活血通脉胶囊对老年股骨粗隆间骨折术后炎症因子的影响  

Huoxuetongmai capsule on inflammatory cytokines in elderly patients after femoral intertrochanteric fracture surgery

作　　者：李金岭 连振刚 宋伟 王建华 吴永东 李占鹏 

机构地区：[1]张家口市第一医院,河北张家口075000

出　　处：《长春中医药大学学报》2016年第6期1217-1219,共3页Journal of Changchun University of Chinese Medicine

基　　金：张家口市科技攻关计划项目(1521047D)

摘　　要：目的探讨活血通脉胶囊对老年股骨粗隆间骨折术后炎症因子的影响。方法选取2015年5月—2016年5月在我院行股骨近端防旋髓内钉(PFNA)治疗的80例老年股骨粗隆间骨折患者为研究对象,按随机数字表法分为治疗组与对照组,各40例,2组采用硬膜外或全身麻醉下行闭合复位PFNA内固定术,术后常规抗凝、抗感染、功能锻炼等,治疗组在对照组基础上口服活血通脉胶囊1粒/次,2次/d,连续治疗2周;于术前和用药后1、7、14 d分别抽取空腹外周静脉血,ELISA法检测C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平;血生化仪测定血红蛋白(HGB)含量;记录术后疼痛缓解时间、下地活动时间、骨折愈合时间。结果 2组术后各炎症因子水平呈先升后降趋势,用药后1 d达高峰,用药后7、14 d逐渐降低,各时间点比,P<0.05,其中IL-10用药后1 d 2组无统计学意义,其余时间点治疗组CRP、IL-6、IL-10、TNF-α水平均低于对照组(P<0.05);2组用药后HGB呈先降后升趋势,用药后1 d降至最低,用药后7、14 d逐渐上升,各时间点比较,P<0.05,其中治疗组HGB变化程度优于对照组(P<0.05);治疗组疼痛缓解时间、下地活动时间、骨折愈合时间均短于对照组(P<0.05)。结论活血通脉胶囊可明显减轻老年股骨粗隆间骨折患者围术期炎症反应,有效促进骨折愈合,减少隐性失血引起的HGB下降,减少并发症的发生。Objective To explore the effect of Huoxuetongmai capsule on the inflammatory cytokines in elderly patients after femoral intertrochanteric fracture surgery. Methods A total of 80 elderly patients with femoral intertrochanteric fracture who were admitted in our hospital from May,2015 to May,2016 for PFNA were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the two groups were performed with PFNA internal fixation of closed reduction under epidural or general anesthesia,and were given routine anti-coagulation,anti-infection,and functional exercise after operation. On this basis,the patients in the observation group were given Huoxuetongmai capsule,1 capsule / time,2 times / d,continuously for 2 weeks. The fasting peripheral venous blood before operation,1,7,and 14 d after medication was extracted. ELISA was used to detect CRP,IL-6,IL-10,and TNF-α levels. The blood biochemical analyzer was used to determine HGB content. The postoperative pain relieving time,out-of-bed activity time,and fracture healing time were recorded. Results The comparison of serum CRP,IL-6,IL-10,and TNF-α levels before operation between the two groups was not statistically significant（ P 〈0. 05）. After operation,the serum CRP,IL-6,IL-10,and TNF-α levels were elevated first and reduced later,reached the peak 1d after medication,were gradually reduced 7d and 14 d after medication,and the comparison among each timing point was statistically significant（ P 〈0. 05）. The comparison of IL-10 1d after medication between the two groups was not statistically significant（ P 〈0. 05）. The serum CRP,IL-6,IL-10,and TNF-α levels in the rest timing points in the observation group were significantly lower than those in the control group（ P 〈0. 05）. The comparison of HGB content before operation between the two groups was not statistically significant（ P 〈0. 05）. After medication,HGB was reduced first and elevated later,reduced the lowest 1d after

关 键 词：活血通脉胶囊 老年 股骨粗隆间骨折 术后 炎症因子 

分 类 号：R274.9[医药卫生—中西医结合]