杜仲补肾健骨颗粒对激素性股骨头缺血性坏死的疗效及血清PⅠNP、BGP、VEGF、TGF-β_1和骨密度影响的研究

The effect of Eucommia Bushenjiangu Granule on steroid induced avascular necrosis of the femoral head and the serum PⅠNP,BGP,VEGF,TGF-beta 1 and bone mineral density

目的观察杜仲补肾健骨颗粒对激素性股骨头缺血性坏死的疗效及血清Ⅰ型胶原氨基端肽原(procollagen typeⅠN-terminal propeptide,PⅠNP)、骨γ-羧基谷氨酸蛋白(bone gamma-carboxyglutamic-acid-containing proteins,BGP)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、转化生长因子β_1(transforming growth factorβtype1,TGF-β_1)及骨密度的影响。方法将2012年12月至2015年6月于本院就诊的142例激素性股骨头坏死患者随机分为两组,对照组71例给予介入治疗,研究组71例在对照组的基础上给予杜仲补肾健骨颗粒治疗。观察两组患者治疗不同时间的PINP、BGP、VEGF、TGF-β_1、同型半胱氨酸(homocysteine,Hcy)、骨密度和治疗前后Harris评分、血流及血脂变化。结果研究组治疗后Harris评分较对照组显著升高(P<0.05),全血高切黏度、全血低切黏度、红细胞聚集指数、总胆固醇、甘油三酯水平较对照组显著降低(P均<0.05);治疗组治疗后4、12和24周的PⅠNP、BGP、TGF-β_1、Hcy水平均低于对照组(P均<0.05),VEGF水平均高于对照组(P均<0.05);治疗后12、24周股骨颈、股骨粗隆、Ward’s三角骨密度水平均高于对照组(P均<0.05)。结论杜仲补肾健骨颗粒联合介入治疗可提高激素性股骨头缺血性坏死的临床疗效,值得推广应用。

Objective To observe the effect of Eucommia Bushenjiangu Granule on steroid induced avascular necrosis of the femoral head and the serum P I NP, BGP, VEGF, TGF-beta 1 and bone mineral density. Method 142 cases of steroid induced necrosis of the femoral head were randomly divided into 2 groups, 71 cases in control group were given interventional treatment, research group 71 cases in the control group given Eucommia Bushenjiangu Granule in the treatment of the 2 groups was observed at different time. PINP, BGP, VEGF, TGF-beta 1, Hey, Harris score, bone density and blood rheology before and after treatment, blood lipid changes. Result The cure After treatment, Harris score significantly higher than the control group （P〈0.05）; whole blood viscosity, whole blood viscosity, erythrocyte aggregation index, TC, TG was significantly lower than the control group （P〈：0.05）; after treatment, 4W, 12W and 24W, PINP, BGP, TGF-[31, Hey level lower than the control group （P〈0.05）, the level of VEGF was higher than that of control group （P〈0.05）; after treatment, 12W, 24W, femoral neck, trochanter, Ward triangle s MVD levels were higher than control group （P〈0.05）. Conclusion Eucommia Bushenjiangu Granule combined interventional therapy can improve the clinical curative effect, is worthy of popularization and application