临床观察桃红四物汤加减协同髌骨爪治疗髌骨骨折病人有什么效果？
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">髌骨，<span style="color: black;">做为</span>膝关节的一个重要<span style="color: black;">构成</span>部分，<span style="color: black;">亦</span>是人体中最大的籽骨，<span style="color: black;">位置于</span>膝关节的前方，大致上呈三角形，其尖端向下，底边在上，<span style="color: black;">出现</span>于此部位的骨折便被<span style="color: black;">叫作</span>为髌骨骨折。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">髌骨骨折多为外伤<span style="color: black;">导致</span>，暴力直接<span style="color: black;">功效</span>于髌骨或因股四头肌猛烈收缩，<span style="color: black;">引起</span>髌骨完整性丧失，<span style="color: black;">出现</span>骨折，并且<span style="color: black;">引起</span>伸膝<span style="color: black;">安装</span>连续性的丧失以及潜在的髌股关节失配。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">髌骨骨折是关节内骨折，在治疗过程中<span style="color: black;">倘若</span>关节面的完整性<span style="color: black;">不可</span>够达到较好的恢复，</span></strong>将会<span style="color: black;">增多</span>远期<span style="color: black;">出现</span>创伤性关节炎的概率，从而<span style="color: black;">引起</span>膝关节功能残留<span style="color: black;">必定</span>的<span style="color: black;">阻碍</span>。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/99294af56b8f4f79a10a99b1aa1c5285~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=79FMwSgf%2FFmnPiVrORl9ibas1C0%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">髌骨骨折在成人中的<span style="color: black;">出现</span>率约为 1%。</span></strong><span style="color: black;">针对</span>髌骨骨折的治疗，其基本治疗原则为最大限度的<span style="color: black;">保存</span>髌骨完整性，恢复其关节面的形态、结构以及平整性，并且<span style="color: black;">经过</span><span style="color: black;">牢靠</span>的内固定，重建伸膝<span style="color: black;">公司</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">以求<span style="color: black;">初期</span>活动膝关节，恢复关节功能，防止后期创伤性关节炎的<span style="color: black;">显现</span>，<span style="color: black;">加强</span><span style="color: black;">病人</span>的治疗效果，这些便是治疗这类<span style="color: black;">损害</span>的最重要目的。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/9186b51c4aeb402393028bdf64b69764~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=OH5I2kydTb6MKG4pZtmcWxEScGc%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">关于髌骨骨折的手术治疗，<span style="color: black;">办法</span>有<span style="color: black;">非常多</span>种，<strong style="color: blue;"><span style="color: black;">如张力带固定、单纯螺钉内固定、接骨板内固定等等，其中髌骨爪治疗髌骨骨折<span style="color: black;">拥有</span><span style="color: black;">许多</span>优点。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">首要</span>，不论是安装还是拆除，操作起来都比较简单，并且易于<span style="color: black;">调节</span>，不至于伤及髌骨；<strong style="color: blue;"><span style="color: black;">再者，髌骨爪的组织生物相容性较好，不会对软组织<span style="color: black;">导致</span>刺激以至于形成感染<span style="color: black;">或</span>滑膜炎；</span></strong>并且它能够为骨折断端<span style="color: black;">供给</span><span style="color: black;">连续</span>的压力，对促进骨折愈合有非常好的效果；</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/841e50c40216488a82ed67963ec2c249~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=1PM%2B0FgBTQ%2FUnVzKO2QJcD39UP0%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">还有一点<span style="color: black;">便是</span>髌骨爪对<span style="color: black;">各样</span>类型的髌骨骨折都适用，<span style="color: black;">尤其</span>是骨折为粉碎性的时候。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">然则</span>在术中对髌骨爪进行塑形时，用力不宜过猛，避免<span style="color: black;">导致</span>内固定的断裂及手术的失败。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/5c2d5a6ed0ea4c70a3712bf9597461b8~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=RmaJjzv3UYBWrhpsiGvc%2BdwEi4U%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">髌骨骨折手术治疗后期的并发症<strong style="color: blue;"><span style="color: black;"><span style="color: black;">重点</span><span style="color: black;">包含</span>伤口边缘坏死、深部感染、膝关节僵硬、肌力下降、创伤性关节炎及可降解生物、置入物<span style="color: black;">导致</span>滑膜炎等。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">经过</span><span style="color: black;">咱们</span>自己在临床中的观察<span style="color: black;">发掘</span>，髌骨骨折术后常<span style="color: black;">导致</span>膝关节活动功能<span style="color: black;">阻碍</span>、患肢肌肉萎缩，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">导致</span><span style="color: black;">病人</span><span style="color: black;">不可</span>快速恢复正常生活及工作，从而加重了其经济及心理<span style="color: black;">包袱</span>。