[1]吴鹏,王博,孔令成,等.强骨饮颗粒联合阿仑膦酸钠维D3片口服在原发性骨质疏松性髋部骨折术后抗骨质疏松治疗中的应用[J].中医正骨,2016,28(05):16-19.
　WU Peng,WANG Bo,KONG Lingcheng,et al.Oral application of Qiangguyin Keli(强骨饮颗粒)and alendronate sodium Vitamin D3 tablets in postoperative anti-osteoporosis treatment in patients with primary osteoporotic hip fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(05):16-19.
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强骨饮颗粒联合阿仑膦酸钠维D3片口服在原发性骨质疏松性髋部骨折术后抗骨质疏松治疗中的应用()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年05期
页码:
16-19
栏目:
临床研究
出版日期:
2016-05-20

文章信息/Info

Title:
Oral application of Qiangguyin Keli(强骨饮颗粒)and alendronate sodium Vitamin D3 tablets in postoperative anti-osteoporosis treatment in patients with primary osteoporotic hip fractures
作者:
吴鹏1; 王博1; 孔令成1; 刘康2; 史晓林2
1.浙江中医药大学,浙江 杭州 310053;
2.浙江省新华医院,浙江 杭州 310005
Author(s):
WU Peng1; WANG Bo1; KONG Lingcheng1; LIU Kang2; SHI Xiaolin2
1.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China
2.Zhejiang Xinhua hospital,Hangzhou 310005,Zhejiang,China
关键词:
骨质疏松性骨折;  髋骨折;  骨折固定术;  骨密度;  强骨饮
Keywords:
osteoporotic fractures;  hip fractures;  fracture fixation;  bone density;  Qianggu Yin
摘要:
目的:探讨强骨饮颗粒联合阿仑膦酸钠维D3片口服用于原发性骨质疏松性髋部骨折术后抗骨质疏松治疗的临床疗效及安全性。方法:原发性骨质疏松性髋部骨折患者68例,随机分为2组,每组34例。2组患者由同一组医生行骨折固定术。术后第1天开始,观察组口服阿仑膦酸钠维D3片,每次1粒,每周1次; 强骨饮颗粒,每次4 g,每日2次。对照组单纯口服阿仑膦酸钠维D3片。连续服用6个月。观察骨折愈合情况,记录骨折愈合时间。分别于术前和术后6个月检测两组患者腰椎及健侧股骨颈骨密度,并采用视觉模拟量表(visual analogue scale,VAS)对患髋疼痛情况进行评价。观察2组患者的不良反应和并发症。结果:采用切开复位动力髋螺钉内固定32例,采用切开复位股骨近端髓内钉内固定33例,采用外固定架固定3例; 68例患者均获随访,随访时间6～9个月,中位数7个月。观察组骨折愈合34例,愈合时间(3.154±0.448)个月; 对照组骨折愈合33例,愈合时间(4.215±0.520)个月; 2组患者骨折愈合时间比较,差异有统计学意义(t=8.956,P=0.032)。术后6个月,2组患者腰椎和健侧股骨颈骨密度均较术前增加[(0.687±0.036)g·cm-2,(0.697±0.028)g·cm-2,t=0.175,P=0.008;(0.685±0.037)g·cm-2,(0.690±0.026)g·cm-2,t=0.074,P=0.035;(0.577±0.104)g·cm-2,(0.734±0.102)g·cm-2,t=0.250,P=0.012;(0.578±0.106)g·cm-2,(0.658±0.099)g·cm-2,t=0.110,P=0.024]; 且观察组高于对照组[(0.697±0.028)g·cm-2,(0.690±0.026)g·cm-2,t=2.031,P=0.023;(0.734±0.102)g·cm-2,(0.658±0.099)g·cm-2,t=3.117,P=0.027]; 2组患者患髋疼痛VAS评分均较术前降低[(5.541±0.732)分,(0.890±0.663)分,t=7.428,P=0.000;(5.494±0.895)分,(2.182±0.676)分,t=4.562,P=0.033],且观察组VAS评分低于对照组[(0.890±0.663)分,(2.182±0.676)分,t=7.997,P=0.031]。服药期间2组患者均未出现不良反应。对照组并发骨折不愈合1例,术后7个月行人工全髋关节置换术。结论:对于原发性骨质疏松性髋部骨折患者,术后应用强骨饮颗粒联合阿仑膦酸钠维D3片口服进行抗骨质疏松治疗,较单纯口服阿仑膦酸钠维D3片能更好地增加骨密度、缓解疼痛,更有利于骨折愈合,且安全可靠。
Abstract:
Objective:To explore the clinical curative effect and safety of oral application of Qiangguyin Keli(强骨饮颗粒,QGYKL)and alendronate sodium Vitamin D3 tablets in postoperative anti-osteoporosis treatment in patients with primary osteoporotic hip fractures.Methods:Sixty-eight patients with primary osteoporotic hip fractures were randomly divided into 2 groups,34 cases in each group.The patients were treated with fracture fixation by the same group of surgeons.Since the 1st day after the surgery,the patients in observation group