自拟壮骨益气汤联合伊班膦酸钠治疗老年骨质疏松性肱骨近端骨折的临床研究

Clinical study of Zhuanggu Yiqi decoction combined with Ibandronate sodium in the treatment of senile osteoporotic proximal humerus fracture

目的:研究自拟壮骨益气汤联合伊班膦酸钠治疗老年骨质疏松性肱骨近端骨折(PHF)的临床疗效。方法:选取2020年1月—2022年6月我院收治的老年骨质疏松性PHF患者90例,按照随机数字表法分为观察组和对照组两组,每组各45例。两组术后均行常规治疗,其中对照组术后1 d给予伊班膦酸钠注射液;观察组术后1 d行自拟壮骨益气汤内服,联合伊班膦酸钠注射液治疗。连续观察12周。比较两组患者肩关节肿痛与功能改善、骨折愈合时间、骨折愈合治疗效果、氧化应激指标血清血红素加氧酶-1(HO-1)与超氧化物歧化酶(SOD)水平。结果:治疗12周后,两组肩关节运动疼痛(VAS)评分、肿胀、肩关节功能康斯坦特(Constant)评分比较差异有统计学意义(t=10.609、6.548、2.801,均P<0.05);治疗12周后,两组腰椎正位(L2-4)、右跟骨的骨密度与骨折愈合时间差异有统计学意义(t=2.030、2.187、7.029,均P<0.05);治疗12周后,观察组的骨折愈合总有效率(88.89%)高于对照组(68.89%),差异有统计学意义(χ^(2)=4.270,P<0.05);治疗1周后,两组血清HO-1、SOD水平比较差异有统计学意义(t=10.073、7.138,P<0.05)。结论:自拟壮骨益气汤联合伊班膦酸钠治疗有助于老年骨质疏松性PHF术后患者肩关节功能的康复,提高骨密度,促进骨折愈合,以及改善氧化应激反应。

Objective To investigate the efficacy of Zhuanggu Yiqi decoction combined with Ibandronate sodium in the treatment of senile osteoporotic proximal humerus fracture(PHF).Methods Ninety elderly osteoporotic PHF patients admitted to Kunshan integrated traditional Chinese medicine and Western medicine hospital from January of 2020 to June of 2022 were selected as the subjects of this study and divided into two groups by referring to random number table method.The two groups received routine treatment after surgery.The control group received ibandronate sodium injection 1 day after surgery,and the observation group were orally administered with Zhuanggu Yiqi decoction 1 day after surgery on the basis of the control group.Ninety patients were observed for 12 weeks.The effects of shoulder joint swelling pain and functional improvement,fracture healing time,fracture healing therapeutic effect,oxidative stress indexes serum levels of heme oxygenase-1(HO-1)and superoxide dismutase(SOD)were compared between the two groups.Results After 12 weeks of treatment,the visual analog scale(VAS)score,swelling and Constant score of shoulder joint function were significantly different between the two groups(t=10.609,6.548,2.801,all P<0.05).After 12 weeks of treatment,there were significant differences in bone density and healing time of lumbar vertebrae(L2-4)and right calcaneal bone between the two groups(t=2.030,2.187,7.029,all P<0.05).After 12 weeks of treatment,the total effective rate of fracture healing in the observation group(88.89%)was more significantly improved than that in the control group(68.89%),and the difference was statistically significant(χ^(2)=4.270,P<0.05).After 1 week of treatment,there were significant differences in serum HO-1 and SOD levels between the two groups(=10.073,7.138,all<0.05).Conclusion In this study,Zhuanggu Yiqi decoction combined with Ibandronate sodium in the treatment of senile osteoporotic PHF can help shoulder joint function rehabilitation of the elderly osteoporotic PHF patients after surgery,improve bone density,promote fracture healing,improve oxidative stress response.