中医药配合手法复位夹板外固定治疗桡骨远端骨折临床研究进展

Advances in Clinical Research on the Treatment of Distal Radial Fractures Using Traditional Chinese Medicine Combined with Manipulative Techniques, Splints, and External Fixation

摘要: 本文系统综述中医药配合手法复位夹板外固定治疗桡骨远端骨折的临床研究进展。桡骨远端骨折作为骨科常见损伤，约占全身骨折的14%，尤其好发于骨质疏松的老年人群。传统中医采用手法复位结合夹板外固定，并分期应用活血化瘀、接骨续筋、补益肝肾类中药，形成特色治疗方案。早期(1~2周)以握拳、伸指、拇指环绕等训练为主，配合桃红四物汤等活血化瘀中药加速肿胀消退；中期(2~6周)通过尺偏、桡偏训练恢复腕关节稳定性，辅以当归续骨汤等接骨续筋方剂促进骨痂形成；晚期(6周后)结合掌屈、背伸强化关节活动度，同步应用补肾壮骨汤等药物巩固疗效。研究表明，中医药可通过调节局部微循环、促进骨痂形成及抑制炎症反应等途径加速康复，结合规范化功能锻炼可显著改善患者远期腕关节功能。

Abstract: This article systematically reviews the clinical research progress on the treatment of distal radius fractures with Traditional Chinese Medicine (TCM) combined with manual reduction and splint external fixation. Distal radius fractures are common orthopedic injuries, accounting for approximately 14% of all fractures, and are particularly prevalent among the elderly population with osteoporosis. Traditional Chinese Medicine employs a characteristic treatment protocol involving manual reduction combined with splint external fixation, supplemented by staged administration of Chinese herbal formulas categorized as promoting blood circulation and removing stasis, connecting bones and sinews, and tonifying the liver and kidney. Early Phase (1~2 weeks): Focuses on exercises such as fist clenching, finger extension, and thumb circumduction, combined with blood-activating and stasis-resolving formulas like Taohong Siwu Decoction (Peach Kernel and Carthamus Four Substances Decoction) to accelerate swelling reduction. Mid Phase (2~6 weeks): Involves ulnar deviation and radial deviation exercises to restore wrist joint stability, supplemented by bone-connecting and sinew-mending formulas like Danggui Xugu Decoction (Angelica Bone-Connecting Decoction) to promote callus formation. Late Phase (>6 weeks): Incorporates palmar flexion and dorsiflexion exercises to enhance joint range of motion, synchronized with kidney-tonifying and bone-strengthening formulas like Bushen Zhuanggu Decoction (Kidney-Tonifying Bone-Strengthening Decoction) to consolidate therapeutic effects. Studies demonstrate that TCM can accelerate rehabilitation by regulating local microcirculation, promoting callus formation, and inhibiting inflammatory responses. When combined with standardized functional exercise, it can significantly improve long-term wrist joint function in patients.