were treated with oral application of alendronate sodium Vitamin D3 tablets(one tablet at a time,once a week)and QGYKL(4 g at a time,twice a day),while the patients in control group were treated with oral application of only alendronate sodium Vitamin D3 tablets for 6 consecutive months.The fracture healing was observed and the fracture healing time was recorded.The BMD of lumbar vertebra and femoral neck of uninjured side were detected before the surgery and at 6 months after the surgery respectively,and the hip pain was evaluated by using visual analogue scale(VAS).Moreover,the adverse reactions and complications were observed and compared between the 2 groups. Results:The patients were treated with open reduction and dynamic hip screw(DHS)internal fixation(32),open reduction and proximal femoral nail(PFN)internal fixation(33)and external fixator fixation(3)respectively.All patients in the 2 groups were followed up for 6-9 months with a median of 7 months.The fracture healing was found in 34 cases and the healing time was 3.154+/-0.448 months in observation group,while the fracture healing was found in 33 cases and the healing time was 4.215+/-0.520 months in control group.There was statistical difference in the fracture healing time between the 2 groups(t=8.956,P=0.032).The BMD of lumbar vertebra and femoral neck of uninjured side increased in the 2 groups at 6 months after the surgery(0.687+/-0.036 vs 0.697+/-0.028 g/cm(2),t=0.175,P=0.008; 0.685+/-0.037 vs 0.690+/-0.026 g/cm(2),t=0.074,P=0.035; 0.577+/-0.104 vs 0.734+/-0.102 g/cm(2),t=0.250,P=0.012; 0.578+/-0.106 vs 0.658+/-0.099 g/cm(2),t=0.110,P=0.024),and the BMD were higher in observation group compared to control group(0.697+/-0.028 vs 0.690+/-0.026 g/cm(2),t=2.031,P=0.023; 0.734+/-0.102 vs 0.658+/-0.099 g/cm(2),t=3.117,P=0.027).The hip pain VAS scores decreased in the 2 groups at 6 months after the surgery(5.541+/-0.732 vs 0.890+/-0.663 points,t=7.428,P=0.000; 5.494+/-0.895 vs 2.182+/-0.676 points,t=4.562,P=0.033).The hip pain VAS scores were lower in observation group compared to control group(0.890+/-0.663 vs 2.182+/-0.676 points,t=7.997,P=0.031).No adverse reactions were found in the 2 groups during the treatment.One patient with fracture nonunion was found in control group and was treated with total hip arthroplasty at 7 months after the surgery.Conclusion:For postoperative treatment of osteoporosis in patients with primary osteoporotic hip fractures,oral application of QGYKL and alendronate sodium Vitamin D3 tablets can better increase bone density and relieve hip pain and is more conducive to fracture healing than the monotherapy of oral application of alendronate sodium Vitamin D3 tablets.Moreover,it is safe and reliable.

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备注/Memo

备注/Memo:
通讯作者:史晓林 E-mail:xlshi-2002@163.com
更新日期/Last Update: 2016-10-30