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/693ecf2e13eb4c548a8c204f9230c208~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=VBAAJpHRLwI5cc2k3XedNoW%2FTmA%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">究其缘由<span style="color: black;">重点</span>有以下几点：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1、<strong style="color: blue;"><span style="color: black;"><span style="color: black;">初期</span>未能<span style="color: black;">即时</span>进行功能<span style="color: black;">熬炼</span>或膝关节的<span style="color: black;">长时间</span>固定，<span style="color: black;">导致</span>静脉和淋巴回流缓慢，</span></strong>组织水肿，浆液纤维素性渗出<span style="color: black;">导致</span>股四头肌与周边粘连、肌纤维弹性度降低并<span style="color: black;">引起</span>挛缩影响膝关节的屈伸活动；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2、髌上囊粘连及髌骨支持带挛缩，<strong style="color: blue;"><span style="color: black;">可影响髌骨在股骨髁间滑动，<span style="color: black;">引起</span>膝关节功能<span style="color: black;">阻碍</span>；</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/990edee5ca6843cf97f935df20bc877e~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=eZt%2Fq80NTQ8pViYs6P2tsf7H5LQ%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3、凝血机制<span style="color: black;">不良</span>或受伤以后膝关节内血肿以及炎性渗出物机化，<strong style="color: blue;"><span style="color: black;">髌股关节间粗细不等的纤维条索得以形成而<span style="color: black;">导致</span>髌骨关节粘连，膝关节功能<span style="color: black;">阻碍</span>；</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4、髌骨骨折后未能解剖复位，髌骨软骨面台阶大于 3 mm，台阶的机械性磨损，<strong style="color: blue;"><span style="color: black;">可<span style="color: black;">引起</span>创伤性关节炎的<span style="color: black;">出现</span>，<span style="color: black;">从而</span><span style="color: black;">显现</span>膝关节功能<span style="color: black;">阻碍</span>。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/7a3e3c5f2a91438c9425508bf5fa18a9~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=ZnyhNtHZKZdX454At4i8Vsd4cao%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此呢</span>，<span style="color: black;">怎样</span>在髌骨骨折术后快速使膝关节功能得到恢复便<span style="color: black;">成为了</span>必须要<span style="color: black;">思虑</span>的问题，<strong style="color: blue;"><span style="color: black;">其中，<span style="color: black;">病人</span><span style="color: black;">由于</span>术后肢体肿痛而未能<span style="color: black;">初期</span><span style="color: black;">即时</span>进行功能<span style="color: black;">熬炼</span><span style="color: black;">常常</span><span style="color: black;">便是</span><span style="color: black;">导致</span>以上后果最重要的<span style="color: black;">原由</span>之一。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/60491aeeb6e34b1ba13942c7d5ae3f9c~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=goOaGLQHAKjuZN4UZm4fu7FcXY0%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《内经》有言“气伤痛，形伤肿”，《诸病源候论》：说<strong style="color: blue;"><span style="color: black;">“卒然致损，故气血隔绝，不得局荣。”</span></strong>瘀血<span style="color: black;">能够</span><span style="color: black;">引起</span>局部肿、痛，变作痈疽或<span style="color: black;">出现</span>痹痿厥等病。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">瘀血的形成，<span style="color: black;">引起</span>经络、筋脉的气机阻滞，使得气血运行不畅，进一步<span style="color: black;">出现</span>组织失养等病变。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/b091125373894bd4b8eb62e43b697c76~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=rYu%2FDlhak3klRIaOZjnp%2FPo8jAU%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《理伤续断方》指出：<strong style="color: blue;"><span style="color: black;">“腹有瘀血，灌注四肢，烦满不安，痈疽发背，筋肉坏烂，诸般风疾，左瘫右痪，手足顽麻，”</span></strong>或“瘀血留滞，外肿内痛，肢节痛倦”。<span style="color: black;">乃至</span>“瘀血不散，腹肚膨胀，<span style="color: black;">体积</span>便不通，上攻心腹，闷乱致死”。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">可见，瘀血是<span style="color: black;">引起</span>骨折术后肿痛的一个重要病理<span style="color: black;">原因</span>，</span></strong><span style="color: black;">针对</span>瘀血的本质，现代医学进行了<span style="color: black;">关联</span>的<span style="color: black;">科研</span>，<span style="color: black;">发掘</span>它是血液循环中的一个病理变化。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p26-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/bae35b8c6ee84fa5bb9e6074a45062bf~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=bni%2Fz3%2Bn%2F46oaHQDvHTLh%2FR9v%2BY%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">瘀血是<span style="color: black;">导致</span>微循环<span style="color: black;">阻碍</span>的<span style="color: black;">原因</span>之一，能够<span style="color: black;">引起</span>血流变迟缓，血液变为粘、凝、聚的状态，从而使血流动减弱、流速降低<span style="color: black;">乃至</span>缓慢。