补肾健骨汤配合阿仑膦酸钠对髋关节置换术后股骨假体周围早期骨溶解的影响

Effect of Bushen Jiangu Soup Combined with Alendronate on the Early Osteolysis of Periprosthetic Femoral after Hip Replacement

目的:探讨补肾健骨汤配合阿仑膦酸钠对髋关节置换术后股骨假体周围早期骨溶解的影响。方法:40例患者按随机数字表法分为4组,分别为补肾健骨汤组、阿仑膦酸钠组、补肾健骨汤+阿仑膦酸钠组(联合组)、空白组。空白组患者常规观察并随访,不服用明显影响骨代谢的药物干预;补肾健骨组口服补肾健骨汤治疗,每次200 mL,每日2次,连续服用2周,休息1周,4周为1个疗程,共治疗6个疗程;阿仑膦酸钠组于每周一早晨空腹服用阿仑膦酸钠每次70 mg治疗;综合组采用补肾健骨+阿仑膦酸钠循环间歇性给药法,即补肾健骨汤连续服用1周,改服阿仑膦酸钠70 mg,每周1次,如此反复,4周为1个疗程;共用6个疗程。治疗后分别采集0个月、3个月、6个月外周静脉血5 mL,用酶联免疫吸附法检测Ⅰ型原胶原N-端前肽和Ⅰ型胶原交联C-末端肽的含量;通过放射影像图文系统观察0个月、6个月后股骨假体周围骨溶解带的变化。结果:①补肾健骨汤、阿仑膦酸钠、补肾健骨汤+阿仑膦酸钠均可延缓股骨假体周围早期骨溶解;②联合组延缓股骨假体周围早期骨溶解的效果优于补肾健骨汤组、阿仑膦酸钠组;补肾健骨汤组优于阿伦膦酸钠组;③补肾健骨汤+阿仑膦酸钠可延缓假体周围早期骨溶解的机制可能是通过抑制破骨激活因子IL-1、IL-6、TNF-α等形成,达到延缓股骨假体周围早期骨溶解的目的。结论:补肾健骨汤配合阿仑膦酸钠对髋关节置换术后股骨假体周围早期骨溶解影响较大,临床疗效显著。

Objective ： To study the effect of Bushen Jiangu Soup combined with Alendronate on the early osteolysis of periprosthetic femo- ral after hip replacement. Methods ：40 patients were divided into four groups according to random number table method, respectively, Bushen Jiangu Soup group, Alendronate group, group of Bushen Jiangu Soup and Alendronate （integrated group） and the blank group. The Blank group of patients with regular follow-up observations and didn＇t take intervention drugs significantly affection the bone metab- olism; Bushen Jiangu Soup group was treated with oral Bushen Jiangu Soup, 200 mL each time, 2 times a day, continuous use for 2 weeks, rest for 1 week, and 4 weeks for a period of treatment, a total of 6 courses of treatment. Alendronate group was treated with alen- dronate 70 mg per time in every Monday morning;Integrated group was given Bushen Jiangu Soup and Alendronate with circulating in- termittent dosing method, namely, Bushen Jiangu Soup continuous use for 1 week, and change to Alendronate 70 mg per week, once per week, and so on,4 weeks for a period of treatment, a total of 6 courses of treatment. Collected respectively 0,3,6 months of peripheral venous blood of 5 mL, enzyme linked immunosorbent method to detect I tropocollagen N-terminal propeptide and I type collagen crosslinking C-peptide content at the end;Observed by radiation graphic system 0,6 month after the femoral implant surrounding bone dissolve with changes. Results：Bushen Jiangu Soup, Alendronate, Bushen Jiangu Soup combined with alendronate all can delay the early osteolysis of periprosthetic femoral; ②Integrated group has superior effect on osteolysis of periprosthetic femoral than Bushen Jiangu Soup and Alendronate, and Bushen Jiangu Soup group is better than alendronate group;③The mechanism of group of Bushen Jiangu Soup and Alendronate delay the early osteolysis of periprosthetic femoral may be formed by inhibiting osteoclasts activated factor,IL-6 ,IL-1 TNF alpha, and obtain the aim of postponing the early osteolysis of periprosthetic femoral. Conclusion：Bushen Jiangu Soup with Alendronate has larger effct on the early osteolysis of periprosthetic femoral after hip replacement, and the clinical curative effect is distinct.