益肾祛瘀方治疗肾虚血瘀型骨质疏松伴股骨粗隆间骨折临床研究

Clinical Study on Yishen Quyu Prescription for Osteoporosis of Kidney Deficiency and Blood Stasis Type Complicated with Intertrochanteric Femur Fractures

目的:观察益肾祛瘀方在肾虚血瘀型骨质疏松伴股骨粗隆间骨折患者治疗中的临床疗效。方法:将116例肾虚血瘀型骨质疏松伴股骨粗隆间骨折患者随机分为对照组与观察组各58例。对照组采用手术及常规治疗,观察组在对照组基础上联合益肾祛瘀方治疗。治疗3个月后比较2组临床疗效及开始负重时间、骨折愈合时间、症状缓解时间,并比较2组治疗前后血清前列腺素E2(PGE2)、D二聚体(D-D)、白细胞介素-17(IL-17)、白细胞介素-10(IL-10)、核因子-κB受体活化因子配体(RANKL)、β-内啡肽(β-EP)、骨碱性磷酸酶(ALP)、护骨素(OPG)水平。结果:治疗前,2组血清PGE2、IL-10、IL-17、β-EP、D-D、RANKL水平比较,差异无统计学意义(P>0.05);治疗后,2组血清PGE2、IL-17、D-D水平均降低(P<0.05),IL-10、β-EP、RANKL水平均升高(P<0.05),且观察组血清PGE2、IL-17、D-D水平低于对照组(P<0.05),IL-10、β-EP、RANKL水平高于对照组(P<0.05)。治疗前,2组血清ALP、OPG水平比较,差异无统计学意义(P>0.05);治疗后,2组血清ALP、OPG水平均升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,观察组症状缓解时间、开始负重时间、骨折愈合时间均短于对照组(P<0.05)。治疗后,观察组总有效率96.55%,高于对照组79.31%(P<0.05)。结论:对于肾虚血瘀型骨质疏松伴股骨粗隆间骨折患者而言,手术联合益肾祛瘀方治疗有助于减轻炎症反应,调节骨代谢指标,促进骨折修复,提高临床疗效。

Objective:To observe the clincal effect of Yishen Quyu Prescription in the treatment of osteoporosis of kidney deficiency and blood stasis type complicated with intertrochanteric femur fractures.Methods:A total of 116 cases of patients with osteoporosis of kidney deficiency and blood stasis type with intertrochanteric femur fractures were randomly divided into the control group and the observation group,with 58 cases in each group.The control group was treated with the operation and routine treatment,and the observation group was additionally treated with Yishen Quyu Prescription based on the treatment of the control group.After 3-month treatment,clinical effects,the time of starting to bear weight,the time of fracture healing,and the remission time of symptoms were compared between the two groups.The levels of prostaglandin E2(PGE2),D-dimer(D-D),interleukin-17(IL-17),interleukin-10(IL-10),receptor activator of nuclear factorκB ligand(RANKL),β-endorphin(β-EP),bone alkaline phosphatase(ALP),and osteoprotegerin(OPG)in serum were compared before and after treatment between the two groups.Results:Before treatment,there was no significant difference being found in the comparison of the levels of PGE2,IL-10,IL-17,β-EP,D-D,and RANKL in serum between the two groups(P>0.05).After treatment,the levels of PGE2,IL-17,and D-D in serum in the two groups were decreased(P<0.05),and the levels of IL-10,β-EP,and RANKL were increased(P<0.05);the levels of PGE2,IL-17,and DD in serum in the observation group were lower than those in the control group(P<0.05),and the levels of IL-10,β-EP,and RANKL were higher than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of the levels of ALP and OPG in serum between the two groups(P>0.05).After treatment,the levels of ALP and OPG in serum in the two groups were increased(P<0.05),and the levels in the observation group were higher than those in the control group(P<0.05).After treatment,the remission time of symptoms,the time of starting to bear weight,and the time of fracture healing in the observation group were shorter than those in the control group(P<0.05).After treatment,the total effective rate was 96.55%in the observation group,higher than that of 79.31%in the control group(P<0.05).Conclusion:For patients with osteoporosis of kidney deficiency and blood stasis type complicated with intertrochanteric femur fractures,the treatment of the operation combined with Yishen Quyu Prescription can help relieve inflammatory responses,regulate bone metabolism indexes,promote fracture healing,and enhance clinical effects.