强骨饮对老年股骨粗隆间骨折术后再发对侧粗隆间骨折疗效的1年随访研究

The 1-year follow up study of efficacy of strong-bone decoction on refractures after the femoral intertrochanter fracture in the opposite side in the elderly

目的观察强骨饮防治老年股骨粗隆间骨折术后再发对侧粗隆间骨折的临床疗效。方法 2016年1月至2016年12月,选取本科室接受手术治疗的老年股骨粗隆间骨折患者并得到完整随访的120例作为研究对象,将其随机分为常规康复组、基础用药组和强骨饮组,每组各40例。其中常规康复组为常规骨折康复治疗,其余两组在常规骨折康复治疗的基础上,基础用药组给予钙尔奇D片和阿法骨化醇胶囊;而强骨饮组给予强骨饮颗粒。均术后随访1年,记录3组病例术后对侧再发骨折发生率及治疗前后对侧股骨大转子、股骨颈骨密度变化情况,并对所收集的数据进行比较。结果 105例获得随访,15例失访。术后1年再发对侧粗隆间骨折4例,其中常规康复组3例、基础用药组1例和强骨饮组0例,经统计再骨折发生率分别为8.57%,2.85%,0.0%,强骨饮组优于其他两组,差异不具有统计学意义(P>0.05);强骨饮组治疗1年后股骨大转子和股骨颈骨密度分别为0.672±0.052 g/m2、0.574±0.063 g/m2,明显高于常规康复组,差异具有统计学意义(P<0.05)。稍高于基础用药组,差异不具有统计学意义(P>0.05)。结论强骨饮可有效提高老年股骨粗隆间骨折术后患者对侧股骨大转子及股骨颈的骨密度,增加骨强度,有效降低再发对侧粗隆间骨折风险。

Objective To observe the efficacy of strong-bone decoction on refractures after the elder femoral intertrochanter fracture in the opposite side. Methods Data of 120 elder patients with intertrochanter fractures operated in our department from January 2016 to December 2016 were collected. The patients were randomly divided to routine recovery group,basic medicine group,and strong-bone decoction group,with 40 patients in each group. Patients in routine recovery group received routine fracture recovery treatment. In other two groups,patients received additional Caltrate D and Alfacalcidol capsules. Patients in strong-bone decoction group received strong-bone decoction granules. The patients were followed up for 1 year. The incidence of fracture and bone mineral density（BMD） of the opposite intertrochanter and femoral neck before and after femoral intertrochanter fracture in the3 groups was recorded and compared. Results One hundred and five patients were followed,and fifteen were lost. There were 4 refractures in 1 year,including 3 cases in routine recovery group,1 case in basic medicine group,and 0 in strong-bone decoction group. The incidence of refracture was 8. 57%,2. 85%,and 0%,respectively. Strong-bone decoction group was better than the other 2 groups,but the difference was not significant（P〉0. 05）. After 1-year treatment,BMD of the intertrochanter and femoralneck was 0. 672 ± 0. 052 g/m^2 and 0. 574 ± 0. 063 g/m^2,respectively,which was higher than that in routine recovery group（P〈0. 05） and basic medicine group（P〈0. 05）. Conclusion Strong-bone decoction increases BMD of the opposite intertrochanter and femoral neck after femoral intertrochanter fracture in the elderly,increases bone strength,and effectively decreases fracture risk of the opposite intertrochanter.