强骨饮对骨质疏松性股骨颈骨折患者全髋关节置换术后血清骨代谢生化指标和骨密度的影响  

Effect of Qianggu Yin( 强骨饮,QGY) on serum bone metabolism indexes and bone density after total hip arthroplasty in patients with osteoporotic femoral neck fractures

作　　者：徐伟锋 叶健[2] 吴连国[2] 

机构地区：[1]浙江省诸暨市第二人民医院,浙江诸暨311811 [2]浙江中医药大学附属第二医院,浙江杭州310005

出　　处：《中医正骨》2015年第2期12-16,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：中国博士后科学基金项目(2013M530290);高等学校博士学科点专项科研基金(20133322120004);浙江省医坛新秀培养对象资助项目(浙卫发〔2013〕245号)

摘　　要：目的:探讨强骨饮对骨质疏松性股骨颈骨折患者全髋关节置换术后骨代谢生化指标及骨密度的影响。方法:骨质疏松性股骨颈骨折患者50例,随机分为2组,每组25例;2组患者均进行全髋关节置换术,术后分别给予强骨饮和钙尔奇D片口服。分别于术前及术后3个月检测血清骨碱性磷酸酶(bone alkaline phosphatase,BALP)及抗酒石酸酸性磷酸酶5b(tartrate resistant acid phosphatase 5b,TRACP5b)含量及健侧股骨颈骨密度,并进行比较。结果:1骨代谢生化指标。术前2组患者血清BALP含量及TRACP5b含量比较,组间差异均无统计学意义[(70.60±3.34)单位·L-1,(71.00±2.47)单位·L-1,t=0.483,P=0.127;(5.56±1.27)单位·L-1,(5.60±1.32)单位·L-1,t=0.109,P=0.324]。术后3个月强骨饮组血清BALP含量高于钙尔奇D片组,血清TRACP5b含量低于钙尔奇D片组[(73.00±3.53)单位·L-1,(71.40±2.26)单位·L-1,t=2.502,P=0.024;(3.54±1.25)单位·L-1,(5.56±1.29)单位·L-1,t=5.622,P=0.009];强骨饮组血清BALP含量较术前升高(t=3.046,P=0.008),而血清TRACP5b含量较术前降低(t=5.745,P=0.007);钙尔奇D片组血清BALP含量及TRACP5b含量与术前比较,差异均无统计学意义(t=0.236,P=0.257;t=0.132,P=0.408)。2骨密度。术前强骨饮组健侧股骨颈骨密度与钙尔奇D片组比较,差异无统计学意义[(0.77±0.24)g·cm-2,(0.81±0.25)g·cm-2,t=0.547,P=0.352]。术后3个月强骨饮组健侧股骨颈骨密度高于钙尔奇D片组[(1.81±0.25)g·cm-2,(0.83±0.26)g·cm-2,t=13.776,P=0.004];强骨饮组健侧股骨颈骨密度较术前升高(t=2.426,P=0.032),而钙尔奇D片组健侧股骨颈骨密度与术前比较,差异无统计学意义(t=0.020,P=0.763)。结论:口服强骨饮能改善骨质疏松性股骨颈骨折患者全髋关节置换术后的骨代谢,提高骨密度。Objective： To explore the effect of Qianggu Yin（ 强骨饮,QGY） on serum bone metabolism indexes and bone mineral density（ BMD） after total hip arthroplasty（ THA） in patients with osteoporotic femoral neck fractures. Methods： Fifty patients with osteoporotic femoral neck fractures were randomly divided into 2 groups,25 cases in each group. The patients were treated with THA and oral application of QGY（ QGY group） and Caltrate D tablets（ Caltrate D group） after the surgery. The serum contents of bone alkaline phosphatase（ BALP）and tartrate resistant acid phosphatase 5b（ TRACP5b） and BMD of uninjured femoral neck were detected and compared between the two groups before the surgery and at 3 months after the surgery. Results： There was no statistical difference in serum contents of BALP and TRACP5 b between the 2 groups before the surgery（ 70. 60 ＋ /- 3. 34 vs 71. 00 ＋ /- 2. 47 unit / L,t = 0. 483,P = 0. 127; 5. 56 ＋ /- 1. 27 vs5. 60 ＋ /- 1. 32 unit / L,t = 0. 109,P = 0. 324）. The serum BALP contents were higher,and the serum TRACP5 b contents were lower in QGY group compared to Caltrate D group at 3 months after the surgery（ 73. 00 ＋ /- 3. 53 vs 71. 40 ＋ /- 2. 26 unit / L,t = 2. 502,P = 0. 024;3. 54 ＋ /- 1. 25 vs 5. 56 ＋ /- 1. 29 unit / L,t = 5. 622,P = 0. 009）. The serum BALP contents of QGY group increased after the treatment（ t =3. 046,P = 0. 008）,while the serum TRACP5 b contents decreased（ t = 5. 745,P = 0. 007）. There was no statistical difference in serum contents of BALP and TRACP5 b between pre-operation and postoperation in Caltrate D group（ t = 0. 236,P = 0. 257; t = 0. 132,P = 0. 408）.There was no statistical difference in BMD of uninjured femoral neck between QGY group and Caltrate D group before the surgery（ 0. 77 ＋/- 0. 24 vs 0. 81 ＋/- 0. 25 g/cm（ 2）,t = 0. 547,P = 0. 352）. The QGY group surpassed the Caltrate D group in BMD of uninjured femoral neck at 3 months after the surgery（ 1. 81 ＋ /- 0. 25 vs 0. 83 ＋ /- 0.

关 键 词：关节成形术 置换 髋 股骨颈骨折 骨质疏松 中药疗法 强骨饮 骨代谢 骨密度 治疗 临床研究性 

分 类 号：R580[医药卫生—内分泌] R687.3[医药卫生—内科学]