艾灸联合骨愈灵片对老年骨质疏松性股骨粗隆间骨折患者PFNA术后的影响  

Effect of Moxibustion Combined with Guyuling Tablets on Senile Patients with Osteoporotic Intertrochanteric Femur Fractures After PFNA

作　　者：宣超 王恒 林伟伟[1] 王家辉[1] 林立国[1] 王晨勋 叶晶[1] XUAN Chao;WANG Heng;LIN Weiwei;WANG Jiahui;LIN Liguo;WANG Chenxun;YE Jing(Taizhou Orthopedics Hospital,Wenling Zhejiang 317500,China)

机构地区：[1]台州骨伤医院,浙江温岭317500

出　　处：《新中医》2025年第3期144-149,共6页New Chinese Medicine

基　　金：温岭市社会发展科技项目(2022S00016)。

摘　　要：目的:观察艾灸联合骨愈灵片对老年骨质疏松性股骨粗隆间骨折(IFF)患者股骨近端防旋髓内钉(PFNA)术后的影响。方法:选取2021年8月—2023年12月台州骨伤医院进行PFNA手术的82例老年骨质疏松性IFF患者,按随机数字表法分为中药组及艾灸组各41例。中药组术后采用骨愈灵片口服治疗,艾灸组在中药组基础上加用补肾活血方艾灸。比较2组临床疗效及脆性骨折发生率,比较2组治疗前后疼痛视觉模拟评分法(VAS)评分、骨转换标志物[骨特异性碱性磷酸酶(BALP)、β-胶原降解产物(β-CTX)、抗酒石酸酸性磷酸酶5b (TRACP-5b)]、骨密度(BMD)、炎症因子[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)]、血管内皮因子指标值的变化。结果:艾灸组临床疗效总有效率为92.68%(38/41),中药组临床疗效总有效率为75.61%(31/41),2组比较,差异有统计学意义(P<0.05)。治疗后,2组VAS评分均较治疗前下降(P<0.05),艾灸组VAS评分低于中药组(P<0.05)。治疗后,2组BALP水平均较治疗前升高(P<0.05), β-CTX、 TRACP-5b水平均较治疗前下降(P<0.05);艾灸组BALP水平高于中药组(P<0.05),β-CTX、TRACP-5b水平均低于中药组(P<0.05)。治疗后,2组组内、组间BMD值比较,差异均无统计学意义(P>0.05)。治疗后,2组IL-6、IL-10、TNF-α水平均较治疗前下降(P<0.05),艾灸组上述3项水平均低于中药组(P<0.05)。治疗后,2组eNOS、NO水平均较治疗前升高(P<0.05),艾灸组eNOS、NO水平均高于中药组(P<0.05)。治疗后随访8个月,中药组脆性骨折发生率为24.39%(10/41),艾灸组脆性骨折发生率为4.88%(2/41),2组脆性骨折发生率比较,差异有统计学意义(P<0.05)。结论:艾灸联合骨愈灵片口服治疗老年骨质疏松性IFF患者PFNA术后效果较好,能调节骨代谢水平,抑制炎症因子表达,提高血管内皮因子水平,减少脆性骨折发生率,安全性高。Objective:To observe the effect of the combination use of moxibustion and Guyuling Tablets on senile patients with osteoporotic intertrochanteric femur fractures(IFF)after proximal femoral nail anti-rotation(PFNA).Methods:A total of 82 senile patients with osteoporotic IFF who underwent PFNA in Taizhou Orthopedics Hospital from August 2021 to December 2023 were selected and divided into the Chinese medicine group and the moxibustion group according to the random number table method,with 41 cases in each group.The Chinese medicine group was treated with Guyuling Tablets orally after PFNA,and the moxibustion group was additionally treated with moxibustion of Bushen Huoxue Prescription based on the treatment of the Chinese medicine group.The clinical effects and the incidence of fragility fracture,and the changes in the scores of Visual Analogue Scale(VAS)of pain,bone turnover markers[bone alkaline phosphatase(BALP),β-isomerized C-terminal telopepetides(β-CTX)and tartrate-resistant acid phosphatase isoform 5b(TRACP-5b)],bone mineral density(BMD),inflammatory factors[interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)]and vascular endothelial growth factors before and after treatment were compared between the two groups.Results:The total clinical effective rate was 92.68%(38/41)in the moxibustion group and 75.61%(31/41)in the Chinese medicine group,the difference being significant(P<0.05).After treatment,the VAS scores in the two groups were dwindled when compared with those before treatment(P<0.05),and the VAS score in the moxibustion group was lower than that in the Chinese medicine group(P<0.05).After treatment,the levels of BALP in the two groups were elevated when compared with those before treatment(P<0.05),and the levels ofβ-CTX and TRACP-5b were reduced when compared with those before treatment(P<0.05);the level of BALP in the moxibustion group was higher than that in the Chinese medicine group(P<0.05),and the levels ofβ-CTX and TRACP-5b were lower than those in the Chinese medic

关 键 词：股骨粗隆间骨折 老年 股骨近端防旋髓内钉 艾灸 骨愈灵片 

分 类 号：R274.1[医药卫生—中医骨伤科学]