葛根素联合常规抗骨质疏松治疗对老年行人工髋关节置换术后骨密度的影响
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摘要
目的:探讨葛根素联合常规抗骨质疏松治疗对老年行人工髋关节置换术后骨密度的影响。方法:选取2015年5月至2016年5月重庆市开州区人民医院收治的行人工髋关节置换术治疗的老年女性患者58例,采用随机数字表法分为观察组和对照组,每组29例,2组均行人工髋关节置换术治疗,术后14 d对照组给予口服钙尔奇D片+骨化三醇胶丸+静脉点注唑来膦酸,观察组同时静脉点注葛根素注射液,2组均连续治疗2个月,术后于门诊随访6个月。统计2组临床治疗效果及不良反应发生情况,术后采用Harris评分系统评估2组髋关节功能,并检测假体周围骨密度。结果:治疗后观察组有效率86. 21%,对照组有效率79. 31%,2组比较差异无统计学意义(P> 0. 05)。从术后7 d至术后6个月2组Harris评分及髋关节功能优良率呈现逐渐升高的趋势,且术后3个月及术后6个月观察组均高于对照组(P <0. 05或P <0. 01)。与术后3个月比较,术后6个月观察组假体各分区骨密度无明显变化,对照组R4～R7区骨密度降低,且术后6个月观察组R6、R7区骨密度明显高于对照组(P <0. 05或P <0. 01)。治疗期间,2组均有不同程度的发热、肌痛、流感样症状、骨关节疼痛及头痛,2组不良反应发生率差异无统计学意义(P> 0. 05)。结论:老年骨质疏松女性患者行人工髋关节置换术后应用葛根素联合常规抗骨质疏松治疗,临床疗效显著,患者的髋关节功能及假体周围骨密度均得到有效提升,且安全性好。
Objective: To investigate the effects of puerarin combined with conventional anti-osteoporosis therapy on bone density after artificial hip arthroplasty in elderly patients. Methods: A total of 58 elderly women who were treated with artificial hip arthroplasty in The People's of Hospital Kaizhou District from May 2015 to May 2016 were selected and divided into experiment group( n= 29) and control group( n = 29) according to computer generated random digital table. The 2 groups were treated with artificial hip arthroplasty. 14 days after the treatment,the control group was given oral calcium Erqi D tablets,ossification triol capsules and intravenous infusion of zoledronic acid,and the experiment group was given intravenous infusion of puerarin injection based on the control group. The 2 groups were treated continuously for 2 months,and the patients were followed up for 6 months. The clinical therapeutic effects and incidence of adverse reactions were collected,and the hip function was assessed by Harris scoring system and the bone density around the prosthesis was measured. Results: The effective rate was 86. 21% in the experiment group and79. 31% in the control group,it had no statically difference between the 2 groups( P > 0. 05). The Harris score and hip function was gradually increasing from 7 days to 6 months after operation,and the experiment group were higher than the control group 3 and6 months after surgery( P < 0. 05 or P < 0. 01). Compared with 3 months after operation,there was no significant changes in bone density in the experiment group at 6 months after operation,R4-R7 of the bone density in the control group decreased,R6 and R7 of the bone density in the experiment group was significantly higher than those in the control group at 6 months after operation( P <0. 05 or P < 0. 01). During the treatment,the 2 groups had varying degrees of fever,myalgia,flu-like symptoms,joint pain and headache,and the incidence of adverse reactions in the 2 groups had no significant difference( P > 0. 05). Conclusion: The clinical efficacy of puerarin combined with conventional anti-osteoporosis treatment after artificial hip arthroplasty therapy in elderly female patients with senile osteoporosis is significant,and the hip function and the bone density around the prosthesis are effectively improved and the safety is good.
