补肾生髓汤促进四肢骨折术后愈合机制临床研究

Clinical research of “Bushen Shengsui Decoction” on healing of fracture of extremities after operation and its mechanism

目的观察补肾生髓汤促进四肢骨折术后愈合的疗效及其作用机制。方法将73例新鲜四肢骨折患者随机分为两组,均行手术复位治疗;观察组(36例)给予补肾生髓汤口服,对照组(37例)给予骨肽注射液静脉滴注,疗程2个月。观察两组临床疗效、骨痂愈合和关节功能评分,及血钙、血磷、1,25二羟维生素D3[1,25-(OH)2D3]、骨钙素(BGP)和骨保护素(OPG)水平变化。结果 1观察组临床优良率为83.3%,对照组为59.5%,两组临床疗效有统计学差异(P<0.05);2治疗后观察组骨痂愈合评分、肘关节和膝关节功能评分均高于对照组(P<0.05,P<0.01);3治疗后两组血钙、血磷、1,25-(OH)2D3、BGP和OPG水平均较治疗前明显升高(P<0.05,P<0.01),且观察组高于对照组(P<0.05)。结论补肾生髓汤可促进四肢骨折术后的愈合,其机制与提高微量元素及促进BGP和OPG生成有关。

Objective To observe the clinical efficacy of ＂Bushen Shengsui Decoction＂for fracture of extremities after operation and to explore its mechanism.Methods Seventy-three cases with limbs fracture were randomized into two groups and underwent reset surgery. Thirty-six cases in the observation group were treated with＂Bushen Shengsui Decoction＂orally,and 37 cases in the control group were treated with Ossotide Injection intravenously,with the course of 2months. The clinical efficacy,scores of callus healing and joint function,and serum levels of calcium,phosphate,1,25 dihydroxy vitamin D3[1,25-（ OH）2D3],bone gla protein（ BGP） and osteoprotegerin（ OPG） were detected and compared between the groups. Results 1 The effective rate was 83. 3% in the observation group and 59. 5% in the control group,with a difference between the two groups（ P〈0. 05）. 2 After treatment,the scores of callus healing,elbow and knee function in the observation group were higher than those of the control group（ P〈0. 05,P〈0. 01）. 3After treatment,the levels of calcium,phosphate in the serum,and levels of [1,25-（ OH）2D3],BGP and OPG were increased markedly in both groups（ P〈0. 05,P〈0. 01）,and the levels of observation group were higher than those of the control group（ P〈0. 05）. Conclusion＂Bushen Shengsui Decoction＂can promote the fracture of extremities after operation,and its mechanisms may be association with improvement of microelements and promotion of BGP and OPG.