possible action mechanism of Cuyuhuoxue decoction assisting emergency lateral approach in the treatment of patients with Sanders type Ⅱ, Ⅲ calcaneal fracture.Methods Totally 134 patients with Sanders type Ⅱ, Ⅲ calcaneal fracture, treated in The First People's Hospital of Zhumadian City during the period from January 2016 to December 2018, were chosen to be randomized into control group (n=67) and experiment group (n=67) by lot. Both groups underwent surgery of emergency lateral approach, and the control group received conventional western medicine treatment after operation while theexperiement received additional Cuyuhuoxue decoction. A comparison was made of the excellent and good rate of postoperative footfunction score, the onset time of postoperative positive result for lateral skinfold test, the postoperative incision drying and healing time,the levels of hypoxia-inducible factor α (HIF-α), vascular endothelial cell growth factor (VEGF), transforming growth factor -β (TGF-β), and bone morphogenetic protein-2 (BMP-2) before and after treatment and the postoperative complication incidence between the 2 groups.Results The excellent and good rate of postoperative foot function score of the experiment group was significantly higher thanthat of the control group (92.54% vs. 77.61%, P<0.05). The onset time of postoperative positive result for lateral skin fold test and thepostoperative incision drying and healing time of the experiment group [(3.20±0.62) d,(3.81±1.04) d, (12.97±3.54) d] were significantlyshorter than those of the control group [(4.68±0.97) d,(5.45±1.39) d, (15.23±4.58) d] (P<0.05). The level of HIF-α of the experimentgroup after treatment [(54.34±7.52) ng/L] was significantly lower than that of the control group [(62.06±8.89) ng/L] and the level beforetreatment [(85.22±11.22) ng/L] (P<0.05). The levels of VEGF, TGF-β and BMP-2 of the experiment group after treatment [(73.55±8.10)mol/L,(217.23±38.41) mol/L,(40.37±6.39) mol/L] were significantly higher than those of the control group [(65.43±6.68) mol/L,(169.89±29.69) mol/L, (33.86±5.48) mol/L] and the levels before treatment [(60.41±5.68) mol/L, (123.87±19.90) mol/L, (25.37±3.82) mol/L] (P< 0.05). Meanwhile, the postoperative complication incidence of the experiment group was significantly lower than that of the controlgroup 4.48% vs. 19.40%, P<0.05].Conclusions Cuyuhuoxue decoction assisting emergency lateral approach in the treatment of patients with Sanders type Ⅱ, Ⅲ calcaneal fracture can efficiently improve the foot function after operation, speed up the recovery and behelpful to reduce the postoperative risk of complications. The strength of clinical effects may be related to the better regulation of HIFα, VEG, TGF-α and BMP-2 levels by such treatment scheme. |
