摘要
目的:观察和营止痛汤辨证内服治疗股骨颈骨折空心螺钉内固定术后患者的临床疗效及对骨代谢和骨生成因子的影响。方法:将155例患者随机分为对照组78例和观察组77例。两组均采用空心螺钉内固定术。术后对照组给予三七伤药片,3片/次,2次/d,口服,连续治疗1周;1周后给予接骨七厘片,2片/次,2次/d,连续口服9周。观察组术后给予和营止痛汤辨证内服,连续服用10周。髋关节功能评分采用Harris,于术后1,3,6,12个月进行评价;记录骨折延迟愈合、骨折不愈合、股骨头坏死和退钉等并发症发生率,记录骨折愈合时间和骨折愈合情况;检测治疗前后碱性磷酸酶(ALP),骨钙素(BGP),骨形态发生蛋白(BMP-2),胰岛素样生长因子-1(IGF-1),血管内皮细胞生长因子(VEGF)和转化生长因子-β1(TGF-β1)水平。结果:经秩和检验,观察组患者临床疗效优于对照组(Z=2.347,P<0.05);观察组术后1,3,6,12个月时Harris评分均高于对照组(P<0.01);经秩和检验,观察组末次随访时髋关节功能情况优于对照组(Z=2.086,P<0.05);观察组并发症的发生率为29.87%,低于对照组的46.15%(χ2=4.358,P<0.05);观察组骨折愈合时间平均为(14.45±3.52)周,短于对照组的(19.23±4.97)周(P<0.01);治疗后观察组患者ALP,BGP,BMP-2,IGF-1,VEGF,TGF-β1水平均高于对照组(P<0.01)。结论:和营止痛汤加减辨证论治用于股骨颈骨折空心螺钉内固定术后患者,能促进成骨因子表达,改善骨代谢,促进骨折愈合、髋关节功能恢复,并减少并发症的发生,对术后康复起到了积极的作用。
Objective:To observe the efficacy of oral administration of Heying Zhitongtang in treating femoral neck fracture patients after internal fixation with hollow screw and on bone metabolism and osteogenic factors.Method:One hundred fifty-five cases were randomly divided into control group (77cases)and treatment group (78cases).All cases were given internal fixation with hollow screw.Control group was orally given Sanqishangyao tablets (3tablets/time,bid)after operation for 1week,and then took Jiegu Qili tablet (2tablets/ time,bid)for 9weeks.Observation group was orally administered with Heying Zhitongtang for 10weeks.Harris was used to evaluate Hip function score at 1,3,6,12months after surgery.The incidence of complications,including delayed fracture healing,nonunion of fracture,femoral head necrosis and nail removal were recorded. Time of fracture healing and fracture healing process were recorded.Levels of lkaline phosphatase (ALP), osteoealein (BGP),BMP (BMP-2),insulin-like growth factor 1(IGF-1),vascular endothelial growth factor (VEGF)and transforming growth factor-β1(TGF-β1)were detected before and after treatment.Result:Clinical efficacy of observation group was superior to that of control group according to Mann-Whiteney (Z =2.347,P < 0.05).Harris score of the observation group was obviously higher than that of the control group at 1,3,6and 12 months after surgery (P <0.01).The hip function of the observation group was superior to that of the control group at the last follow-up according to Mann-Whiteney (Z =2.086,P <0.05).The incidence of complications of observation group was 29.87%,which was evidently lower than 46.15%in the control group (X^2=4.358,P < 0.05).Fracture healing time of observation group was (14.45±3.52)weeks,which remarkably shorter than (19.23±4.97)weeks of control group (P <0.01).After treatment,levels of ALP,BGP,BMP-2,IGF-1, VEGF,TGF-131of observation group were remarkably higher than those of control group (P <0.01).Conclusion: Modified Heying Zhitongtang can treat femoral neck fra
作者
李贞
孙远远
李伦兰
LI Zhen;SUN Yuan-yuan;LI Lun-lan(The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;The Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230000,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2018年第24期195-200,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
安徽省自然科学基金项目(1508085MH183)
关键词
股骨颈骨折
空心螺钉内固定
和营止痛汤
分期
辨证论治
骨代谢
骨生成因子
femoral neck fracture
internal fixation with hollow screw
Heying Zhitongtang
stage
treatment based on syndrome differentiation
bone metabolism
osteogenic facto
