CAJ | 학술논문

背景：髋关节置换是目前修复股骨颈骨折的有效手段，但是随着手术量的增多，髋关节置换后失败率也随之升高，特别是置换后假体松动与周围骨折比较常见。强骨饮能促进成骨细胞形成，有抗骨质疏松的作用，抑制破骨细胞活性，增加骨密度。其中骨碎补具有补肾、壮骨、强筋、止痛的功能，具有促进骨形成和抑制骨吸收的双向调节作用。 　　目的：探讨强骨饮对患者股骨颈骨折髋关节置换后假体周围骨密度的影响。 　　方法：96例股骨颈骨折患者根据随机数字表法分为观察组与对照组，每组48例。两组都给予择期髋关节置换，置入美国史赛克公司的人工股骨头后使用骨水泥固定。置换后对照组口服碳酸钙D3片与阿法骨化醇胶囊，在此基础上观察组加用复方中药强骨饮口服，药物干预时间为1个月。观察两组假体周围骨密度变化情况，检测碱性磷酸酶与抗酒石酸盐酸性磷酸酶活性，并进行修复效果对比。 　　结果与结论：所有患者均顺利完成手术，均无感染、假体松动的情况发生。观察组的置换后下床时间与骨折愈合时间都明显少于对照组(P <0.05)。两组用药前的假体周围骨密度差异无显著性意义，用药后都有明显上升的趋势(P <0.05)，用药后观察组的假体周围骨密度明显高于对照组(P <0.05)。两组用药后的血清碱性磷酸酶活性明显升高，而抗酒石酸盐酸性磷酸酶活性明显降低，与用药前对比差异有显著性意义(P <0.05)；同时用药后观察组的血清碱性磷酸酶与抗酒石酸盐酸性磷酸酶活性与对照组对比差异均有显著性意义(P <0.05)。在置换后6个月进行评定，观察组的关节功能优良率显著高于对照组(94%，79%，P <0.05)。提示强骨饮在髋关节置换后应用能起到抗骨吸收和抑制过高的骨转换的作用，提高假体周围骨密度，从而达到恢复关节功能的目的。揹景：髖關節置換是目前脩複股骨頸骨摺的有效手段，但是隨著手術量的增多，髖關節置換後失敗率也隨之升高，特彆是置換後假體鬆動與週圍骨摺比較常見。彊骨飲能促進成骨細胞形成，有抗骨質疏鬆的作用，抑製破骨細胞活性，增加骨密度。其中骨碎補具有補腎、壯骨、彊觔、止痛的功能，具有促進骨形成和抑製骨吸收的雙嚮調節作用。 　　目的：探討彊骨飲對患者股骨頸骨摺髖關節置換後假體週圍骨密度的影響。 　　方法：96例股骨頸骨摺患者根據隨機數字錶法分為觀察組與對照組，每組48例。兩組都給予擇期髖關節置換，置入美國史賽剋公司的人工股骨頭後使用骨水泥固定。置換後對照組口服碳痠鈣D3片與阿法骨化醇膠囊，在此基礎上觀察組加用複方中藥彊骨飲口服，藥物榦預時間為1箇月。觀察兩組假體週圍骨密度變化情況，檢測堿性燐痠酶與抗酒石痠鹽痠性燐痠酶活性，併進行脩複效果對比。 　　結果與結論：所有患者均順利完成手術，均無感染、假體鬆動的情況髮生。觀察組的置換後下床時間與骨摺愈閤時間都明顯少于對照組(P <0.05)。兩組用藥前的假體週圍骨密度差異無顯著性意義，用藥後都有明顯上升的趨勢(P <0.05)，用藥後觀察組的假體週圍骨密度明顯高于對照組(P <0.05)。兩組用藥後的血清堿性燐痠酶活性明顯升高，而抗酒石痠鹽痠性燐痠酶活性明顯降低，與用藥前對比差異有顯著性意義(P <0.05)；同時用藥後觀察組的血清堿性燐痠酶與抗酒石痠鹽痠性燐痠酶活性與對照組對比差異均有顯著性意義(P <0.05)。在置換後6箇月進行評定，觀察組的關節功能優良率顯著高于對照組(94%，79%，P <0.05)。提示彊骨飲在髖關節置換後應用能起到抗骨吸收和抑製過高的骨轉換的作用，提高假體週圍骨密度，從而達到恢複關節功能的目的。
배경：관관절치환시목전수복고골경골절적유효수단，단시수착수술량적증다，관관절치환후실패솔야수지승고，특별시치환후가체송동여주위골절비교상견。강골음능촉진성골세포형성，유항골질소송적작용，억제파골세포활성，증가골밀도。기중골쇄보구유보신、장골、강근、지통적공능，구유촉진골형성화억제골흡수적쌍향조절작용。 　　목적：탐토강골음대환자고골경골절관관절치환후가체주위골밀도적영향。 　　방법：96례고골경골절환자근거수궤수자표법분위관찰조여대조조，매조48례。량조도급여택기관관절치환，치입미국사새극공사적인공고골두후사용골수니고정。치환후대조조구복탄산개D3편여아법골화순효낭，재차기출상관찰조가용복방중약강골음구복，약물간예시간위1개월。관찰량조가체주위골밀도변화정황，검측감성린산매여항주석산염산성린산매활성，병진행수복효과대비。 　　결과여결론：소유환자균순리완성수술，균무감염、가체송동적정황발생。관찰조적치환후하상시간여골절유합시간도명현소우대조조(P <0.05)。량조용약전적가체주위골밀도차이무현저성의의，용약후도유명현상승적추세(P <0.05)，용약후관찰조적가체주위골밀도명현고우대조조(P <0.05)。량조용약후적혈청감성린산매활성명현승고，이항주석산염산성린산매활성명현강저，여용약전대비차이유현저성의의(P <0.05)；동시용약후관찰조적혈청감성린산매여항주석산염산성린산매활성여대조조대비차이균유현저성의의(P <0.05)。재치환후6개월진행평정，관찰조적관절공능우량솔현저고우대조조(94%，79%，P <0.05)。제시강골음재관관절치환후응용능기도항골흡수화억제과고적골전환적작용，제고가체주위골밀도，종이체도회복관절공능적목적。
