桃红四物汤对股骨头坏死患者BGP、BAP水平及血液流变学影响

Hemorheology in Patients with Avascular Necrosis of Femoral Head

目的分析桃红四物汤对股骨头坏死患者骨钙素(bone gla protein,BGP)、骨碱性磷酸酶(bone alkaline phosphatase,BAP)水平及血液流变学的影响。方法 2019年1月—2020年2月本院骨科收治的120例股骨头坏死患者随机分为对照组和观察组,各60例。对照组采用保髋手术治疗(钻孔减压、病灶刮除、人工骨植入术),观察组在对照组的基础上联合桃红四物汤进行治疗,两组均治疗24周。比较两组治疗前、治疗12周后、治疗24周后骨密度水平、骨质相关指标BGP和BAP水平、髋关节功能和生活质量、血液流变学指标,治疗24周后不良反应发生情况。结果治疗12周和24周后,两组股骨颈、股骨粗隆、Ward’s三角骨密度较治疗前均呈升高趋势,且治疗24周后观察组股骨颈、股骨粗隆、Ward’s三角骨密度高于对照组(P<0.05)。治疗12周和24周后,两组血清BGP水平、全血高切黏度、全血低切黏度、血浆黏度较治疗前呈降低趋势,观察组低于对照组,血清BAP水平较治疗前呈升高趋势,观察组高于对照组(P<0.05)。治疗12周和24周后,两组Harris评分和健康调查简表-36(SF-36)评分较治疗前均呈升高趋势,观察组高于对照组(P<0.05)。治疗24周后,对照组总不良反应发生率为8.33%,观察组总不良反应发生率为6.67%,组间比较,差异无统计学意义(P>0.05)。结论桃红四物汤治疗股骨头坏死能显著提高患者血清BAP水平,降低血清BGP水平,同时改善患者骨密度和血液流变学指标,促进髋关节功能好转,提高生活质量,同时安全性高。

Objective To analyze the effects of Taohong Siwu Decoction(桃红四物汤)on bone gla protein(BGP),bone alkaline phosphatase(BAP)levels and hemorheology in patients with avascular necrosis of femoral head. Methods A total of 120 patients with avascular necrosis of femoral head admitted to the department of orthopedics of our hospital between January 2019 and February 2020 were selected as the study objects. The patients in the control group were treated with conventional therapy,and the observation group was treated with Taohong Siwu Decoction on the basis of the control group. Both groups were treated for 24 weeks. Bone mineral density,bone-related indicators BGP and BAP levels,hip function score and quality of life score,hemorheology indexes before treatment,12 weeks after treatment and 24 weeks after treatment,and adverse reactions occurred after 24 weeks of treatment were compared between the two groups. Results After 12 and 24 weeks of treatment,the femoral neck,femoral trochanter and Ward’s triangle in the two groups showed an increasing trend compared with that before treatment,and the bone mineral density of femoral neck,femoral trochanter and Ward’s triangle in the observation group was higher than that in the control group after 24 weeks of treatment(P<0.05). After 12 and 24 weeks of treatment,serum BGP level,whole blood high cutting viscosity,whole blood low cutting viscosity and plasma viscosity of the two groups showed a trend of decrease compared with that before treatment,while the observation group was lower than the control group,and the serum BAP level showed a trend of increase compared with that before treatment,and the control group was lower than the observation group(P<0.05). After 12 and 24 weeks of treatment,Harris score and SF-36 score in the two groups showed an increasing trend compared with that before treatment,and the control group was lower than the observation group(P<0.05). After 24 weeks of treatment,the total incidence of adverse reactions was 8.33% in the control group and 6.67% in the observation group,and there was no significant difference between the two groups(P>0.05). Conclusion Taohong Siwu Decoction for the treatment of avascular necrosis of femoral head can significantly increase the serum BAP level of patients,reduce the serum BGP level,improve the bone mineral density and hemorheological indexes of patients,promote the improvement of hip joint function,improve the quality of life,and have high safety.