Objective: To investigate the effects of puerarin combined with conventional anti-osteoporosis therapy on bone density after artificial hip arthroplasty in elderly patients. Methods: A total of 58 elderly women who were treated with artificial hip arthroplasty in The People's of Hospital Kaizhou District from May 2015 to May 2016 were selected and divided into experiment group( n= 29) and control group( n = 29) according to computer generated random digital table. The 2 groups were treated with artificial hip arthroplasty. 14 days after the treatment,the control group was given oral calcium Erqi D tablets,ossification triol capsules and intravenous infusion of zoledronic acid,and the experiment group was given intravenous infusion of puerarin injection based on the control group. The 2 groups were treated continuously for 2 months,and the patients were followed up for 6 months. The clinical therapeutic effects and incidence of adverse reactions were collected,and the hip function was assessed by Harris scoring system and the bone density around the prosthesis was measured. Results: The effective rate was 86. 21% in the experiment group and79. 31% in the control group,it had no statically difference between the 2 groups( P > 0. 05). The Harris score and hip function was gradually increasing from 7 days to 6 months after operation,and the experiment group were higher than the control group 3 and6 months after surgery( P < 0. 05 or P < 0. 01). Compared with 3 months after operation,there was no significant changes in bone density in the experiment group at 6 months after operation,R4-R7 of the bone density in the control group decreased,R6 and R7 of the bone density in the experiment group was significantly higher than those in the control group at 6 months after operation( P <0. 05 or P < 0. 01). During the treatment,the 2 groups had varying degrees of fever,myalgia,flu-like symptoms,joint pain and headache,and the incidence of adverse reactions in the 2 groups had no significant difference( P > 0. 05). Conclusion: The clinical efficacy of puerarin combined with conventional anti-osteoporosis treatment after artificial hip arthroplasty therapy in elderly female patients with senile osteoporosis is significant,and the hip function and the bone density around the prosthesis are effectively improved and the safety is good.
引文
[1]张成宝,马信龙,马剑雄,等.股骨颈骨折术前空间移位三维重建研究及其临床意义[J].中华创伤杂志,2016,32(3):203-206.
[2]张启锋,张鹏程,杨将,等.老年股骨颈骨折全髋关节置换术时机选择与临床疗效及预后分析[J].重庆医学,2016,45(24):3369-3372.
[3]魏述永.葛根素心血管保护作用及其机制研究进展[J].中国中药杂志,2015,40(12):2278-2284.
[4]于俊龙,孙玉明,詹秀琴.葛根素治疗绝经后骨质疏松症[J].吉林中医药,2015,35(8):806-809.
[5]王亦璁,姜保国.骨与关节损伤[M].5版.北京:人民卫生出版社,2012:399-400.
[6]应志强.自拟通脉活血汤联合利伐沙班预防人工髋关节置换术后深静脉血栓42例[J].浙江中医杂志,2017,52(2):133-133.
[7]郭文辉.独活寄生汤与强骨活血汤联合钙尔奇D、仙灵骨葆治疗老年骨质疏松性骨折的临床疗效比较研究[J].世界中医药,2016,11(11):2281-2285.
[8]李钦柱.中西医结合治疗股骨头置换术后并发深层静脉血栓的临床研究[J].中国医学创新,2011,8(11):139-140.
[9]Ellman M B,Levine B R.Fracture of the modular femoral neck component in total hip arthroplasty[J].Journal of Arthroplasty,2013,28(1):1-5.
[10]王业杨,王明森,李贵涛,等.不稳定型老年股骨转子间骨折行PFNA与人工髋关节置换术治疗的对比研究[J].实用医学杂志,2015,31(8):1254-1255.
[11]Mkinen TJ,Alm JJ,Laine H,et al.The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement[J].Bone,2007,40(4):1041-1047.
[12]Berry DJ,Von KM,Schleck CD,et al.The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty[J].Journal of Bone&Joint Surgery-american Volume,2004,86(1):9-14.
[13]赵利民.中西药物预防人工髋关节假体置换后下肢深静脉血栓形成[J].中国组织工程研究,2013,17(22):4130-4136.
[14]刘姝含,刘美含,刘飞.针刺结合桂枝加葛根汤治疗颈型颈椎病的疗效[J].中国老年学杂志,2017,37(1):183-184.
[15]Tiyasatkulkovit W,Malaivijitnond S,Charoenphandhu N,et al.Pueraria mirifica,extract and puerarin enhance proliferation and expression of alkaline phosphatase and type I collagen in primary baboon osteoblasts[J].Phytomedicine,2014,21(12):1498-1503.
[16]Turan S,Topcu B,G9k9e I,et al.Serum Alkaline Phosphatase Levels in Healthy Children and Evaluation of Alkaline Phosphatasezscores in Different Types of Rickets[J].J Clini Res in Pediat Endocrinol,2011,3(1):7-11.
