益气续骨汤联合股骨近端防旋转髓内钉对股骨粗隆间骨折骨性标志物的影响

Effect of Yiqi Xugu Decoction(益气续骨汤)Combined with PFNA on Bone Markers of Femoral Intertrochanteric Fracture

目的探究益气续骨汤联合股骨近端防旋转髓内钉(proximal femoral nail antirotation,PFNA)对股骨粗隆间骨折的疗效以及对其骨性标志物的影响。方法将2015年3月—2019年8月于本院就诊并接受治疗的140例股骨粗隆间骨折患者,采用随机数字表法分为对照组和观察组,每组各70例。对照组给予PFNA手术,术后进行常规术后预防治疗,观察组给予PFNA手术联合益气续骨汤,PFNA手术操作同对照组,对比两组治疗前后视觉模拟评分法(visutal analogue scale,VAS)分数、Harris分数、髋部骨密度和血清Ⅰ型前胶原氨基端前肽(procollagen type I N-terminal propeptide,PINP)水平。结果治疗后两组的VAS分数均明显降低(P<0.05),且治疗后2周、1月、3月的观察组的VAS分数均明显低于对照组,治疗后两组间VAS分数的差异有统计学意义(P<0.05)。治疗后两组Harris分数明显升高(P<0.05),且治疗后2周、1个月、3个月的观察组的VAS分数均明显高于对照组,治疗后两组间Harris分数的差异有统计学意义(P<0.05)。治疗1个月后两组的髋部骨密度值均明显升高,且治疗后2周、1个月、3个月的观察组的髋部骨密度值均明显低高于对照组,治疗后两组间髋部骨密度值的差异有统计学意义(P<0.05)。治疗后两组的血清PINP水平均明显降低(P<0.05),且治疗后2周、1个月、3个月的观察组的血清PINP水平均明显低于对照组(P<0.05)。结论益气续骨汤联合PFNA治疗股骨粗隆间骨折效果明确,可有效改善临床疗效,增强髋部骨密度值,降低血清PINP水平,促进骨愈合。

Objective To explore the effect of Yiqi Xugu Decoction(益气续骨汤)combined with Proximal Femoral Nail Antirotation(PFNA)on femoral intertrochanteric fractures and its effect on bone markers.Methods A total of 140 patients with femoral intertrochanteric fractures who were treated in our hospital from March 2015 to August 2019 were divided into a control group and an observation group using a random number table method,with 70 cases in each group.The control group was given PFNA surgery,and routine postoperative preventive treatment was given after the operation.The observation group was given PFNA surgery combined with Yiqi Xuguo Decoction.The PFNA surgery was the same as that of the control group.The visual analogue scale(VAS)score,Harris score,hip bone density and serum procollagen type I N-terminal propeptide(PINP)level of two groups before and after treatment were compared.Results After treatment,the VAS scores of the two groups were significantly reduced(P<0.05),and the VAS scores of the observation group at 2 weeks,1 and 3 months after treatment were significantly lower than those of the control group.The difference in VAS scores between the two groups after treatment was statistical significance(P<0.05).The Harris scores of the two groups were increased significantly after treatment(P<0.05),and the VAS scores of the observation group at 2 weeks,1 and 3 months after treatment were significantly higher than those of the control group.The difference in Harris scores between the two groups after treatment was statistically significant(P<0.05).After 1 month of treatment,the hip bone mineral densities of the two groups were significantly increased,and the hip bone mineral density of the observation group was significantly lower than that of the control group at 2 weeks,1 and 3 months after treatment.The difference in hip bone mineral density between the two groups was statistically significant(P<0.05).After treatment,the serum PINP levels of the two groups were significantly reduced(P<0.05),and the serum PINP levels of the observation group at 2 weeks,1 and 3 months after treatment were significantly lower than those of the control group(P<0.05).Conclusion Yiqi Xugu Decoction combined with PFNA has a clear effect on the treatment of femoral intertrochanteric fractures.It can effectively improve the clinical efficacy,enhance the bone mineral density of the hip,reduce the serum PINP level and promote bone healing.