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">组织细胞在瘀血的<span style="color: black;">功效</span>下会<span style="color: black;">出现</span>水肿炎症，糜烂，坏死，以及增生硬化等一系列继发性的病变，<strong style="color: blue;"><span style="color: black;">并且人体免疫功能<span style="color: black;">错乱</span>以及<span style="color: black;">反常</span>的结缔组织代谢等病理改变<span style="color: black;">亦</span>与瘀血息息<span style="color: black;">关联</span>。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/7ea89fc8514944b1bc0b7713b710fc79~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=ZZSK91aBJctMJxON26UcqwjXhHw%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span>髌骨骨折术后的<span style="color: black;">病人</span>，结合骨折病之病机特点，<strong style="color: blue;"><span style="color: black;">辩证认为其肿痛<span style="color: black;">重点</span>为气血不足，瘀血阻滞<span style="color: black;">导致</span>，故应益气活血养血，祛瘀止痛消肿。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">桃红四物汤加减为我科经验用方之一，是在桃红四物汤的<span style="color: black;">基本</span>上改白芍为赤芍，再加白术、牛膝、黄芪这三味<span style="color: black;">药品</span>，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">一起</span>发挥益气活血养血，祛瘀止痛消肿之功效。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/1df0e00f6c6847ca8268b97db5bb4e68~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=AJQCNoIqr%2FE64Njv9p73bEuk9p8%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">结合现代药理学的<span style="color: black;">科研</span>来看，<strong style="color: blue;"><span style="color: black;">此方中赤芍、当归、熟地黄、牛膝等<span style="color: black;">药品</span>有非常好的抗炎以及<span style="color: black;">止疼</span>的<span style="color: black;">功效</span>，</span></strong>方子中的桃仁、红花、川芎、当归、黄芪、白术等<span style="color: black;">药品</span>有非常好的抗凝以及改善微循环的<span style="color: black;">功效</span>。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/e102db06f9914d7b996d70bf7ac3173f~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=OnEVuNg2JOyQfA2LseeMn3dYcm8%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">髌骨骨折<span style="color: black;">病人</span>的临床症状</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">髌骨骨折<span style="color: black;">病人</span>，<span style="color: black;">通常</span>可见患膝肿胀，髌骨前皮下青紫，</span></strong>肿胀严重的<span style="color: black;">病人</span>还会<span style="color: black;">显现</span>张力性水疱，并且伴有膝关节腔内的<span style="color: black;">海量</span>积血。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">病人</span>的膝关节屈伸活动度<span style="color: black;">常常</span>受到<span style="color: black;">显著</span>的限制，<strong style="color: blue;"><span style="color: black;">且活动时关节<span style="color: black;">病痛</span><span style="color: black;">显著</span>。<span style="color: black;">针对</span>骨折有移位以及断端不稳定的<span style="color: black;">病人</span>，还可触及骨擦感，</span></strong>更甚者，则可在体表看见<span style="color: black;">反常</span><span style="color: black;">凸出</span><span style="color: black;">或</span>肿胀。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/14a433ffa3a34be9bc777e721e463c9a~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=YOTCO2pNnisdLJbFvdsUuHIMTmU%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span><span style="color: black;">有些</span>陈旧性髌骨骨折的<span style="color: black;">病人</span>，<strong style="color: blue;"><span style="color: black;">其伸膝装置连续性遭到破坏，骨折断端分离又大，膝关节<span style="color: black;">长期</span><span style="color: black;">处在</span>屈曲状态，则会<span style="color: black;">导致</span>关节内外的粘连以及屈伸<span style="color: black;">有害</span>。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">况且</span>会<span style="color: black;">导致</span>股四头肌萎缩，<span style="color: black;">引起</span><span style="color: black;">病人</span>下肢力量减弱，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">从而</span><span style="color: black;">显著</span>影响<span style="color: black;">平常</span>生活，若不恰当处理，则会进一步<span style="color: black;">导致</span>功能<span style="color: black;">阻碍</span>。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/be01101e115a45598453f8de8422fff6~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=2l0TvYk%2B23%2BpxcIaEzQ01cSQt%2FM%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">髌骨骨折的诊断及<span style="color: black;">归类</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">除了结合<span style="color: black;">病人</span>病史以及症状体征来判断<span style="color: black;">病人</span>伤情，<strong style="color: blue;"><span style="color: black;">影像学的<span style="color: black;">评定</span><span style="color: black;">一样</span><span style="color: black;">非常</span>重要，在<span style="color: black;">病人</span>来院时，其正侧位的 X 片均需获取。