2018 年第 7 期 第 13 卷

骨疏康胶囊联合股骨近端防旋髓内钉内固定治疗老年骨质疏松性股骨粗隆间骨折的临床效果

Clinical effect of Gushukang capsules combined with proximal femoral anti-spin intramedullary nail fixation on elderly patients with osteoporotic intertrochanteric fracture of femur

作者：龚健梁俊生张洪斌张辉良张静梅刘丽云

英文作者：

单位：063000河北省唐山市第二医院老年骨科（龚健、梁俊生、张洪斌、张辉良、张静梅）；063000河北省唐山市工人医院病理科（刘丽云）

英文单位：

关键词：股骨粗隆间骨折；骨质疏松；股骨近端防旋髓内钉内固定；骨疏康胶囊

英文关键词：

• 摘要：

• 【摘要】目的    探讨骨疏康胶囊联合股骨近端防旋髓内钉内固定治疗老年骨质疏松性股骨粗隆间骨折的临床效果。方法    选取唐山市第二医院2014年7月至2017年1月收治的老年骨质疏松性股骨粗隆间骨折患者86例，按照随机数字表法分为观察组与对照组，各43例。2组均行股骨近端防旋髓内钉内固定治疗，在术后常规对症支持治疗及功能康复锻炼基础上，对照组给予阿法骨化醇软胶囊治疗，观察组给予骨疏康胶囊治疗，共治疗12周。比较2组手术时间、术中出血量、骨折愈合时间、手术前及术后12周骨代谢指标［血清骨钙素、骨碱性磷酸酶（BALP）］水平、中医证候积分，随访1年，比较2组手术前、术后12周、术后1年髋关节功能（Harris评分）。结果    2组手术时间、术中出血量比较，差异均无统计学意义（均P＞0.05），观察组骨折愈合时间短于对照组［（9.4±1.0）周比（10.5±1.4）周］，差异有统计学意义（P＜0.001）。术后12周，观察组血清骨钙素、BALP水平明显高于对照组，中医证候积分明显低于对照组［（6.3±1.5）μg/L比（5.2±1.4）μg/L、（99±8）U/L比（77±7）U/L、（5.4±0.7）分比（6.3±1.4）分］，差异均有统计学意义（均P＜0.05）。手术前2组Harris评分比较，差异无统计学意义（P＞0.05），术后12周及术后1年2组Harris评分均明显高于手术前，且观察组Harris评分均明显高于对照组，差异均有统计学意义（均P＜0.05）。结论    骨疏康胶囊联合股骨近端防旋髓内钉内固定治疗老年骨质疏松性股骨粗隆间骨折，可有效缩短骨折愈合时间，改善骨代谢及骨质疏松性骨折临床症状，有利于提高患者短、中期髋关节功能。

• 【Abstract】Objective    To investigate the clinical effect of Gushukang capsules combined with proximal femoral anti-spin intramedullary nail fixation on elderly patients with osteoporotic intertrochanteric fracture of femur. Methods    A total of 86 elderly patients with osteoporotic intertrochanteric fracture of femur were enrolled from July 2014 to January 2017 in the Second Hospital of Tangshan; they were randomly divided into observation group and control group, with 43 cases in each group. All patients had proximal femoral anti-spin intramedullary nail fixation; the control group took alfacalcidol soft capsules and the observation group took Gushukang capsules for 12 weeks plus conventional symptomatic support treatment and functional rehabilitation exercise after operation. Operation time, intraoperative blood loss volume and fracture healing time were recorded; bone metabolism indexes［serum osteocalcin and bone alkaline phosphatase(BALP)］ and traditional Chinese medicine（TCM） syndrome score were analyzed before and 12 weeks after operation; hip joint function score(the Harris score) was analyzed before and 12 weeks, 1 year after operation. Results    There were no significant differences of operation time and intraoperative blood loss volume between groups（P＞0.05）; fracture healing time in observation group was significantly shorter than that in control group［（9.4±1.0）weeks vs （10.5±1.4）weeks］（P＜0.05）. Levels of serum osteocalcin and BALP 12 weeks after operation in observation group were significantly higher and TCM syndrome score was significantly lower than those in control group［（6.3±1.5）μg/L vs（5.2±1.4）μg/L,（99±8）U/L vs（77±7）U/L,（5.4±0.7）vs（6.3±1.4）］（P＜0.05）. There was no significant difference of the Harris score between groups before operation（P＞0.05）; the Harris score 12 weeks and 1 year after operation was significantly higher than that before operation（P＜0.05）; the Harris score 12 weeks and 1 year after operation in observation group was significantly higher than that in control group（P＜0.05）. Conclusion    Gushukang capsules combined with anti-spin proximal femoral intramedullary nail fixation treating elderly patients with osteoporotic intertrochanteric fracture of femur can effectively shorten fracture healing time, improve bone metabolism, relieve clinical symptoms of fracture and improve short-and mid-term hip joint function recovery. 

  【Key words】Intertrochanteric fracture of femur；Osteoporosis；Proximal femoral anti-spin intramedullary nail fixation；Gushukang capsule

  【Fund program】Medical Science Research Key Project of Hebei Province（20171321）