强骨宝方对女性非骨水泥全髋关节置换术后髋臼侧骨密度影响的研究

发布时间：2019-05-16 17:53

【摘要】：目的:通过中药强骨宝方加常规抗骨质疏松治疗方案对女性非骨水泥全髋术后患者进行干预对照研究,观察其髋臼假体周围骨量的动态变化,以探讨强骨宝方对女性全髋关节置换术后髋臼侧骨密度的影响,为临床防治假体周围骨量丢失提供有效指导,提高女性全髋关节置换术手术疗效。方法:选取2015年12月到2016年08月期间就诊于福州市第二医院骨科的50例符合纳入标准和排除标准的患者为研究对象。采用随机分组方法将50例研究对象分为强骨宝组和对照组,每组各25例。两组均于术后1周开始口服钙尔奇D(1片/日)、罗盖全(1粒/日),强骨宝组另外加服中药强骨宝方方剂(1剂/日),三种药物均持续服用3个月。两组均于术后1周、术后3个月、术后6个月采用双能X线骨密度仪行髋关节假体周围骨密度测定,同时行髋关节功能评分,详细记录结果,对比分析两组的测量值,评估综合疗效。结果:本研究获得完整随访病例共47例。患者的基本情况包括年龄、体重指数、左右髋数目、疾病类型以及术后髋臼假体的外展角和前倾角两组相比较差异无统计学意义(P0.05)。术后1周各区骨密度两组患者相比较差异无统计学意义(P0.05),术后3、6个月两组患者各区骨密度均呈持续下降趋势,且强骨宝组各区骨密度变化幅度小于对照组。其中以术后6个月强骨宝组Ⅲ区骨密度明显高于对照组Ⅲ区骨密度,差异有统计学意义(P0.05),其余测量区骨密度两组相比较差异无统计学意义(P0.05)。两组患者术后6个月髋关节功能评分差异无统计学意义(P0.05)。结论:中药强骨宝方用于女性非骨水泥型全髋关节置换术后治疗可有效减少髋臼区骨密度的下降,减少髋臼假体周围骨量丢失,减低髋关节假体松动的发生率,提高女性全髋关节置换术疗效,对维持人工髋关节假体稳定性具有重要意义,且安全、优效、价廉,值得临床推广应用。
[Abstract]:Objective: to observe the dynamic changes of bone mass around acetabular prosthesis in female patients after total hip surgery with non-bone cement by traditional Chinese medicine Qianggubao recipe combined with conventional anti-osteoporosis treatment. To investigate the effect of Qianggubao recipe on the bone mineral density of acetabular side after total hip arthroplasty in women, and to provide effective guidance for clinical prevention and treatment of bone mass loss around the prosthesis, and to improve the curative effect of total hip arthroplasty in women. Methods: from December 2015 to August 2016, 50 patients who met the inclusion and exclusion criteria in the Department of Orthopaedics of Fuzhou second Hospital were selected as the subjects. Fifty subjects were randomly divided into Qianggubao group (n = 25) and control group (n = 25). Both groups were treated with calcium D (1 tablet / day) and Luo Gaiquan (1 tablet / day) 1 week after operation, and Qianggubao group was treated with Qianggubao square agent (1 dose / day). All three drugs were taken for 3 months. The bone mineral density around hip joint was measured by dual energy X-ray absorptiometry at 1 week, 3 months and 6 months after operation, and the hip joint function score was measured at the same time. The results were recorded in detail, and the measured values of the two groups were compared and analyzed. Evaluate the comprehensive efficacy. Results: a total of 47 cases were followed up. There was no significant difference in age, body mass index, left and right hip number, disease type, abduction angle and anteversion angle between the two groups (P 0.05). One week after operation, there was no significant difference in bone mineral density between the two groups (P 0.05). At 3 and 6 months after operation, the bone mineral density of the two groups continued to decrease, and the change range of bone mineral density in Qianggubao group was smaller than that in the control group. At 6 months after operation, the bone mineral density of area III in Qianggubao group was significantly higher than that in control group (P 0.05), but there was no significant difference in bone mineral density in other measured areas between the two groups (P 0.05). There was no significant difference in hip function score between the two groups at 6 months after operation (P 0.05). Conclusion: Qianggubao recipe can effectively reduce the decrease of bone mineral density in acetabular area, reduce the loss of bone mass around acetabular prosthesis and reduce the incidence of hip joint loosening. It is of great significance to improve the curative effect of female total hip arthroplasty to maintain the stability of hip arthroplasty, and it is safe, effective and cheap, so it is worth popularizing and applying in clinic.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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