BACKGROUND:Hip arthroplasty is an effective means currently in repair of femoral neck fractures. With the increased in the amount of surgery, surgery failure rate also has increased. In particular, prosthesis loosening and fracture are very common after replacement.Qiangguyin can promote the formation of osteoblasts, resist osteoporosis, inhibit osteoclast activity, and increase bone density. Drynaria invigorates the kidney, strengthens the bone and tendon and relieves pain, and has bidirectional regulatory effects on promoting bone formation and inhibiting bone resorption. OBJECTIVE:To investigate effects ofQiangguyin on periprosthetic bone density in patients with femoral neck fracture after hip arthroplasty. METHODS:96 patients with femoral neck fracture were equaly divided into observation group and control group based on the random number table. Both groups were given selective joint replacement. Patients were implanted with femoral head made by US Stryker Corporation, and fixed with bone cement. After replacement, patients in the control group were treated with calcium D3 tablets and capsules alfacalcidol. On this basis, the treatment group was given theQiangguyin oral drug intervention for a month. Bone density surrounding the prosthesis was observed in both groups. Alkaline phosphatase and tartrate-resistant hydrochloric acid phosphatase activities were detected. Repair effects were compared. RESULTS AND CONCLUSION:The surgery was successfuly completed in al patients. No infection or loosening of the prosthesis occurred. Ambulation time and healing time were significantly less in the observation group than in the control group (P < 0.05). No significant difference in bone density surrounding the prosthesis was detected between the two groups before medication, and an obvious increased trend was found after medication (P < 0.05). Bone density was significantly higher in the observation group than in the control group after medication (P < 0.05). Serum alkaline phosphatase activity was significantly higher in the two groups after medication, but tartrate-resistant hydrochloric acid phosphatase activity was significantly decreased, which showed significant differences as compared with that before medication (P < 0.05). Simultaneously, significant differences in serum alkaline phosphatase activity and tartrate-resistant hydrochloric acid phosphatase activity were detected between the observation and control groups after medication (P < 0.05). At 6 months after replacement, the excelent and good rate of joint function was significantly higher in the observation group than in the control group (94%, 79%,P < 0.05). These results indicate that Qiangguyin could resist bone resorption and suppress excessive bone turnover, improve bone density around the prosthesis, and restore joint function after hip arthroplasty.