目的 探討云南白藥膠囊聯(lián)合碳酸鈣D3治療兒童橈骨遠(yuǎn)端青枝骨折的臨床療效。方法 選取2022年1月—2024年1月河南省中醫(yī)院骨傷診療中心收治的126例橈骨遠(yuǎn)端青枝骨折患兒，按照隨機(jī)數(shù)字法分為對(duì)照組和治療組，每組63例。手法復(fù)位小夾板固定后，對(duì)照組口服碳酸鈣D3咀嚼片（Ⅱ），1片/次，2次/d。在對(duì)照組的基礎(chǔ)上，治療組口服云南白藥膠囊，2歲≤患兒≤5歲按1/2粒/次，6歲＜患兒≤12歲按1粒/次，4次/d。兩組治療8周。觀察兩組療效，比較兩組視覺(jué)模擬疼痛量表（VAS）評(píng)分、影像學(xué)骨痂評(píng)分（RUST）、Ⅰ型前膠原氨基端延長(zhǎng)肽（P1NP）、血清骨鈣素（BGP）、Ⅰ型膠原羧基端肽β（β-CTX）、血清核因子-КB（NF-КB）、轉(zhuǎn)化生長(zhǎng)因子-β1（TGF-β1）、血清骨堿性磷酸酶（BALP）、白細(xì)胞介素-6（IL-6）、血管內(nèi)皮生長(zhǎng)因子（VEGF）水平。結(jié)果 治療8周后，治療組總有效率是96.83%，顯著高于對(duì)照組的84.13%（P＜0.05）。治療后，兩組VAS評(píng)分顯著降低，而骨痂密度評(píng)分、骨痂邊緣評(píng)分、骨痂量評(píng)分、斷端邊緣評(píng)分均顯著升高（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組VAS評(píng)分更低，且治療組骨痂密度評(píng)分、骨痂邊緣評(píng)分、骨痂量評(píng)分、斷端邊緣評(píng)分均高于對(duì)照組（P＜0.05）。治療后，兩組BALP、BGP、P1NP水平顯著升高，而β-CTX水平降低（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組BALP、BGP、P1NP水平更高，β-CTX水平更低（P＜0.05）。治療后，兩組患兒IL-6、NF-κB水平顯著降低，而TGF-β1、VEGF顯著升高（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組IL-6、NF-κB水平均較低，且TGF-β1、VEGF水平更高（P＜0.05）。結(jié)論 云南白藥膠囊聯(lián)合碳酸鈣D3在促進(jìn)兒童橈骨遠(yuǎn)端青枝骨折的愈合方面具有顯著優(yōu)勢(shì)，且能緩解患處疼痛，調(diào)節(jié)骨代謝及改善炎性反應(yīng)，有效促進(jìn)骨痂生成及鈣化，值得借鑒與應(yīng)用。

Objective To explore the clinical efficacy of Yunnan Baiyao Capsules combined with calcium carbonate D3 in treatment of distal radial green branch fractures in children. Methods A total of 126 children with distal radius green branch fracture admitted to Bone Injury Diagnosis and Treatment Center of Henan Hospital of Traditional Chinese Medicine from January 2022 to January 2024 were selected and divided into control group and treatment group according to random number method, with 63 cases in each group. After manual reduction and fixation with small splint, children in control group were given Calcium Carbonate and Vitamin D3 Chewable Tablets (Ⅱ), 1 tablet/time, twice daily. On the basis of control group, children in treatment group were given Yunnan Baiyao Capsules orally, 1/2 capsule/time for children ≤ 2 years old ≤ 5 years old, 1 capsule/time for children < 6 years old ≤ 12 years old, 4 times daily. Both groups were treated for 8 weeks. The curative effect of two groups was observed, and VAS score, RUST score, P1NP, BGP, β-CTX, NF-КB, TGF-β1, BALP, IL-6, and VEGF were compared between two group. Results After 8 weeks of treatment, the total effective rate of treatment group was 96.83%, which was significantly higher than that of the control group (84.13%, P < 0.05). After treatment, VAS score was significantly decreased in both groups, but callus density score, callus margin score, callus volume score and broken end margin score were significantly increased (P < 0.05). After treatment, VAS score of treatment group was lower than that of control group, but callus density score, callus edge score, callus volume score and broken end edge score of treatment group were higher than those of the control group (P < 0.05). After treatment, the levels of BALP, BGP, P1NP, and β-CTX in two groups were significantly increased, while the levels of β-CTX were decreased (P < 0.05). After treatment, compared with control group, BALP, BGP, and P1NP levels were higher in treatment group, but β-CTX levels were lower (P < 0.05). After treatment, the levels of IL-6 and NF-κB were decreased significantly, but TGF-β1 and VEGF were increased significantly (P < 0.05). After treatment, compared with control group, the levels of IL-6 and NF-КB were lower, and the levels of TGF-β1 and VEGF were higher in treatment group (P < 0.05). Conclusion Yunnan Baiyao Capsules combined with calcium carbonate D3 has significant advantages in promoting the healing of distal radius green branch fracture in children, and can relieve pain in the affected area, regulate bone metabolism and improve inflammatory response, effectively promote callus formation and calcification, which is worth reference and application.

R977

河南省中醫(yī)藥科學(xué)研究專項(xiàng)課題（2024ZYZD06）