三期辨证中药复方对老年性骨质疏松髋部骨折患者生化指标的影响

Effect of Chinese Herbal Compound Based on Triple-Stage Syndrome Differentiation on Biochemical Indexes of Patients with Senile Osteoporotic Hip Fracture

目的:观察三期辨证中药复方对老年性骨质疏松髋部骨折患者生化指标的影响。方法:将60例老年性骨质疏松髋部骨折患者随机分为中药复方组30例及非服药对照组30例。2组均按照标准治疗操作流程骨折予以微创固定处理。中药复方组采用中药三期辨证治疗,于术后2周内应用增液汤并益骨汤随证加减,术后2~4周应用归脾汤并益骨汤随证加减,术后4周应用独活寄生汤并益骨汤随证加减。非服药对照组则禁止患者服用其它影响骨代谢的相关药物。于术前及术后1周、术后2周、术后1月、术后3月检测分别2组患者血中碱性磷酸酶(ALP)、钙(Ca2+)、C-反应蛋白(CRP)、血浆D-二聚体和25羟基维生素D[VD(25-OH)]相关生化指标。结果:术后1周、2周、1月、3月中药复方组中血清ALP、Ca2+及VD(25-OH)均明显高于非服药对照组。其中血清ALP术后1月、3月2组间比较,差异均有统计学意义(P<0.05,P<0.01);血清Ca2+术后1周、2周2组间比较,差异均有统计学意义(P<0.05,P<0.01);血清VD(25-OH)术后2周、1月、3月2组间比较,差异均有统计学意义(P<0.05,P<0.01)。术后1周、2周、1月、3月中药复方组C-反应蛋白、血浆D-二聚体均明显低于非服药对照组。其中C-反应蛋白术后1周、2周2组间比较,差异均有统计学意义(P<0.05),术后1月、3月2组间比较,差异均无统计学意义(P>0.05);血浆D-二聚体术后2周、1月、3月2组间比较,差异均有统计学意义(P<0.05,P<0.01)。结论:三期辨证中药复方早期补肾活血对老年性骨质疏松髋部骨折患者生化指标影响明显,可以早期有效改善机体炎性及血凝状态,改善患者体质状态,促进骨形成,是快速康复的有力保障之一。

Objective：To observe the effect of Chinese herbal compound based on triple-stage syndrome differentiation on biochemical indexes of patients with senile osteoporotic hip fracture.Methods：Divided 60 cases of patients with senile osteoporotic hip fracture randomly into Chinese herbal compound group with 30 cases and the control group with 30 cases.Both groups received minimally invasive fixation for fractures according to standard operation procedure.Chinese herbal compound group received the treatment of Chinese herbal medicine based on triple-stage syndrome differentiation：modified Zengye tang and Yigu tang according to the changes of syndromes during the first two weeks after surgery;modified Guipi tang and Yigu tang according to the changes of syndromes from the second week to the fourth week after surgery;modified Duhuo Jisheng tang and Yigu tang according to the changes of syndromes four weeks after surgery.The control group was forbidden from taking other relevant medicine affecting bone metabolism.Before surgery,in the 1 st week,2 nd week,1 stmonth,and 3 rd month after surgery,detected relevant biochemical indexes in blood of both groups respectively,including alkaline phosphatase（ALP）,calcium（Ca2＋）,C-reactive protein（CRP）,plasma D-dimer and 25-hydroxyvitamin D[VD（25-OH）].Results：In the 1 st week,2 nd week,1 st month and 3 rd month after surgery,the levels of serum ALP,Ca2＋ and VD（25-OH）in Chinese herbal compound group were all significantly higher than those in the control group.Compared serum ALP levels between the two groups in 1 month and 3 months after surgery,differences being significant（P 0.05,P 0.01）;compared the serum Ca2＋ levels between the two groups in the 1 st week,and 2 nd week after surgery,differences being significant（P 0.05,P 0.01）;compared serum VD levels（25-OH）between the two groups in the 2 nd week,1 st month and 3 rd month after surgery,differences being significant（P 0.05,P 0.01）.The levels of CRP,plasma D-dimer and VD（25-OH）in Chinese herbal compound group were all evidently lower than those in the control group in the 1 st week,2 nd week,1 st month and 3 rd month after surgery.Compared CRP levels between the two groups in the 1 st week and 2 nd week after surgery,differences being significant（P 0.05）.Compared the two groups in 1 month and 3 months after surgery,differences being insignificant（P 0.05）.Compared levels of plasma D-dimer between the two groups in the 2 nd week,1 st month,and 3 rd month after surgery,differences being significant（P 0.05,P 0.01）.Conclusion：Reinforcing kidney and activating blood in the early stage with Chinese herbal compound based on triple-stage syndrome differentiation has a significant effect on biochemical indexes of patients with senile osteoporotic hip fracture.It can effectively improve body inflammation and hemagglutination in the early stage,improve the constitutional status of patients and promote bone formation,which can powerfully ensure quick recovery.