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">由于</span>单纯在正位片上，<span style="color: black;">针对</span>髌骨和股骨髁重叠的部分，还是让医者难以区别，加上侧位片，<strong style="color: blue;"><span style="color: black;">则<span style="color: black;">能够</span>让临床工作者<span style="color: black;">针对</span>横行骨折的移位<span style="color: black;">状况</span>以及关节的完整性做出更佳的判断。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/3eb2bb20bbc64eb883c8d24473364fe1~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=McAajFgeKkh8FpHJdDDWgzBY63M%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">髌骨骨折虽然易于诊断，<span style="color: black;">然则</span><span style="color: black;">必定</span><span style="color: black;">不可</span>忘了与二分髌骨进行鉴别，</span></strong>二分髌骨大多<span style="color: black;">出现</span>在髌骨外上极，少有外缘及下缘者。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">副髌骨与主髌骨之间的间隙较整齐，边缘硬化而不锐利，<strong style="color: blue;"><span style="color: black;">临床上局部无压痛，临床不多见。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/ee3bbf8bbeab4c278bd36698b7d0c680~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=f1vFhShLJ6OHLXaWIoV15bh9YpM%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">关于髌骨骨折的<span style="color: black;">归类</span>，有<span style="color: black;">按照</span>骨折线的方向和骨折机制的分型</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">①横形及斜形骨折：膝关节<span style="color: black;">处在</span>屈曲位时，髌骨及股骨髁的接触面<span style="color: black;">作为</span>支点。股四头肌<span style="color: black;">忽然</span>强力收缩时可<span style="color: black;">导致</span>横形或斜形骨折。②上（下）极型骨折：<strong style="color: blue;"><span style="color: black;">多因股四头肌的牵拉而<span style="color: black;">引起</span>。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/9ca929d321564c8c813649f938110906~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=0%2FK37SjsiwZEB4o5BIEV1LzKxeM%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">③<strong style="color: blue;"><span style="color: black;">粉碎性骨折：髌骨受到直接打击形成。</span></strong>④纵形骨折：膝屈曲状态合并外翻动作时，髌骨受拉偏向外侧，股骨外髁上<span style="color: black;">形成</span>支点，<span style="color: black;">引起</span>髌骨外侧的纵形骨折。<strong style="color: blue;"><span style="color: black;">另有<span style="color: black;">按照</span>骨折<span style="color: black;">是不是</span>有移位的分型分为无移位型和移位型。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/fbac2d5736514cebb8cbaf3858392851~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=2U5cWfmmLJt0nSIMblRJ%2FNKs4UU%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">髌骨骨折的治疗目的和原则</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">髌骨骨折，常<span style="color: black;">引起</span>伸膝结构完整性的破坏，从而影响到肢体功能，<strong style="color: blue;"><span style="color: black;">髌骨骨折治疗的目的<span style="color: black;">便是</span>为了恢复肢体功能，不影响<span style="color: black;">病人</span>生活质量，</span></strong><span style="color: black;">因此</span>，为达到这一目的，<strong style="color: blue;"><span style="color: black;">其治疗原则<span style="color: black;">便是</span>尽可能的<span style="color: black;">保存</span>髌骨完整性，恢复其解剖形态结构，<span style="color: black;">保准</span>关节面的光滑平整。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p26-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/133ae0be9da9475b854451c325219a83~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=nEPaEdvNqhP%2FU7Z6YL2rkpS0Abo%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">并且要使其内侧及外侧支持带完好无损，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">尽可能</span>不影响伸膝<span style="color: black;">安装</span>的运作，<span style="color: black;">针对</span>手术<span style="color: black;">病人</span>行以坚强内固定，</span></strong>并行以<span style="color: black;">初期</span>的膝关节功能<span style="color: black;">熬炼</span>，以防对膝关节功能<span style="color: black;">导致</span>削弱，<strong style="color: blue;"><span style="color: black;">防止创伤性关节炎，关节僵硬、肌力下降等并发症。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/643316b4e5b34953b90d29b181dad60e~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=T5wCB6LwNVNWTemt6orACf4wXLY%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">髌骨骨折的治疗</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">针对</span>髌骨骨折的治疗<span style="color: black;">亦</span>分为保守（非手术）治疗和手术治疗，</span></strong><span style="color: black;">首要</span>，<span style="color: black;">针对</span>有禁忌证以及<span style="color: black;">自己</span>有严重的内科<span style="color: black;">疾患</span><span style="color: black;">不可</span>耐受手术的<span style="color: black;">病人</span>，应<span style="color: black;">思虑</span>保守治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另一</span>，有临床<span style="color: black;">科研</span><span style="color: black;">显示</span>，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">针对</span>尚未破坏伸膝<span style="color: black;">安装</span>的，其骨折断端移位少于 4mm，<span style="color: black;">或</span>关节面的台阶＜3mm 的髌骨骨折。