【摘要】：目的:通過中藥強骨寶方加常規(guī)抗骨質(zhì)疏松治療方案對女性非骨水泥全髖術后患者進行干預對照研究,觀察其髖臼假體周圍骨量的動態(tài)變化,以探討強骨寶方對女性全髖關節(jié)置換術后髖臼側(cè)骨密度的影響,為臨床防治假體周圍骨量丟失提供有效指導,提高女性全髖關節(jié)置換術手術療效。方法:選取2015年12月到2016年08月期間就診于福州市第二醫(yī)院骨科的50例符合納入標準和排除標準的患者為研究對象。采用隨機分組方法將50例研究對象分為強骨寶組和對照組,每組各25例。兩組均于術后1周開始口服鈣爾奇D(1片/日)、羅蓋全(1粒/日),強骨寶組另外加服中藥強骨寶方方劑(1劑/日),三種藥物均持續(xù)服用3個月。兩組均于術后1周、術后3個月、術后6個月采用雙能X線骨密度儀行髖關節(jié)假體周圍骨密度測定,同時行髖關節(jié)功能評分,詳細記錄結(jié)果,對比分析兩組的測量值,評估綜合療效。結(jié)果:本研究獲得完整隨訪病例共47例�；颊叩幕厩闆r包括年齡、體重指數(shù)、左右髖數(shù)目、疾病類型以及術后髖臼假體的外展角和前傾角兩組相比較差異無統(tǒng)計學意義(P0.05)。術后1周各區(qū)骨密度兩組患者相比較差異無統(tǒng)計學意義(P0.05),術后3、6個月兩組患者各區(qū)骨密度均呈持續(xù)下降趨勢,且強骨寶組各區(qū)骨密度變化幅度小于對照組。其中以術后6個月強骨寶組Ⅲ區(qū)骨密度明顯高于對照組Ⅲ區(qū)骨密度,差異有統(tǒng)計學意義(P0.05),其余測量區(qū)骨密度兩組相比較差異無統(tǒng)計學意義(P0.05)。兩組患者術后6個月髖關節(jié)功能評分差異無統(tǒng)計學意義(P0.05)。結(jié)論:中藥強骨寶方用于女性非骨水泥型全髖關節(jié)置換術后治療可有效減少髖臼區(qū)骨密度的下降,減少髖臼假體周圍骨量丟失,減低髖關節(jié)假體松動的發(fā)生率,提高女性全髖關節(jié)置換術療效,對維持人工髖關節(jié)假體穩(wěn)定性具有重要意義,且安全、優(yōu)效、價廉,值得臨床推廣應用。
[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.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

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