摘要
目的 探讨加味参芪四物汤在老年不稳定性股骨粗隆间骨折患者(气血亏虚型)血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、骨代谢及免疫功能的影响.方法 选取老年不稳定性股骨粗隆间骨折(气血亏虚型)患者89 例,采用随机数字表法分为两组.对照组45 例采用股骨近端防旋髓内钉(PFNA)内固定术治疗,观察组44 例在对照组的基础上联合加味参芪四物汤治疗,治疗2 周后比较临床疗效.结果 治疗后观察组血清IL-6、TNF-α、D-二聚体(D-D)水平低于对照组,β-内啡肽(β-EP)、血清骨特异性碱性磷酸酶(BALP)、骨钙素(BGP)水平、CD3+、CD4+、CD4+/CD8+高于对照组(t分别=9.19、12.18、12.94、-8.29、7.92、9.35、7.61、9.27、7.90,P均＜0.05).观察组总有效率明显高于对照组(χ2=8.21,P＜0.05);并发症总发生率明显低于对照组(χ2=7.35,P＜0.05).结论 对于PFNA内固定术联合加味参芪四物汤治疗老年不稳定性股骨粗隆间骨折(气血亏虚型)可有效降低炎症反应和并发症的发生,对骨代谢具有一定的调节作用,还能促进患者术后康复效果,改善预后.
Abstract
Objective To investigate the effects of Shenqi Siwu decoction on serum interleukin-6,tumor necrosis fac-tor-α,bone metabolism and immune function in elderly patients with unstable intertrochanteric femur fractures(qi and blood deficiency type).Methods Eighty-nine cases of elderly patients with unstable intertrochanteric femoral fractures(qi and blood deficiency type)were selected and divided into two groups using the randomized numerical table method.Forty-five cases in the control group were treated with proximal femoral anti-rotation intramedullary nailing(PFNA)in-ternal fixation,and 44 cases in the observation group were treated with Shenqi Siwu decoction on the basis of the control group,and the clinical efficacy was compared after 2 weeks of treatment.Results After treatment,serum IL-6,TNF-α,and D-dimer(D-D)levels in the observation group were lower than those in the control group,and β-endorphin(β-EP),serum bone-specific alkaline phosphatase(BALP),bone calcin(BGP)levels,CD3+,CD4+,and CD4+/CD8+ were high-er than those in the control group(t=9.19,12.18,12.94,-8.29,7.92,9.35,7.61,9.27,7.90,P＜0.05).The total effective rate of the observation group was significantly higher than that of the control group(χ2=8.21,P＜0.05),the total compli-cation rate was significantly lower than that of the control group(χ2=8.21,P＜0.05).Conclusion For PFNA internal fixation combined with Shenqi Siwu decoction for the treatment of unstable intertrochanteric femur fracture in the elderly(qi and blood deficiency type)can effectively reduce the inflammatory reaction and the occurrence of complications,and has a certain effect on the regulation of bone metabolism,but also can promote the rehabilitation effect of the patients af-ter the operation and improve the prognosis.
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