续骨活血汤加减联合常规西药对老年股骨转子间骨折患者术后髋关节功能及骨密度的影响

Effects of Xugu Huoxue decoction combined with conventional western medicine on hip joint function and bone mineral density in postoperative elderly patients with intertrochanteric fractures of femur

目的:续骨活血汤加减联合常规西药对老年股骨转子间骨折(IFOF)患者术后髋关节功能及骨密度的影响。方法:选取2019年12月至2021年12月该院收治的98例老年IFOF患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各49例。两组均行股骨近端防旋髓内钉(PFNA)内固定治疗,在此基础上,对照组采用常规西药(鲑降钙素注射液+碳酸钙D3片)治疗,观察组在对照组基础上联合续骨活血汤加减治疗。比较两组术后恢复指标(骨折愈合时间、下地行走时间及住院时间)、临床疗效、术后髋关节功能(Harris髋关节功能评分)、治疗前后髋部骨密度和骨生化标志物[血清Ⅰ型前胶原氨基端前肽(P1NP)]水平及不良反应发生率。结果:观察组骨折愈合时间、下地行走时间及住院时间均短于对照组,治疗后Harris评分、髋部骨密度、血清P1NP水平均高于对照组,差异有统计学意义(P<0.05);观察组治疗后髋关节功能优良率为95.92%(47/49),高于对照组的81.63%(40/49),差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:续骨活血汤加减联合常规西药治疗老年IFOF术后患者效果较好,利于缩短骨折愈合时间、下地行走时间及住院时间,改善髋关节功能,提高骨密度和骨代谢功能,效果优于单纯常规西药治疗。

Objective:To observe effects of Xugu Huoxue decoction combined with conventional western medicine on hip joint function and bone mineral density in postoperative elderly patients with intertrochanteric fractures of femur(IFOF).Methods:A prospective study was conducted on 98 elderly patients with IFOF admitted to the hospital from December 2019 to December 2021.These patients were divided into control group and observation group by using the random number table method,49 cases in each.Both groups were treated with PFNA internal fixation.On this basis,the control group was treated with conventional western medicine(Salmon calcitonin injection+Calcium carbonate D3 tablets),while the observation group was treated with Xugu Huoxue decoction on the basis of that of the control group.The clinical efficacy,the postoperative hip function,the hip bone mineral density,the serum procollagen type I N-terminal propeptide(P1NP)level,and the adverse reactions were compared between the two groups.Results:The fracture healing time,the walking time and the hospitalization time in the observation group were shorter than those in the control group;after the treatment,the Harris score,the hip bone mineral density and the serum P1NP level were higher than those in the control group;and the differences were statistically significant(P<0.05).The excellent and good rate of hip joint function in the observation group was 95.92%(47/49),which was higher than 81.63%(40/49)in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Xugu Huoxue decoction combined with western medicine is effective in the treatment of the postoperative elderly patients with IFOF,which is beneficial to shorten the fracture healing time,the walking time and the hospitalization time and improve the hip joint function,the bone mineral density and the bone metabolism function.Moreover,it is superior to single western medicine treatment.