摘要
目的观察益肾坚骨汤联合股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折(IFF)的临床实用性及对骨生化标志物Ⅰ型前胶原氨基端前肽(PINP)水平的影响并探讨其作用机制。方法患者120例随机分为两组,观察组应用PFNA联合益肾坚骨汤进行治疗,对照组仅行PFNA并给予安慰剂,疗程为3个月。观察两组治疗前、治疗第2周、4周、12周的疼痛视觉模拟量表(VAS)评分、Harris髋关节功能评分;记录以上时间点健侧髋部骨密度值(BMD)并检测血清骨生化标志物PINP的变化情况。结果两组治疗第2周、4周、12周的VAS评分、Harris评分、健侧髋部骨密度和血清PINP水平与治疗前比较均改善,且观察组改善情况均优于对照组同期(均P <0.05)。结论益肾坚骨汤联合PFNA能够显著缓解老年股骨粗隆间骨折患者疼痛症状,改善骨代谢生化指标,防止骨破坏并增加骨密度,促进骨愈合。
Objective:To observe the clinical practicability of Yishen Jianggu Decoction combined with PFNA internal fixation on senile femoral intertrochanteric fractures and its effects on bone biochemical marker PINP level.Methods:120 patients were randomly divided into the observation group(60 cases)and the control group(60 cases).The observation group was treated with PFNA combined with Yishen Jianggu Decoction.The control group only received PFNA and was given placebo for 3 months.Visual analog scale scores(VAS)and Harris hip function scores were evaluated before treatment,in 2 weeks,4 weeks,and 12 weeks.The hip bone mineral density(BMD)was recorded at the time points above and the changes of serum biochemical indicators PINP were detected.Results:The VAS scores,Harris scores and bone mineral density(BMD)were significantly improved in the two groups before treatment and in the 2nd,4th,and 12th week of treatment.The improvement in the observation group was better than that in the control group(P<0.05).Serum PINP levels decreased significantly in the 2nd,4th,and 12th week of treatment,and the indicators above in the observation group were lower than those in the control group(P<0.05).Conclusion:Yishen Jianggu Decoction combined with PFNA can significantly relieve the pain symptoms of patients,improve bone metabolism biochemical indicators,prevent bone destruction,increase bone density,and promote bone healing,worthy of clinical application.
作者
张莹
曹舜
Zhang Ying;Cao Shun(The Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu,Nanjing 210029,China)
出处
《中国中医急症》
2019年第2期259-261,272,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
江苏省中医药局科技项目(YB2015055)
关键词
股骨粗隆间骨折
益肾坚骨汤
股骨近端防旋髓内钉
骨密度
骨代谢
Intertrochanteric fracture of the femur
Yishen Jianggu Decoction
Proximal femoral nail anti-rotation
Bone density
Bone metabolism
