虎力散胶囊联合空心钉内固定治疗GardenⅢⅣ型中青年股骨颈骨折的临床疗效及其机制分析

Clinical Efficacy and Mechanism of Hulisan Capsule combined Nail Internal Fixation on Garden TypeⅢandⅣFemoral Neck Fractures in Young and Middle-aged Patients

目的:探讨虎力散胶囊联合空心钉内固定治疗GardenⅢ、Ⅳ型中青年股骨颈骨折的临床疗效及其机制。方法:回顾性收集股骨颈骨折患者,根据不同的治疗方法分为对照组和联合组。对照组患者行股骨颈骨折空心钉内固定术,联合组患者在股骨颈骨折空心钉内固定术后给予虎力散胶囊联合治疗,观察两组患者术后6个月骨折愈合情况、股骨头坏死率、股骨颈短缩发生率、血清氧化应激和炎症因子浓度和髋关节功能。结果:虎力散胶囊联合空心钉内固定患者术后骨折愈合时间显著降低(P<0.01),骨折愈合率显著增加(P<0.05),术后6个月股骨头坏死率和股骨颈短缩发生率均显著降低(P<0.05)、血清氧化应激指标显著增加(P<0.01)、血清炎症因子指标显著降低(P<0.01)、Harris髋关节功能评分显著增加(P<0.01)以及Harris髋关节功能评价效果即优良率显著增加(P<0.05)。结论:虎力散胶囊联合空心钉内固定显著改善了GardenⅢ型和Ⅳ型中青年患者的骨折愈合情况和股骨头坏死率,提高了患者的髋关节功能,其作用机制可能是通过抗氧化应激和炎症反应实现的。

Objective:To investigate the clinical curative effect and the mechanism of Hulisan capsule combined nail internal fixation on GardenⅢ,Ⅳyoung and middle-aged femoral neck fracture.Methods:130 patients with femoral neck fractures were divided into control group and combined treatment group.Patients in the control group were treated with nail internal fixation,and patients in the combined treatment group were treated with Hulisan capsule after nail internal fixation.Fracture healing,femoral head necrosis rate,incidence of femoral neck shortening,serum oxidative stress and inflammatory factors concentration and hip joint function of patients in the two groups were observed.Results:After surgery,the patients received Hulisan capsule combined nail internal fixation showed the fracture healing time was significantly shorter(P<0.01)and fracture healing rate increased significantly(P<0.05),and 6 months after operation,femoral head necrosis rate and incidence of femoral neck shortening significantly decreased(P<0.05),serum oxidative stress indicators increased significantly(P<0.01),serum inflammatory factors indicators decreased significantly(P<0.01),Harris hip score increased significantly(P<0.01),and Harris hip function evaluation effect of excellent and good rate increased significantly(P<0.05).Conclusion:Hulisan capsule combined nail internal fixation treatment significantly improved fracture healing and femoral head necrosis rate,improve the patient's hip joint function of GardenⅢ,Ⅳyoung and middle-aged femoral neck fracture.Its mechanism of action may be achieved through anti-oxidative stress and anti-inflammation.