目的 探讨云南白药胶囊联合碳酸钙D3治疗儿童桡骨远端青枝骨折的临床疗效。方法 选取2022年1月—2024年1月河南省中医院骨伤诊疗中心收治的126例桡骨远端青枝骨折患儿，按照随机数字法分为对照组和治疗组，每组63例。手法复位小夹板固定后，对照组口服碳酸钙D3咀嚼片（Ⅱ），1片/次，2次/d。在对照组的基础上，治疗组口服云南白药胶囊，2岁≤患儿≤5岁按1/2粒/次，6岁＜患儿≤12岁按1粒/次，4次/d。两组治疗8周。观察两组疗效，比较两组视觉模拟疼痛量表（VAS）评分、影像学骨痂评分（RUST）、Ⅰ型前胶原氨基端延长肽（P1NP）、血清骨钙素（BGP）、Ⅰ型胶原羧基端肽β（β-CTX）、血清核因子-КB（NF-КB）、转化生长因子-β1（TGF-β1）、血清骨碱性磷酸酶（BALP）、白细胞介素-6（IL-6）、血管内皮生长因子（VEGF）水平。结果 治疗8周后，治疗组总有效率是96.83%，显著高于对照组的84.13%（P＜0.05）。治疗后，两组VAS评分显著降低，而骨痂密度评分、骨痂边缘评分、骨痂量评分、断端边缘评分均显著升高（P＜0.05）；治疗后，与对照组对比，治疗组VAS评分更低，且治疗组骨痂密度评分、骨痂边缘评分、骨痂量评分、断端边缘评分均高于对照组（P＜0.05）。治疗后，两组BALP、BGP、P1NP水平显著升高，而β-CTX水平降低（P＜0.05）；治疗后，与对照组对比，治疗组BALP、BGP、P1NP水平更高，β-CTX水平更低（P＜0.05）。治疗后，两组患儿IL-6、NF-κB水平显著降低，而TGF-β1、VEGF显著升高（P＜0.05）；治疗后，与对照组对比，治疗组IL-6、NF-κB水平均较低，且TGF-β1、VEGF水平更高（P＜0.05）。结论 云南白药胶囊联合碳酸钙D3在促进儿童桡骨远端青枝骨折的愈合方面具有显著优势，且能缓解患处疼痛，调节骨代谢及改善炎性反应，有效促进骨痂生成及钙化，值得借鉴与应用。

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

河南省中医药科学研究专项课题（2024ZYZD06）