温肾逐瘀壮骨汤对老年股骨粗隆间骨折的治疗效果及对炎症因子的影响

Clinical Effect of Wenshen Zhuyu Zhuanggu Decoction on Elderly Patients with Femoral Intertrochanteric Fracture and its Influence on Inflammatory Factors

目的:探讨温肾逐瘀壮骨汤在老年股骨粗隆间骨折患者中的临床效果及对炎症因子的影响。方法:选择2017年5月—2019年7月我院收治的老年股骨粗隆间骨折患者86例,随机分为对照组(n=43例)和观察组(n=43例)。对照组采用股骨近端防旋髓内钉内固定治疗,观察组在对照组基础上联合温肾逐瘀壮骨汤治疗,术后4周对患者效果进行评估,比较两组髋关节功能、炎症因子、骨代谢指标及治疗预后。结果:观察组术后1周、2周、3周及4周的Harris量表评分分别为(74.62±5.76)分、(81.13±5.79分)、(87.45±6.46)分及(92.14±6.98)分,均高于对照组的(67.81±5.41)分、(74.47±5.63)分、(79.43±5.81)分、(83.45±6.32)分(P<0.05);观察组术后4周的TNF-a(23.23±4.31)pg/mL、IL-6(18.41±5.37)pg/mL和IL-10水平(19.43±3.21)pg/mL均低于对照组TNF-a(45.41±5.65)pg/mL、IL-6(32.59±10.49)pg/mL和IL-10水平(26.49±4.36)pg/mL(P<0.05);观察组手术后4周的BALP(5.92±0.61)μg/L、BGP(6.42±0.77)μg/L及PICP水平(162.14±13.25)μg/L高于对照组BALP(4.34±0.57)μg/L、BGP(5.69±0.74)μg/L及PICP水平(104.39±10.49)μg/L(P<0.05);观察组手术后4周β-CTX水平(0.41±0.08)ng/L低于对照组(0.75±0.11)ng/L(P<0.05);观察组术后感染、深静脉血栓、愈合不良、延迟愈合及非感染性发热发生率合计为4.65%低于对照组的18.60%,差异有统计学意义(P<0.05)。结论:温肾逐瘀壮骨汤能提高老年股骨粗隆间骨折患者髋关节功能,可降低炎症因子水平,提高患者骨代谢水平,可获得良好的治疗预后,值得推广应用。

Objective To explore the clinical effect of Wenshen Zhuyu Zhuanggu Decoction on elderly patients with intertrochanteric fractures and its effect on inflammatory factors.Methods From May 2017 to July 2019,86 elderly patients with intertrochanteric fractures were selected as subjects and the random number method was divided into the control group(n=43 cases)and the observation group(n=43 cases).The control group was treated with proximal femoral anti-rotational intramedullary nailing.The observation group was treated with Wenshen Zhuyu Zhuanggu Decoction on the basis of the control group.The effect of the patients was evaluated four weeks after operation.The hip function,inflammation factors,bone metabolism indicators and treatment prognosis.were compared between the two groups.Results The Harris scale scores in the observation group at 1 week,2 weeks,3 weeks and 4 weeks(74.62±5.76 points,81.13±5.79 points,87.45±6.46 points,92.14±6.98 points)were higher than those in the control group.Table scores were(67.81±5.41 points,74.47±5.63 points,79.43±5.81 points,83.45±6.32 points)(P<0.05);TNF-α(23.23±4.31)pg/mL,IL-6 after four weeks in observation group(18.41±5.37)pg/mL and IL-10 level(19.43±3.21)pg/mL were lower than those in the control group which TNF-α(45.41±5.65)pg/mL,IL-6(32.59±10.49)pg/mL and IL-10 level(26.49±4.36)pg/mL(P<0.05).BALP(5.92±0.61)μg/L,BGP(6.42±0.77)μg/L and PICP level(162.14±13.25)μg/L was higher than those in the control group which BALP(4.34±0.57)μg/L,BGP(5.69±0.74)μg/L and PICP level(104.39±10.49)μg/L(P<0.05).The observation group was recorded four weeks after surgery.The weeklyβ-CTX level(0.41±0.08)ng/L was lower than that in the control group(0.75±0.11)ng/L(P<0.05).The observation group had postoperative infections,deep vein thrombosis,poor healing,delayed healing and non-infectiousness.The incidence of fever was lower than that in the control group(P<0.05).Conclusion Wenshen Zhuyu Zhuanggu Decoction can improve hip joint function,reduce inflammatory factor levels and increase bone metabolism in elderly patients with intertrochanteric fractures of the femur.It can obtain a good prognosis and is worthy of popularization and application.