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[1]鄧森,蔡樺.阿法骨化醇聯(lián)合補(bǔ)中益氣湯口服治療老年股骨頸骨折股骨頭置換術(shù)后肌減少癥脾胃虛弱證的臨床研究[J].中醫(yī)正骨,2018,30(11):28-31.
　DENG Sen,CAI Hua.Oral applications of alfacalcidol and Buzhong Yiqi Tang(補(bǔ)中益氣湯)for treatment of spleen-stomach-deficiency-type sarcopenia appeared after femoral head replacement in aged patients with femoral neck fractures:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(11):28-31.
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阿法骨化醇聯(lián)合補(bǔ)中益氣湯口服治療老年股骨頸骨折股骨頭置換術(shù)后肌減少癥脾胃虛弱證的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年11期
頁(yè)碼:
28-31
欄目:
臨床研究
出版日期:
2018-11-20

文章信息/Info

Title:
Oral applications of alfacalcidol and Buzhong Yiqi Tang(補(bǔ)中益氣湯)for treatment of spleen-stomach-deficiency-type sarcopenia appeared after femoral head replacement in aged patients with femoral neck fractures:a clinical study
作者:
鄧森1; 蔡樺2
(1.廣東省高州市中醫(yī)院,廣東 高州 525200; 2.廣州中醫(yī)藥大學(xué)附屬骨傷科醫(yī)院,廣東 廣州 510240)
Author(s):
DENG Sen1; CAI Hua2
1.Gaozhou Hospital of Traditional Chinese Medicine,Gaozhou 525200,Guangdong,China 2.The Orthopedic Hospital Affiliated to Guangzhou University of Chinese Medicine,Guangzhou 510240,Guangdong,China
關(guān)鍵詞:
股骨頸骨折;  關(guān)節(jié)成形術(shù); 置換; 髖;  肌減少癥;  補(bǔ)中益氣湯;  痿證;  維生素D;  老年人;  臨床試驗(yàn)
Keywords:
femoral neck fractures;  arthroplasty; replacement; hip;  sarcopenia;  Buzhong Yiqi Tang;  flaccidity syndrome;  vitamin D;  aged;  clinical trial
摘要:
目的:觀察阿法骨化醇聯(lián)合補(bǔ)中益氣湯口服治療老年股骨頸骨折股骨頭置換術(shù)后肌減少癥脾胃虛弱證的臨床療效。方法:將80例老年股骨頸骨折股骨頭置換術(shù)后肌減少癥脾胃虛弱證患者隨機(jī)分為2組,阿法骨化醇組40例、聯(lián)合治療組40例。阿法骨化醇組術(shù)后1 d口服阿法骨化醇片,每日0.5 μg,連續(xù)服用60 d; 聯(lián)合治療組術(shù)后1 d在阿法骨化醇組的治療基礎(chǔ)上口服補(bǔ)中益氣湯,每日1劑,早晚各溫服200 mL,連續(xù)服用60 d。分別于治療前、治療30 d后、治療60 d后測(cè)定患者的握力,并采用簡(jiǎn)易軀體能力測(cè)試(short physical performance battery,SPPB)量表評(píng)價(jià)臨床綜合療效。結(jié)果:握力測(cè)試結(jié)果,時(shí)間因素和分組因素存在交互效應(yīng)(F=13.453,P=0.006); 2組患者握力總體比較,組間差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=17.537,P=0.000); 治療前后不同時(shí)間點(diǎn)握力的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=23.812,P=0.000); 2組患者握力隨時(shí)間變化均呈增高趨勢(shì),但2組的增高趨勢(shì)不完全一致[(19.13±3.21)kg,(20.71±2.18)kg,(21.91±3.16)kg,F=16.634,P=0.000;(18.72±4.15)kg,(22.04±3.56)kg,(23.51±3.82)kg,F=51.427,P=0.000]; 治療前,2組患者握力的組間差異無(wú)統(tǒng)計(jì)學(xué)意義(t=0.341,P=0.367); 治療30 d、60 d后,聯(lián)合治療組的握力均大于阿法骨化醇組(t=2.252,P=0.013; t=2.631,P=0.005)。2組患者治療60 d后的SPPB評(píng)分均較治療30 d后增高[(6.63±1.85)分,(7.91±2.26)分,t=1.871,P=0.033;(7.85±2.17)分,(9.23±2.25)分,t=2.930,P=0.002],治療30 d、60 d后聯(lián)合治療組的SPPB評(píng)分均高于阿法骨化醇組(t=1.927,P=0.029; t=6.620,P=0.000)。結(jié)論:阿法骨化醇聯(lián)合補(bǔ)中益氣湯口服治療老年股骨頸骨折股骨頭置換術(shù)后肌減少癥脾胃虛弱證,可以改善肌肉功能、提高肌力,且效果優(yōu)于單純口服阿法骨化醇治療。
Abstract:
Objective:To observe the clinical curative effects of oral applications of alfacalcidol and Buzhong Yiqi Tang(補(bǔ)中益氣湯,BZYQT)for treatment of spleen-stomach-deficiency-type sarcopenia appeared after femoral head replacement in aged patients with femoral neck fractures.Methods:Eighty aged patients with spleen-stomach-deficiency-type sarcopenia appeared after femoral head replacement for treatment of femoral neck fractures were randomly divided into monotherapy group and combination therapy group,40 cases in each group.The patients in the 2 groups were treated with oral application of alfacalcidol since postoperative day 1,0.5 μg a day for consecutive 60 days,moreover,the patients in combination therapy group were treated with oral application of warm BZYQT,200 mL at a time,one dose a day, in the morning and evening respectively for consecutive 60 days.The grip strengths of patients in the 2 groups were measured before the treatment and after 30- and 60-day treatment respectively,and the clinical comprehensive curative effects were evaluated by using short physical performance battery(SPPB)scale.Results:The grip strength test results showed that there was interaction between time factor and group factor(F=13.453,P=0.006).There was statistical difference in grip strength between the 2 groups in general,in other words,there was group effect(F=17.537,P=0.000).There was statistical difference in grip strength between different timepoints before and after the treatment,in other words,there was time effect(F=23.812,P=0.000).The grip strength presented a time-dependent increasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the increasing trend of grip strength(19.13+/-3.21,20.71+/-2.18,21.91+/-3.16 kg,F=16.634,P=0.000; 18.72+/-4.15,22.04+/-3.56,23.51+/-3.82 kg,F=51.427,P=0.000).There was no statistical difference in grip strength between the 2 groups before treatment(t=0.341,P=0.367).The grip strengths were greater in combination therapy group compared to monotherapy group after 30- and 60-day treatment(t=2.252,P=0.013; t=2.631,P=0.005).The SPPB scores measured after 60-day treatment were higher than that measured after 30-day treatment in both of the 2 groups(6.63+/-1.85 vs 7.91+/-2.26 points,t=1.871,P=0.033; 7.85+/-2.17 vs 9.23+/-2.25 points,t=2.930,P=0.002),and the SPPB scores were higher in combination therapy group compared to monotherapy group after 30- and 60-day treatment(t=1.927,P=0.029; t=6.620,P=0.000).Conclusion:Oral applications of alfacalcidol and BZYQT can improve muscle function and muscle strength in treatment of spleen-stomach-deficiency-type sarcopenia appeared after femoral head replacement in aged patients with femoral neck fractures,and its curative effect is better than that of monotherapy of oral application of alfacalcidol.

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更新日期/Last Update: 2018-11-30