益骨汤联合阿法骨化醇软胶囊对股骨粗隆间骨折患者PFNA术后血清骨折愈合因子及髋关节功能的影响

The Influence of Bone-Replenishing Decoction Combined with Alfacalciferol Soft Capsules on Serum Fracture Healing Factors and Hip Function in Patients with Intertrochanteric Fracture of Femur After PFNA

目的:观察益骨汤联合阿法骨化醇软胶囊对股骨粗隆间骨折患者股骨近端防旋髓内钉(proximal femoral nail anti-rotation, PFNA)术后患者血清骨折愈合因子及髋关节功能的影响。方法:选取2020年8月至2022年2月于分宜县中医院行PFNA术的股骨粗隆间骨折患者92例,按照随机数字表法分为研究组和对照组,各46例。对照组术后给予阿法骨化醇软胶囊口服治疗,研究组在对照组治疗的基础上加用益骨汤治疗。观察两组患者治疗前后Harris髋关节评分、血清骨折愈合因子[成纤维细胞生长因子-2(fibroblast growth factor-2,FGF-2)、转化生长因子-β(transforming growth factor-β,TGF-β)]、中医证候积分变化情况及临床疗效、用药期间安全性。结果:对照组有效率为78.26%,研究组有效率为95.65%,研究组有效率高于对照组,差异有统计学意义(P<0.05);研究组治疗后Harris髋关节评分高于对照组,差异有统计学意义(P<0.05);研究组治疗后血清FGF-2、TGF-β水平高于对照组,差异有统计学意义(P<0.05);对照组不良反应发生率为8.70%,研究组不良反应发生率为2.17%,两组比较差异无统计学意义(P>0.05);研究组治疗后中医证候积分低于对照组,差异有统计学意义(P<0.05)。结论:益骨汤联合阿法骨化醇软胶囊能促进股骨粗隆间骨折PFNA患者术后髋关节功能恢复,提高血清FGF-2、TGF-β水平。

Objective:To observe the influence of Bone-Replenishing Decoction combined with Alfacalciferol Soft Capsules on serum frac-ture healing factor and hip function in patients with intertrochanteric fracture of femur after proximal femoral nail anti-rotation(PFNA).Methods:A total of 92 patients with intertrochanteric fracture of femur who underwent PFNA in Fenyi County Hospital of Traditional Chinese Medicine from August 2020 to February 2022 were selected and divided into the study group and the control group according to the random number table method,with 46 cases in each group.The control group was treated with Alfacalciferol Soft Capsules after oper-ation,while the study group was treated with Bone-Replenishing Decoction on the basis of the control group.Then the changes in Harris hip score,serum fracture healing factor[including fibroblast growth factor-2(FGF-2) and transforming growth factor-β(TGF-β)],TCM syndrome scores of the two groups before and after treatment,clinical efficacy,and safety during medication were observed.Re-sults:The effective rate was 78.26%in the control group and 95.65%in the study group.The effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the Harris hip score of the study group was higher than that of the control group and the difference was statistically significant(P<0.05);The levels of FGF-2 and TGF-βin the study group were higher than those in the control group,and all the differences were statistically significant(P<0.05).The incidence of adverse reactions was 8.70%in the control group and 2.17%in the study group,and there was no statistical significance between the two groups(P>0.05).The score of TCM syndrome in the study group after treatment was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Bone-Replenishing Decoction combined with Alfacalciferol Soft Capsules can promote postoperative hip joint function recovery in PFNA patients with intertrochanteric fracture of fe-mur,and increase serum FGF-2 and TGF-βlevels.