杜仲补肾健骨颗粒对骨折不愈合患者血清标志物和血液流变学的影响

Effects of Duzhong Bushen Jiangu Granules in the Treatment of Patients with Nonunion on Serum Markers and Hemorheology

目的:探讨杜仲补肾健骨颗粒对骨折不愈合患者血清标志物和血液流变学的影响。方法:选取2014年1月至2015年12月在日照市中医医院就诊的胫骨骨折不愈合患者74例,采用简单随机化法分为2组,各37例。对照组给予交锁髓内钉治疗,术后常规处理,观察组在对照组的基础上给予杜仲补肾健骨颗粒口服,观察2组术前、术后1个月、术后2个月骨形态发生蛋白-2(BMP-2)、胰岛素样生长因子-1(IGF-1)、可溶性细胞间黏附分子-1(s ICAM-1)、血管细胞黏附分子-1(s VCAM-1)、血管内皮生长因子(VEGF)、特异性碱性磷酸酶(ALP)水平及血液流变学指标,统计2组骨痂生成时间。结果:观察组术后1个月、2个月BMP-2、IGF-1、VEGF、ALP与同期对照组比较均显著升高(P<0.05);s ICAM-1、s VCAM-1、全血高切黏度、全血低切黏度和红细胞聚集指数与同期对照组比较均显著降低(P<0.05);少量骨痂、中量骨痂、大量骨痂和临床愈合时间与对照组相较均显著降低(P<0.05)。结论:杜仲补肾健骨颗粒联合交锁髓内钉治疗胫骨骨折不愈合可加速骨折愈合,具有临床推广价值。

Objective： To investigate the effects of Duzhong Bushen Jiangu Granules in the treatment of patients with nonunion on serum markers and hemorheology. Methods： A total of 74 cases of tibia fracture nonunion were admitted and treated in Rizhao Hospital of TCM from January 2014 to December 2015. The patients were randomly divided into 2 groups by simple randomization with 37 cases in each group. The patients in control group were treated with interlocking intramedullary nail and conventional treatment,and the observation group patients were treated on the basis of the control group,who were given the administration of Duzhong Bushen Jiangu Granules. The indexes of bone morphogenenic protein-2（ BMP-2）,insulin-like growth factor-1（ IGF-1）,soluble intracellular cell adhesion molecule-1（ s ICAM-1）,soluble vascular cell adhesion molecule（ s VCAM-1）,vascular endothelial growth factor（ VEGF）,specific alkaline phosphatase（ ALP） levels and blood rheology indexes,as well as statistics of 2 groups of callus formation time were recorded before and after 1 month＇s,2 months＇ treatment of the two groups. Results： BMP-2,IGF-1,VEGF,and ALP in the observation group after 1 month＇s and 2 months＇ treatment were significantly higher than those in the control group at the same time（ P〈0. 05）; compared with the control group,s ICAM-1,s VCAM-1,whole blood viscosity,whole blood viscosity and erythrocyte aggregation index at the same time decreased significantly（ P〈0. 05）; compared with the control group,small dose of callus,medium dose of callus,a large number of callus and clinical healing time decreased significantly（ P〈0. 05）. Conclusion： Duzhong Bushen Jiangu Granules combined with interlocking intramedullary nail in treatment of tibial fracture nonunion can accelerate fracture healing,which has clinical popularized values.