参骨方对脾虚湿困型老年骨质疏松性骨折患者术后疗效影响研究  

Study on the Influence of Shengufang Granules on Postoperative Efficacy of Elderly Patients with Osteoporotic Fractures of Spleen Deficiency with Dampness Retention Type

作　　者：陈晓聪 吕朝晖[2] 曾家莹 黄栩研 李伟举[2] CHEN Xiao-Cong;LYU Zhao-Hui;ZENG Jia-Ying;HUANG Xu-Yan;LI Wei-Ju(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广东省第二中医院,广东广州510095

出　　处：《广州中医药大学学报》2024年第2期348-353,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20221023);广州市科技局科技计划项目(编号:202102080119)。

摘　　要：【目的】观察参骨方颗粒剂(以参苓白术散合四妙散为基础方进行加减)对脾虚湿困型老年骨质疏松性骨折患者术后疗效、中医证候、骨折愈合及骨密度的影响。【方法】将80例脾虚湿困型老年骨质疏松性骨折患者随机分为治疗组和对照组,每组各40例。对照组给予服用骨化三醇胶囊治疗,治疗组在对照组的基础上给予参骨方颗粒剂治疗,疗程均为8周。观察2组患者治疗前后中医证候积分、骨密度值及骨代谢指标的变化情况,并比较2组患者的骨折愈合时间及术后疗效。【结果】(1)疗效方面,治疗8周后,治疗组的总有效率为87.50%(35/40),对照组为67.50%(27/40),组间比较,治疗组的疗效明显优于对照组(P<0.05)。(2)中医证候积分方面,治疗后,2组患者的中医证候积分均较治疗前明显下降(P<0.01),且治疗组对中医证候积分的下降幅度明显优于对照组(P<0.01)。(3)骨代谢指标方面,治疗后,2组患者的血清骨钙素(OC)水平均较治疗前明显升高(P<0.05),血清Ⅰ型原胶原氨基端前肽(PINP)水平均较治疗前明显下降(P<0.05);而血清β-胶原交联羧基端肽(β-CTX)水平方面,治疗组患者较治疗前明显下降(P<0.05),对照组患者较治疗前有下降趋势,但差异无统计学意义(P>0.05);组间比较,治疗组对血清OC水平的升高幅度及对血清PINP、β-CTX水平的下降幅度均明显优于对照组(P<0.05)。(4)骨密度值方面,治疗后,2组患者的骨密度值均较治疗前明显升高(P<0.05),且治疗组对骨密度值的升高幅度明显优于对照组(P<0.05)。(5)骨折愈合时间方面,经过8周治疗后,治疗组患者的股骨骨折、桡骨骨折、胫骨骨折、肱骨骨折的骨折愈合时间均较对照组明显缩短(P<0.05)。【结论】参骨方颗粒剂可显著改善脾虚湿困型老年骨质疏松性骨折患者的术后临床症状和脾虚湿困症状,改善骨代谢,促进骨质疏松性骨折的愈合。Objective To observe the influence of Shengufang Granules(developed from the modification of Shenling Baizhu Powder plus Simiao Powder)on the postoperative therapeutic efficacy,traditional Chinese medicine(TCM)syndromes,healing of the fractures,and bone mineral density(BMD)of elderly patients with osteoporotic fractures of spleen deficiency with dampness retention syndrome.Methods Eighty cases of postoperative patients with osteoporotic fractures of spleen deficiency with dampness retention type were randomly divided into treatment group and control group,40 cases in each group.The control group was given oral use of Rocaltrol Capsules,and the treatment group was treated with Rocaltrol Capsules combined with Shengufang Granules orally for 8 weeks.Before and after treatment,the two groups were observed in the changes of TCM syndrome scores,BMD value and bone metabolism indicators.Moreover,the time for fracture healing and postoperative efficacy were compared between the two groups.Results(1)After 8 weeks of treatment,the total effective rate of the treatment group was 87.50%(35/40)and that of the control group was 67.50%(27/40),and the intergroup comparison showed that the efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(2)After treatment,the TCM syndrome scores in the two groups were decreased compared with those before treatment(P<0.01),and the decrease of TCM syndrome scores in the treatment group was significantly superior to that in the control group(P<0.01).(3)After treatment,the level of serum bone metabolism indicator of osteocalcin(OC)in the two groups was significantly higher(P<0.05)and the serum level of procollagen type 1 N-terminal propeptide(PINP)was significantly lower than the pre-treatment levels(P<0.05).For the serumβ-collagen cross-linked C-telopeptide(β-CTX),its level was decreased in the treatment group(P<0.05)while tended to decrease in the control group when compared with the pre-treatment period,and the difference was not statistically signi

关 键 词：参骨方颗粒剂 参苓白术散 四妙散 老年骨质疏松性骨折 脾虚湿困 术后疗效 骨密度 骨折愈合 

分 类 号：R274.9[医药卫生—中西医结合]