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/e0c31136e3b54d959571e8dea14f2b98~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=a9%2FYIWqsY8qZjVYO%2B5X7P8NYGVs%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">在<span style="color: black;">保持</span><span style="color: black;">一月</span>的制动后，基本上有 99％的<span style="color: black;">病人</span>能够得到良好的治疗效果，</span></strong><span style="color: black;">然则</span><span style="color: black;">倘若</span>制动的时间继续加长，则会使<span style="color: black;">引起</span>关节僵硬以及股四头肌肌肉萎缩和关节粘连<span style="color: black;">出现</span>的可能性大大的<span style="color: black;">增多</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">即使是保守治疗，<span style="color: black;">亦</span>应在适当的时间如伤后 7～14 天后<span style="color: black;">起始</span>进行适度的伸膝动作训练，</span></strong>在六周后<span style="color: black;">起始</span>进行对抗阻力的<span style="color: black;">熬炼</span>，以<span style="color: black;">帮忙</span>膝关节肢体功能的恢复。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/cde1ea884ab2433c83a87ab4fc8c52da~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=pEma5MWS0yRaIODrIeJ%2BBsWBRIs%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span>髌骨骨折的手术治疗，其方式多种多样，<span style="color: black;">区别</span>的手术方式各有其<span style="color: black;">优良</span>劣势，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">针对</span>采取何种手术方式来对<span style="color: black;">病人</span>进行治疗，<span style="color: black;">一般</span>需要结合<span style="color: black;">病人</span>髌骨骨折的类型，以及临床临床工作者的操作习惯。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">平常</span>的手术方式有切开复位内固定术，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">包含</span>钢丝环扎加“8”字钢丝张力带内固定术、克氏针张力带钢丝固定、拉力螺钉加张力带固定、镍钛髌骨爪固定；</span></strong>在关节镜辅助下不在关节镜下闭合复位张力带固定术；髌骨上极或下极切除术，股四头肌腱重新附丽术；髌骨全切除术。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/54ee5d2f1edf42d49a674c15f9a30aef~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=9l7X%2BFzD6awY0BkCcuB0tywnYqo%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span>髌骨全切术，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">亦</span>是<span style="color: black;">仅有</span>在髌骨骨质<span style="color: black;">海量</span>损失的<span style="color: black;">状况</span>下才予以应用，</span></strong><span style="color: black;">做为</span>相应的<span style="color: black;">解救</span><span style="color: black;">办法</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另一</span>，<span style="color: black;">针对</span>陈旧性髌骨骨折的治疗，<span style="color: black;">咱们</span><span style="color: black;">亦</span>需要<span style="color: black;">按照</span>其骨折的<span style="color: black;">区别</span>类型来采取<span style="color: black;">区别</span>的治疗施，<span style="color: black;">针对</span>横断性髌骨骨折，<strong style="color: blue;"><span style="color: black;">它的分离间隙<span style="color: black;">通常</span>比较<span style="color: black;">显著</span>，<span style="color: black;">因为</span>股四头肌的挛缩以及<span style="color: black;">周边</span>软组织的粘连<span style="color: black;">引起</span>对其直接复位<span style="color: black;">不易</span>。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/294ff38239f942f5b397fd36cd121725~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=Sr7Ll87Ya8us92SJjg9RkHqfcu8%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">因此</span><span style="color: black;">咱们</span>采取从髌骨上极穿克氏针来行骨牵引，待骨折断端的分离间隙变小后，再行切开复位内固定治疗；</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span>粉碎性髌骨骨折，<strong style="color: blue;"><span style="color: black;">手术<span style="color: black;">通常</span><span style="color: black;">能够</span>直接完成断端拼接对位，<span style="color: black;">然则</span>行固定之前应该先清除断端之间的瘢痕增生，</span></strong>并且在复位时应尽最大可能将关节面按平整，避免影响后期肢体功能；</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/10258603ff114355abefab09476091de~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=Lbi2o%2B6Fu71Sm8rpDtZ691B0WHA%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">针对</span>下极型的髌骨骨折，<span style="color: black;">没法</span>直接完成断端对位的<span style="color: black;">亦</span>应先行骨牵引治疗，</span></strong><span style="color: black;">而后</span>将下极的骨折块切除，重新构建髌韧带。