温阳补肾法治疗胸腰椎骨质疏松性骨折内固定术后骨不愈合疗效及其对血清网膜素-1、转化生长因子β1、铁蛋白水平的影响  

Efficacy of self-made Wenyang Bushen Formula on serum Omentin-1,TGF-β1 and SF in thoracolumbar osteoporotic fracture patients with internal fixation-associated bone nonunion

作　　者：周南邻 王彩霞 范小春 韦林 ZHOU Nanlin;WANG Caixia;FAN Xiaochun;WEI Lin(North Sichuan Medical College,Nanchong,Sichuan 637000;Nanchong Hospital of Traditional Chinese Medicine Affiliated to North Sichuan Medical College,Nanchong,Sichuan 637000;Key Laboratory of Traditional Chinese Medicine for the Prevention and Treatment of Muscle and Bone Diseases in Nanchong,Nanchong,Sichuan 637000)

机构地区：[1]川北医学院,四川南充637000 [2]川北医学院附属南充市中医医院,四川南充637000 [3]筋骨病中医药防治南充市重点实验室,四川南充637000

出　　处：《河北中医》2025年第1期31-35,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：四川省中医药管理局研发资金项目(编号:2021MS374);南充市哲学社会科学重点研究基地名老中医医案研究中心2022年度资助项目,(编号:YAZX22-ZD-03);南充市市级科技计划项目(编号:NCKL202204)。

摘　　要：目的 观察温阳补肾药方治疗胸腰椎骨质疏松性骨折行内固定术后骨不愈合患者的临床疗效,以及对血清网膜素-1(Omentin-1)、转化生长因子(TGF-β1)和铁蛋白(SF)水平的影响。方法 选取2021年4月至2022年10月收治的80例胸腰椎骨质疏松性骨折内固定术后骨不愈合的患者为研究对象,按照随机数字表法分为中药组(45例)、对照组(35例)。对照组采用常规西药保守治疗,中药组在对照组基础上加温阳补肾药方治疗。2组均治疗3个月后评价疗效,比较2组治疗前及治疗后3、6个月骨痂生长评分、中医证候积分,比较治疗前及治疗后1、3、6个月Omentin-1、TGF-β1和SF水平变化。结果 中药组总有效率95.56%(43/45),对照组总有效率74.29%(26/35),治疗组总有效率高于对照组(P<0.05)。治疗后2组第3、6个月与治疗前比较骨痂生长积分均提高(P<0.05),且中药组治疗第3、6个月骨痂生长积分显著高于对照组治疗同期(P<0.05)。治疗后2组第3、6个月与治疗前比较中医证候积分均降低(P<0.05),且中药组治疗第3、6个月中医证候积分低瘀对照组治疗同期(P<0.05)。治疗后2组第1、3、6个月与治疗前比较血清Omentin-1、TGF-β1水平均升高(P<0.05),SF水平均降低(P<0.05),且中药组治疗第1、3、6个月血清Omentin-1、TGF-β1及SF水平改善显著优于对照组同期(P<0.05)。结论 温阳补肾药方对胸腰椎骨质疏松性骨折行内固定术后骨不愈合患者的临床疗效确切,可提高患者血清Omentin-1、TGF-β1水平,降低SF水平,促进术后患者骨修复及愈合,抑制炎症反应,提高临床疗效。Objective To investigate the clinical efficacy of self-made Wenyang Bushen Formula in the treatment of thoracolumbar osteoporotic fracture(OTLF)patients with internal fixation-associated bone nonunion and its influence on serum omentin-1,transforming growth factor-beta1(TGF-β1)and serum ferritin(SF)levels.Methods This retrospective analysis included 80 OTLF patients with internal fixation-associated bone nonunion in the Department of Orthopedics of our hospital from April 2021 to October 2022.They were randomly devided into traditional Chinese medicine(TCM)group(n=45)and control group(n=35).All patients were managed by routine Western medicine(RWM),and those in TCM group were additionally treated with self-made Wenyang Bushen Formula.Treated for 3 months,the aim was to compare callus growth score and TCM syndrome score,omentin-1,TGF-β1 and SF from base to months 3 and 6 of treatment.The curative effect was assessed.Results The overall effective rate in the TCM group was significantly higher than that in the control group(95.56%[43/45]vs 74.29%[26/35],P<0.05).The callus growth scores on months 3 and 6 after treatment in the both groups were significantly increased than those before treatment(P<0.05),which increased notably in the TCM group compared with the control group(P<0.05).TCM scores on months 3 and 6 after treatment in the both groups were significantly decreased than those before treatment(P<0.05),which were significantly lower in the TCM group than in the control group(P<0.05).On months 1,3 and 6,significantly increased omentin-1 and TGF-β1,and decreased SF levels were found in the both groups than those before treatment(all P<0.05),and the TCM group was superior to the control group for omentin-1,TGF-β1 and SF levels(all P<0.05).Conclusion The self-made Wenyang Bushen Formula can increase serum omentin-1 and TGF-β1 levels,reduce SF levels,promote postoperative bone repair and healing,inhibit inflammatory response,and improve clinical efficacy in OTLF patients with internal fixation-associated bone n

关 键 词：骨质疏松骨折 术后康复 骨折愈合 中药疗法 温阳补肾 

分 类 号：R681.1[医药卫生—骨科学]