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  

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] 

机构地区：[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

出　　处：《中医正骨》2016年第5期16-19,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

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- 9months 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.

关 键 词：骨质疏松性骨折 髋骨折 骨折固定术 骨密度 强骨饮 

分 类 号：R580[医药卫生—内分泌] R687.3[医药卫生—内科学]