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span>陈旧性髌骨骨折，<strong style="color: blue;"><span style="color: black;">其术后<span style="color: black;">亦</span>需<span style="color: black;">初期</span>行功能<span style="color: black;">熬炼</span>，<span style="color: black;">由于</span>在术中对<span style="color: black;">周边</span>软组织进行了松解，</span></strong>若不<span style="color: black;">即时</span><span style="color: black;">熬炼</span>，就会形成新的粘连。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/5cc54465f77c4dccab34a55c7b637ea9~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=VtyYsb3MUKzQ6S%2BkuRmrBRS6qOw%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">中医骨伤科学以及其对髌骨骨折的认识</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">中医骨伤科是中医学中的一门专科，它的基本理论<span style="color: black;">亦</span>源自中医学理论体系之中。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">中医骨伤科的基本理论，便是<span style="color: black;">相关</span>于筋骨、关节、肌肉的形态以及生理病理等<span style="color: black;">关联</span>的理论。《灵枢·经脉》有言：“骨为干，脉为营，筋为刚，肉为墙。”<strong style="color: blue;"><span style="color: black;"><span style="color: black;">非常</span>生动形象的指出了筋肉骨脉等的生理特征及功能。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/52329e2a3a43488dbade84e798944426~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=A3f4KUZEgK84Per6GWehExb4Kc4%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《医宗金鉴》有言：<strong style="color: blue;"><span style="color: black;">“盖一身之骨体，既非一致，而十二经脉之<span style="color: black;">陈列</span>序属，又各<span style="color: black;">区别</span>，故必知其体相，识其部位”</span></strong>,这<span style="color: black;">便是</span>在中医整体观的<span style="color: black;">指点</span>之下，从肢体之外的变化探查到肢<span style="color: black;">身体</span>部的<span style="color: black;">损害</span>病变。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">详细</span>到骨伤科，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">便是</span>从<span style="color: black;">病人</span>肢体的外观如肿胀程度、外形、色泽、骨性<span style="color: black;">凸出</span>、皮下淤血以及关节功能的受损等来判断内部筋肉骨骼的<span style="color: black;">损害</span><span style="color: black;">状况</span>，</span></strong><span style="color: black;">一样</span><span style="color: black;">亦</span><span style="color: black;">能够</span><span style="color: black;">经过</span>这些来判断治疗的<span style="color: black;">状况</span>，<span style="color: black;">例如</span>骨折复位成功，他的体外形态<span style="color: black;">亦</span>必有相应之改变。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/4b15aef57fc14ba19ffaf8c7dfcefae8~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=6ROjVp7lr7HvDelLOx7eAMMssAQ%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">说到</span>骨伤，<span style="color: black;">首要</span>想到的便是解剖二字，</span></strong>“解剖”一词起源于《灵枢经》，从《灵枢经·骨度论》<span style="color: black;">起始</span>，中医学便有<span style="color: black;">各样</span>著作描述解剖学的内容，<strong style="color: blue;"><span style="color: black;">譬如《洗冤集录》便是骨骼形态解剖学的论著，中医骨伤科的临证医学与解剖学关系密切。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/e4c8fdc6cd7e4177a3b9b47cf820bea8~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=5zzUPZCo9rD5i8Rz1MIbRFgdor0%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但中医骨伤科的解剖学观点，并非仅是直视之下的肢体解剖学，而是机能解剖观，<strong style="color: blue;"><span style="color: black;">不论是中医手法正骨，还是对筋、骨缝<span style="color: black;">损害</span>等方面的治疗，都是站在机能解剖观之下进行的。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这一科学理论，<strong style="color: blue;"><span style="color: black;">便是<span style="color: black;">源自</span>于中医学的整体观、体相观以及天人相应的观念之中。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/88703c212b614e419b1ab46d562ced3c~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=VWjVThCWsU9ftIJLQuFJaWTVBd4%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">中医学对骨骼形态的叙述在《内经》中已有专篇，</span></strong><span style="color: black;">针对</span>人体的各个骨骼，《内经》中都有其对应的名<span style="color: black;">叫作</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">如头躯干骨中的颅骨《内径》<span style="color: black;">叫作</span>之为顶盖，颈椎<span style="color: black;">叫作</span>之为天柱，剑突<span style="color: black;">叫作</span>之为鸠尾，耻骨<span style="color: black;">叫作</span>之为横骨，在上肢骨中，如桡骨<span style="color: black;">叫作</span>之为臂外上骨，尺骨<span style="color: black;">叫作</span>之为臂外下骨，关节<span style="color: black;">亦</span>对应有相应名<span style="color: black;">叫作</span>，<strong style="color: blue;"><span style="color: black;">如肩关节<span style="color: black;">叫作</span>之为曲腋，而下肢骨中，<span style="color: black;">咱们</span><span style="color: black;">这次</span><span style="color: black;">科研</span>的髌骨，其名<span style="color: black;">叫作</span>则是膝髌或连骸。