机构地区:[1]首都医科大学附属北京中医医院,北京100010
出 处:《中医药学报》2024年第10期78-82,共5页Acta Chinese Medicine and Pharmacology
基 金:北京市自然科学基金项目(7222035)。
摘 要:目的:分析活血舒筋生骨汤联合针灸在股骨颈骨折内固定患者术后降低股骨头坏死的临床效果。方法:回顾性分析2021年1月—2023年12月在首都医科大学附属北京中医医院行股骨颈骨折内固定术的105例患者的临床资料,依据不同治疗方法分成联合组(53例)与对照组(52例)。两组患者均接受常规西医治疗,对照组患者另给予针灸治疗,联合组患者在对照组基础上加用活血舒筋生骨汤口服治疗。连续治疗1个月后,观察两组患者的中医证候积分、骨代谢指标、髋关节功能、疼痛程度及生活质量评分、临床疗效、不良反应发生情况。结果:治疗后,两组患者中医证候积分、股骨头坏死与主要并发症总发生率均降低(P<0.05),且联合组低于对照组(P<0.05);两组患者血清总Ⅰ型前胶原氨基端延长肽(tPⅠNP)、骨钙素(BGP)、碱性磷酸酶(ALP)、骨形态发生蛋白(BMP-2)水平、治疗总有效率及Harris评分与SF-36评分均升高(P<0.05),且联合组高于对照组(P<0.05);不良反应总发生率两组无明显差异(P>0.05)。结论:活血舒筋生骨汤联合针灸应用于股骨颈骨折内固定术患者,可有效缓解患者术后疼痛等临床症状,改善骨代谢情况与髋关节功能,降低股骨头坏死率,提高治疗效果,且安全性较高。Objective:To analyze the clinical effects of Huoxue Shujin Shenggu Decoction combined with acupuncture in reducing femoral head necrosis after internal fixation of femoral neck fractures.Methods:A retrospective analysis was conducted on the clinical data of 105 patients who underwent internal fixation for femoral neck fractures at Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,between January 2021 and December 2023.Based on different treatment methods,the patients were divided into the Combination Group(53 patients)and the Control Group(52 patients).Both groups received conventional Western medical treatment,with the Control Group additionally receiving acupuncture therapy.The Combination Group received oral Huoxue Shujin Shenggu Decoction in addition to the treatment given to the Control Group.After continuous treatment for one month,the two groups were assessed for Traditional Chinese Medicine(TCM)syndrome scores,bone metabolism indicators,hip joint function,pain levels,quality of life scores,clinical efficacy,and incidence of adverse reactions.Results:After treatment,both groups showed reductions in TCM syndrome scores,femoral head necrosis,and the total incidence of major complications(P<0.05),with the Combination Group showing lower rates compared to the Control Group(P<0.05).Serum levels of total Type Ⅰ pro-collagen N-terminal propeptide(tPⅠNP),osteocalcin(BGP),alkaline phosphatase(ALP),and bone morphogenetic protein-2(BMP-2),as well as overall treatment efficacy,Harris scores,and SF-36 scores were increased in both groups(P<0.05),with higher levels in the Combination Group compared to the Control Group(P<0.05).The total incidence of adverse reactions showed no significant difference between the two groups(P>0.05).Conclusion:The use of Huoxue Shujin Shenggu Decoction combined with acupuncture in patients undergoing internal fixation of femoral neck fractures can effectively alleviate postoperative pain and other clinical symptoms,improve bone metabolism and hip joint functio
关 键 词:股骨颈骨折 内固定术 股骨头坏死 活血舒筋生骨汤 针灸
分 类 号:R274.12[医药卫生—中医骨伤科学]
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