[17]钱康琦,孙玉明,詹秀琴.蛋白免疫印迹杂交法研究葛根素对成骨细胞TGF-β1及Smad 2/3蛋白表达的影响[J].长春中医药大学学报,2013,29(1):18-20.
[18]刘浩,李斌斌.葛根素抑制1,25-二羟基维生素D3促破骨细胞骨吸收功能的最佳剂量[J].中国组织工程研究,2012,16(28):5141-5144.
[19]高彤彤,吴燕文,许云.葛根素联合雌二醇干预对去卵巢大鼠骨质疏松疗效和认知功能影响分析[J].中国妇幼保健,2015,30(34):6112-6114.
[20]粟凤,林安晓,乔东方,等.葛根素减轻大鼠心肌缺血-再灌注损伤[J].基础医学与临床,2015,35(6):836-837.
[2]张启锋,张鹏程,杨将,等.老年股骨颈骨折全髋关节置换术时机选择与临床疗效及预后分析[J].重庆医学,2016,45(24):3369-3372.
[3]魏述永.葛根素心血管保护作用及其机制研究进展[J].中国中药杂志,2015,40(12):2278-2284.
[4]于俊龙,孙玉明,詹秀琴.葛根素治疗绝经后骨质疏松症[J].吉林中医药,2015,35(8):806-809.
[5]王亦璁,姜保国.骨与关节损伤[M].5版.北京:人民卫生出版社,2012:399-400.
[6]应志强.自拟通脉活血汤联合利伐沙班预防人工髋关节置换术后深静脉血栓42例[J].浙江中医杂志,2017,52(2):133-133.
[7]郭文辉.独活寄生汤与强骨活血汤联合钙尔奇D、仙灵骨葆治疗老年骨质疏松性骨折的临床疗效比较研究[J].世界中医药,2016,11(11):2281-2285.
[8]李钦柱.中西医结合治疗股骨头置换术后并发深层静脉血栓的临床研究[J].中国医学创新,2011,8(11):139-140.
[9]Ellman M B,Levine B R.Fracture of the modular femoral neck component in total hip arthroplasty[J].Journal of Arthroplasty,2013,28(1):1-5.
[10]王业杨,王明森,李贵涛,等.不稳定型老年股骨转子间骨折行PFNA与人工髋关节置换术治疗的对比研究[J].实用医学杂志,2015,31(8):1254-1255.
[11]Mkinen TJ,Alm JJ,Laine H,et al.The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement[J].Bone,2007,40(4):1041-1047.
[12]Berry DJ,Von KM,Schleck CD,et al.The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty[J].Journal of Bone&Joint Surgery-american Volume,2004,86(1):9-14.
[13]赵利民.中西药物预防人工髋关节假体置换后下肢深静脉血栓形成[J].中国组织工程研究,2013,17(22):4130-4136.
[14]刘姝含,刘美含,刘飞.针刺结合桂枝加葛根汤治疗颈型颈椎病的疗效[J].中国老年学杂志,2017,37(1):183-184.
[15]Tiyasatkulkovit W,Malaivijitnond S,Charoenphandhu N,et al.Pueraria mirifica,extract and puerarin enhance proliferation and expression of alkaline phosphatase and type I collagen in primary baboon osteoblasts[J].Phytomedicine,2014,21(12):1498-1503.
[16]Turan S,Topcu B,G9k9e I,et al.Serum Alkaline Phosphatase Levels in Healthy Children and Evaluation of Alkaline Phosphatasezscores in Different Types of Rickets[J].J Clini Res in Pediat Endocrinol,2011,3(1):7-11.
[17]钱康琦,孙玉明,詹秀琴.蛋白免疫印迹杂交法研究葛根素对成骨细胞TGF-β1及Smad 2/3蛋白表达的影响[J].长春中医药大学学报,2013,29(1):18-20.
[18]刘浩,李斌斌.葛根素抑制1,25-二羟基维生素D3促破骨细胞骨吸收功能的最佳剂量[J].中国组织工程研究,2012,16(28):5141-5144.
[19]高彤彤,吴燕文,许云.葛根素联合雌二醇干预对去卵巢大鼠骨质疏松疗效和认知功能影响分析[J].中国妇幼保健,2015,30(34):6112-6114.
[20]粟凤,林安晓,乔东方,等.葛根素减轻大鼠心肌缺血-再灌注损伤[J].基础医学与临床,2015,35(6):836-837.