鲑鱼降钙素围手术期应用对骨质疏松性股骨颈骨折镇痛效果的随机对照研究

Randomized controlled trials assessing the analgesic effect of perioperative application of salmon calcitonin on osteoporotic femoral neck fracture

目的探讨骨质疏松症(OP)性股骨颈骨折疼痛的缓解作用。方法将68例拟进行人工全髋置换术或人工半髋置换术的患者随机分为试验组和对照组,其中试验组34例,给予鲑鱼降钙素治疗;对照组34例,给予双氯芬酸钠双释放肠溶胶囊治疗。观察指标:术前第3天、术后第1天、术后第4天和术后第7天,两组患者均行VAS评分,以评估疼痛改善的情况。结果术后第1天双氯芬酸钠双释放肠溶胶囊的止痛效果优于鲑鱼降钙素(P<0·05);至术后第7天,鲑鱼降钙素的止痛效果则优于双氯芬酸钠双释放肠溶胶囊(P<0·05)。结论在急性创伤反应期双氯芬酸钠双释放肠溶胶囊的止痛作用优于鲑鱼降钙素,随着创伤反应的减轻,其止痛作用有限,而鲑鱼降钙素的止痛作用逐渐显现,其止痛效果可能与改善OP性骨痛作用有关。

Objective To evaluate the pain relief effect of calcitonin salmon for osteoporotic femoral neck tractures in peri-operative period （preoperative three days to postoperative seven days ）. Methods 68 patients who accepted total hip replacement （THR） or artificial half hip arthroplasty were randomly divided into trial group and control group. Trial group （34 patients） were given calcitonin salmon and control group （34 patients ） were given Diclofenac sodium double release intestine-sol Capsule. Observing indexes： on the 1st day before operation and, respectively on the 1st, 4th and 7th day after the operation, both groups used the scores of VAS to estimate the pain improvement. Results The pain relief effectiveness of Diclofenac sodium double release Intestine-sol Capsule was better than calcitonin salmon at the 1st day after the operation （P 〈 0.05 ）. On the 7th day after the operation caicitonin salmon was superior to Diclofenac sodium double release Intestine-sol Capsule （P 〈 0. 05 ）. Conclusions During the period of the acute traumatic reaction, the pain relief effect of Diclofenac sodium double release Intestine-sol Capsule is better than calcitonin salmon, but as trauma responses reducing gradually, the analgesic effect of calcitonin salmon appears increasing, which may relate to the relief of osteoporotic pain.