骨疏康胶囊辅助治疗绝经后骨质疏松性股骨转子间骨折的临床效果分析

Clinical Effect Analysis of Gushukang Capsule in the Adjuvant Treatment of Postmenopausal Osteoporotic Intertrochanteric Fracture of Femur

目的:探讨骨疏康胶囊辅助治疗绝经后骨质疏松性股骨转子间骨折的临床效果。方法:选取2015年1月~2019年12月本院收治的80例绝经后骨质疏松性股骨转子间骨折患者作为研究对象,按照随机数字表法分为研究组和对照组,各40例。两组均采用切开复位内固定术治疗,术后均服用碳酸钙D3片(Ⅱ),连续治疗4个月。在此基础上,研究组口服骨疏康胶囊,连续治疗4个月。比较两组临床疗效、手术情况和并发症发生率。术前、术后2个月和术后4个月均采用视觉模拟评分(VAS)评价两组骨痛状况,同期通过双能X线吸收法检测两组腰椎、大转子、股骨颈的骨密度状况,并检测两组血清骨钙素(BGP)、β-胶原降解产物(β-CTX)、骨碱性磷酸酶(BALP)、Ⅰ型胶原交联羧基末端肽(ⅠCTP)等骨代谢指标水平。术后4个月采用髋关节Harris评分评价两组髋关节功能恢复状况。结果:与同组术前比较,两组术后2个月和术后4个月VAS评分、β-CTX和ⅠCTP水平降低,腰椎和大转子的骨密度、BGP和BALP水平升高(P <0.05)。与对照组比较,研究组总有效率升高;术后2个月和术后4个月VAS评分、β-CTX和ⅠCTP水平降低,腰椎和大转子的骨密度、BGP和BALP水平升高;术后4个月髋关节Harris评分升高(P <0.05)。两组手术情况、并发症总发生率比较无统计学差异(P> 0.05)。结论:骨疏康胶囊辅助切开复位内固定术治疗绝经后骨质疏松性股骨转子间骨折,有助于改善骨质疏松病情、提高疗效、缓解疼痛和促进关节功能恢复,具有良好的可行性和安全性,值得推广应用。

Objective: To explore the clinical effect of Gushukang capsule in the adjuvant treatment of postmenopausal osteoporotic intertrochanteric fracture of femur. Methods: A total of 80 patients with postmenopausal osteoporotic intertrochanteric fracture of femur in our hospital from January 2015 to December 2019 were selected as the study subjects,and divided into the study group and the control group by number random table method,40 cases in each group. The two groups were treated with open reduction and internal fixation. After operation,the two groups were treated with calcium carbonate D3 tablet( Ⅱ) for 4 months. In addition,the study group was treated with Gushukang capsule for 4 months. The clinical efficacy,surgical situation and complication rate of the two groups were compared. Before operation,2 months after operation and 4 months after operation,visual analogue score( VAS) was used to evaluate the status of bone pain in the two groups. Bone mineral density of lumbar spine,greater trochanter and femoral neck of the two groups were measured by dual energy X-ray absorption method. Serum osteocalcin( BGP),β-collagen degradation products( β-CTX),bone alkaline phosphatase( BALP),carboxy terminal cross-linked peptide of type I collagen( ⅠCTP) and other bone metabolism indexes of the two groups were measured and compared. Harris score of hip joint was used to evaluate the recovery of hip joint function of the two groups in 4 months after operation. Results: Compared with those of the same group before operation,2 months after operation and 4 months after operation,VAS score and the levels of β-CTX andⅠCTP decreased,bone mineral density of lumbar spine and greater trochanter and the levels of BGP and BALP increased in the two groups( P < 0. 05).Compared with those of the control group,the total effective rate of treatment increased in the study group;2 months after operation and 4 months after operation,VAS score and the levels of β-CTX and ⅠCTP decreased,bone mineral density of lumbar spine and greater trochanter and the levels of BGP and BALP increased in the study group;4 months after operation,Harris score of hip joint increased in the study group( P < 0. 05). There was no significant difference in operation indexes and the total rate of complications in the two groups( P > 0. 05). Conclusion:Gushukang capsule in the adjuvant treatment of postmenopausal osteoporotic intertrochanteric fracture of femur after open reduction and internal fixation is helpful to improve the osteoporosis and the curative effect,relieve pain and promote the recovery of joint function. It has good feasibility and safety,and is worth to be widely used.