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/0aff06b37f1846009b112048aba111a5~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=nq6dhe%2F0Ah%2Bk2zmarqqVpZ%2FZajs%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">中医骨伤科是一门实践性很强的学科，它依据于<span style="color: black;">详细</span>的治疗手段<span style="color: black;">才可</span>达到预期的效果和目的。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">中医骨伤科的治疗学<span style="color: black;">一样</span>遵循中医学理论，讲求内外并治，<span style="color: black;">非常</span>看重整体观念，时<span style="color: black;">迄今</span>日<span style="color: black;">咱们</span><span style="color: black;">针对</span>骨伤科<span style="color: black;">疾患</span>的治疗，仍然遵循着这个原则。<strong style="color: blue;"><span style="color: black;">在传统正骨学中，内外固定法更加强调外固定，外固定以小夹板为主，它取材容易，制作简单，疗效<span style="color: black;">靠谱</span>。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/58cc31b3ad904fe5a1017d6bd538f43d~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=ZVEZdXoGolMgUcgabyqLWtzo7a8%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">桃红四物汤概述</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">桃红四物汤，出自《医宗金鉴》一书，又名加味四物汤，本为妇人调经之良方，它是在由白芍、川芎、当归、熟地黄<span style="color: black;">构成</span>的四物汤的<span style="color: black;">基本</span>之上再加桃仁、红花这两味药<span style="color: black;">形成</span>的新方。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">四物汤，出自《仙授理伤续断秘方》，<strong style="color: blue;"><span style="color: black;">本为补血调血之方，用于治疗因营血亏虚，冲任虚损血行不畅<span style="color: black;">导致</span>的营血虚滞症，</span></strong>再加桃仁、红花这一对活血散瘀之品，共起活血、养血之功效。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/b82fcef4211c48c38963afa55f715460~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=eyM%2FChCEoNfwg0lWbeePcwJYY2k%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">桃红四物汤养血又活血，且偏重于后者，</span></strong>与骨折三期辩证初期的治疗思路<span style="color: black;">非常</span>契合，<span style="color: black;">始终</span>为各朝各代骨伤科医家所<span style="color: black;">喜爱</span>，许多骨伤科用方便是从中化裁而来。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在现代医学的<span style="color: black;">科研</span>中<span style="color: black;">发掘</span>，<strong style="color: blue;"><span style="color: black;">桃红四物汤能够促进 eNOS、VEGF、HIF-1等在细胞分子水平上因子的分泌，以促进骨折端的血管再生的方式促进骨折断端的愈合。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/0682f016eba24863a05a33330efa76f5~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=Qu%2FXTP7meRgE89Cz1IYbbIL2BIg%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">桃红四物汤加减方解及单味<span style="color: black;">药品</span>的分析</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">以桃红四物汤改白芍为赤芍外加白术、牛膝、黄芪三味<span style="color: black;">药品</span>用于髌骨骨折术后的治疗，</span></strong>其中，桃仁红花，共为君药，珠联璧合，活血散瘀；熟地甘温归肝肾，当归辛温归心脾，赤芍苦酸归肝脾。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/1fd2d25609d448e8aa5dff9b1265280a~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=e9A9O2tMSCcGfdtG9ufUTzGqz6Q%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">三者相辅而行共为臣药，补血调血，相辅相成；血中之气药川芎，行气活血；黄芪白术，益气健脾；<strong style="color: blue;"><span style="color: black;">牛膝逐瘀血，强筋骨，引血下行，<span style="color: black;">非常</span>适用于下肢骨折。诸药相伍，共奏活血散瘀，养血益气之妙效。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">桃仁属蔷薇科植物桃或山桃干燥成熟种子，苦、甘、平，归心肝大肠三经，<span style="color: black;">重点</span>含甘油三酯、苦杏仁苷、野樱苷等。<strong style="color: blue;"><span style="color: black;">还含糖类、蛋白质、氨基酸、苦杏仁酶、尿囊素酶等。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/a8b489c7d0d0483f9edda3e3bf99580e~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=lgGzN8hsVSFyezoAxlxLSBZQQ5Y%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">桃仁含脂肪油可润肠促排便，完美解释了其在中医学上归大肠经治疗肠燥便秘，另肺与大肠相表里，虽归大肠经，</span></strong><span style="color: black;">也</span>可<span style="color: black;">经过</span>表里<span style="color: black;">功效</span>治疗咳嗽气喘，而现代现<span style="color: black;">科研</span><span style="color: black;">亦</span><span style="color: black;">显示</span>，桃仁中所含的苦杏仁苷对抗肺纤维化及治疗咳嗽喘促有着<span style="color: black;">必定</span>的<span style="color: black;">功效</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">而其活血散瘀的功效在现代<span style="color: black;">科研</span>中对应的则是<span style="color: black;">经过</span>改善血流动力学来完成来达到。