强骨饮对股骨颈骨折患者人工股骨头置换术后假体周围骨密度的影响  

Effect of QIANGGU DRINK on peri-prosthetic bone density after artificial femoral head replacement in patients with femoral neck fractures

作　　者：吴连国[1] 刘康[1] 黄俊俊[1] 毛应德龙[1] 陈华[2] 史晓林[1] 

机构地区：[1]浙江中医药大学附属第二医院,浙江杭州310005 [2]浙江中医药大学附属第三医院,浙江杭州310005

出　　处：《中医正骨》2014年第4期15-18,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：中国博士后科学基金项目(2013M530290);国家中医药管理局2013年度中医药行业科研专项项目(201307010);浙江省自然科学基金资助项目(LY12H27013);浙江省医坛新秀培养对象资助项目(浙卫发2013-245号);浙江省博士后科研项目择优资助项目(BSH1302082);2013年浙江省医药卫生科技计划项目(2013KYA143)

摘　　要：目的：探讨强骨饮对股骨颈骨折患者人工股骨头置换术后假体周围骨密度的影响。方法：股骨颈骨折患者78例,按就诊顺序随机分为观察组和对照组,每组39例;2组患者均进行人工股骨头置换术,术后分别采用口服钙尔奇D片和强骨饮及单纯口服钙尔奇D片进行干预。观察2组患者术后髋关节功能恢复情况;将人工假体柄周围分为7个区（R1-R7）,测量2组患者各区术后1周、术后3个月、术后6个月时假体周围的骨密度,并进行比较。结果：78例患者均顺利完成手术,74例获得随访,观察组失访3例,对照组失访1例;随访时间9-24个月,中位数18.5个月;患肢疼痛缓解、髋关节功能恢复。参照Harris髋关节评分标准对患肢髋关节进行评分,治疗组（87.5±7.6）分,对照组（86.7±8.1）分,2组间差异无统计学意义（t=10.437,P=0.896）。均无假体松动等并发症发生。R1区,各时间点间骨密度值比较,差异有统计学意义（F=76.367,P=0.000）,存在时间效应;2组间骨密度值比较,差异有统计学意义（F=6.375,P=0.001）,存在分组效应;术后1周,2组间骨密度值比较,差异无统计学意义[（0.772±0.214）g·cm^-2,（0.761±0.178）g·cm^-2;t=0.578,P=0.683）;术后3个月、术后6个月,观察组骨密度值均高于对照组[（0.758±0.268）g·cm^-2,（0.602±0.244）g·cm^-2;t=2.232,P=0.024;（0.732±0.227）g·cm^-2,（0.518±0.188）g·cm^-2;t=2.847,P=0.004）];时间因素和分组因素存在交互效应（F=36.726,P=0.000）。R2-R6区骨密度值[R2：（1.532±0.342）g·cm^-2,（1.478±0.451）g·cm^-2,（1.432±0.403）g·cm^-2;（1.613±0.268）g·cm^-2,（1.582±0.265）g·cm^-2,（1.533±0.275）g·cm^-2。R3：（1.746±0.276）g·cm^-2,（1.641±0.324）g·cm^-2,（1.615±0.327）g·cm^-2;（1.692±0.312）g·cm^-2,（1.634±0.403）g·cm^-2,（1.589±0.157）g·cm^-2。R4：（1.831±0.302）g·cm^-2,（1.768±0.256）g·cm^-2,（1.711±0.236）g·cm^-2;（1.798±0.275）g·cm^-2,（1.73Objective：To study the effect of QIANGGU DRINK on peri-prosthetic bone density after artificial femoral head replacement in patients with femoral neck fractures. Methods：Seventy-eight patients with femoral neck fractures were randomly divided into observation group and control group according to the visit sequence,39 cases in each group. All of the patients in the 2 groups were treated with artificial femoral head replacement, and then they were treated with oral application of caltrate D tablets combined with QIANGGU DRINK and monotherapy of oral application of cahrate D tablets respectively. Postoperative hip function restoration were reviewed and compared between the 2 groups. The areas around artificial prosthesis stem were divided into 7 zones （ R＋ - R＋ ） and the bone density was measured in each zone and compared between the 2 groups at 1 week and 3 and 6 months after the surgery. Results：The surgery were performed successfully in all the patients and 74 patients were available for follow-up. Three patients lost to follow-up in observation group and one patient lost to follow-up in control group. The median follow-up period was 18.5 years（ range,9 -24 months）. The pain were relieved and the function of the hip joint were recovered in all the patients. The hip performance were evaluated according to the Harris Hip Score and the results showed that there was no statistical difference between the 2 groups （ 87.5 ＋/- 7.6 vs 86.7 ＋/- 8.1 points, t = 10. 437, P = 0. 896）. No complications such as prosthesis loosening were found in the two groups. There was statistical difference in the bone density between different time points in R1 zone （ F = 76. 367, P = 0.000）, in other words, there was time effect. There was statistical difference in the bone density between the 2 groups （ F = 6. 375, P = 0.001 ）, in other words, there was group effect. There was no statistical difference in the bone density between the 2 groups one week after the surgery（0. 772 ＋/- 0. 214 vs 0. 761

关 键 词：关节成形术 置换 髋 骨密度 股骨颈骨折 手术后并发症 强骨饮 

分 类 号：R687.3[医药卫生—骨科学]