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/2325a7f3cde642c4907a3e9f704bfbcc~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=n7BpsAfFU2iGGuyurgz6K%2Bl06kY%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">红花，别名红蓝花刺红花，是菊科植物红花的干燥花，</span></strong>其归心经，归肝经，活血散瘀，通经止痛的效果<span style="color: black;">明显</span>，含有红花苷等黄酮类<span style="color: black;">成份</span>，绿原酸等酚类<span style="color: black;">成份</span>，棕榈酸等脂肪酸类<span style="color: black;">成份</span>以及桂皮酸甲酯等挥发性<span style="color: black;">成份</span>，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">科研</span><span style="color: black;">发掘</span>红花含有的这些<span style="color: black;">成份</span>有扩张血管、降低血脂，镇静止痛以及抗炎降脂等功效。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/051fba5e40544712a8f46d657934d774~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=bNAd4GKbfjHp48bXI2g0HfgqsyA%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">将桃红四物汤加减<span style="color: black;">这里</span>次<span style="color: black;">科研</span>中的<span style="color: black;">功效</span>总结如下，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">首要</span>，<span style="color: black;">便是</span>其活血散瘀及<span style="color: black;">止疼</span>的<span style="color: black;">功效</span>机制，手术<span style="color: black;">做为</span>一种创伤性的治疗手段，<span style="color: black;">一样</span>会<span style="color: black;">导致</span><span style="color: black;">海量</span>炎症介质的释放。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另一</span>，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">因为</span>在术中<span style="color: black;">运用</span>了止血带，其缺血再灌注<span style="color: black;">损害</span><span style="color: black;">亦</span>会伴有炎症因子的释放，这些炎症因子，会在其特有的机制下使<span style="color: black;">病痛</span>感受器受到刺激，</span></strong>从而让<span style="color: black;">病人</span>感受到<span style="color: black;">病痛</span>，观察组<span style="color: black;">病人</span><span style="color: black;">病痛</span>度的降低，<span style="color: black;">亦</span>可从侧面说明桃红四物汤加减方中的<span style="color: black;">药品</span>有<span style="color: black;">必定</span>的抗炎<span style="color: black;">功效</span>。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/29d9fd716de641799a1616e2afe0246f~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=C6ZGtxcEVOv%2Fj%2FRnvBy35a6P0nA%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">同理，<strong style="color: blue;"><span style="color: black;">观察组<span style="color: black;">病人</span>肢体肿胀程度轻于对照组<span style="color: black;">亦</span>是该方活血化瘀，改善局部循环的<span style="color: black;">功效</span><span style="color: black;">表现</span>，</span></strong>当<span style="color: black;">病痛</span>度和肿胀程度降低，<span style="color: black;">病人</span>患肢膝关节的活动度<span style="color: black;">亦</span>就会相应增大，三者结合，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">病人</span>就<span style="color: black;">能够</span>更早更好的行膝关节功能<span style="color: black;">熬炼</span>，相应的其 HSS 评分<span style="color: black;">亦</span>就水涨船高。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/473589675cff46a98d4dcec35c6a605a~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=kk8X55LJIb6DfyXNiV%2F8mC76fuk%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span>桃红四物汤，<strong style="color: blue;"><span style="color: black;">在其活血散瘀功效上的<span style="color: black;">科研</span>和应用<span style="color: black;">已经是</span><span style="color: black;">非常</span>广泛，并且<span style="color: black;">得到</span>了<span style="color: black;">必定</span>的<span style="color: black;">发展</span>，</span></strong>近些年来学者们对其抗炎，促进骨折愈合以及<span style="color: black;">提高</span>免疫力等方面的药理学机制的<span style="color: black;">科研</span><span style="color: black;">更加是</span>在<span style="color: black;">持续</span>深入，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">经过</span><span style="color: black;">创立</span>动物模型实验，对桃红四物汤的治疗<span style="color: black;">功效</span>机制进行更加细致的探索和<span style="color: black;">发掘</span>。</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/edb997e61b4e471588e2029dc8248ad9~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=B6qe5FAUuuFG9FLNjcM9rLLqy7M%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">总之，我相信，祖国医学会给<span style="color: black;">咱们</span>带来<span style="color: black;">更加多</span>的惊喜，中医科学会给<span style="color: black;">咱们</span>带来更大的自豪！</span></strong></p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-qvj2lq49k0/b1f441a8262342af9bf239d55b929ad1~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1728622014&x-signature=dF2kv6n4mkgmtjX7kZ2MHm1Zm4M%3D" style="width: 50%; margin-bottom: 20px;"></div>
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