| 黄东良.骨苓通痹丸与双氯芬酸钠肠溶片联合治疗激素性股骨头坏死患者临床研究[J].浙江中西医结合杂志,2020,30(1): |
| 骨苓通痹丸与双氯芬酸钠肠溶片联合治疗激素性股骨头坏死患者临床研究 |
| Clinical Study of Guling Tongbi Pill and Diclofenac Sodium Enteric-coated Tablets in the Treatment of Hormone-induced Femoral Head NecrosisHuang Dongliang Zhou Xiang No.1 People"s Hospital of Hangzhou pharmacy, 321000 |
| 投稿时间：2019-03-29 修订日期：2019-12-01 |
| DOI： |
| 中文关键词: 骨苓通痹丸 双氯酚酸钠肠溶片 激素性股骨头坏死 |
| 英文关键词:Guling Tongbi Pill Sodium dichlorophenolate enteric-coated tablets Steroid-induced femoral head necrosis |
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| 中文摘要: |
| 目的：探讨骨苓通痹丸与双氯芬酸钠肠溶片联合治疗激素性股骨头坏死患者临床研究。方法：选择我院于2017年6月至2018年6月期间收治的激素性股骨头坏死患者83例作为研究对象,依据随机表法分为对照组41例与观察组42例。对照组患者给予双氯芬酸钠肠溶片治疗,观察组在对照组基础上结合骨苓通痹丸治疗。两组疗程均为3个月。比较两组治疗疗效,治疗前后视觉模拟评分法(VAS评分)和Harris评分、血液流变学和肿瘤坏死因子-α(TNF-α)及骨代谢变化。结果：观察组总有效率(92.86%)高于对照组(70.73%)(P<0.05)。两组治疗后VAS评分较治疗前降低,而Harris评分较治疗前升高(观察组：t=24.428、15.449,对照组：t=13.604、9.682,P<0.05)；观察组治疗后VAS评分低于对照组,而Harris评分高于对照组(t=9.040、7.018,P<0.05)。两组治疗后全血黏度高切、血浆粘度和全血黏度低切水平较治疗前降低(观察组：t=13.223、13.614、17.284,对照组：t=7.748、6.781、11.047,P<0.05)；观察组治疗后全血黏度高切、血浆粘度和全血黏度低切水平低于对照组(t=8.343、6.465、11.851,P<0.05)。两组治疗后血浆TNF-α水平较治疗前降低(观察组：t=20.284,对照组：t=12.049,P<0.05)；观察组治疗后血浆TNF-α水平低于对照组(t=14.252,P<0.05)。两组治疗后血清OST水平较治疗前升高,而CTX和PINP水平较治疗前降低(观察组：t=17.152、22.818、13.844,对照组：t=10.055、10.261、6.153,P<0.05)；观察组治疗后血清OST水平高于对照组,而CTX和PINP水平低于对照组(t=7.360、12.557、10.291,P<0.05)。结论：骨苓通痹丸与双氯芬酸钠肠溶片联合治疗激素性股骨头坏死患者临床疗效良好,可改善患者血液流变学和骨代谢,缓解疼痛,降低TNF-α水平,值得临床借鉴。 |
| 英文摘要: |
| Objective: To investigate the clinical study of Guling Tongbi Pill combined with diclofenac sodium enteric-coated tablets in the treatment of steroid-induced femoral head necrosis. Methods: The 83 patients with steroid-induced avascular necrosis of the femoral head admitted to our hospital from June 2017 to June 2018 were selected as the research objects. According to the random table method, 41 patients in the control group and 42 patients in the observation group were divided into two groups. The patients in the control group were treated with diclofenac sodium enteric-coated tablets, while the patients in the observation group were treated with Guling Tongbi pills on the basis of the control group. The course of treatment was 3 months in both groups. The therapeutic effects of the two groups were compared. The changes of visual analogue scale (VAS) and Harris score, Hemorheology and tumor necrosis factor-a(TNF-a) and bone metabolism before and after treatment were compared. Resluts: The total effective rate of the observation group (92.86%) was higher than that of the control group (70.73%) (P<0.05). After treatment, the VAS score of the two groups was lower than that before treatment, while the Harris score was higher than that before treatment (observation group: t=24.428, 15.449, control group: t=13.604, 9.682, P<0.05); after treatment, the VAS score of the observation group was lower than that of the control group, while the Harris score was higher than that of the control group (t=9.040, 7.018, P<0.05). After treatment, the whole blood viscosity, plasma viscosity and whole blood viscosity low shear level in the two groups were lower than those before treatment (observation group: t=13.223, 13.614, 17.284, control group: t=7.748, 6.781, 11.047, P<0.05); after treatment, the whole blood viscosity high shear, plasma viscosity and whole blood viscosity low shear level in the observation group were lower than those in the control group (t=8.343, 6.465, 11.851, P<0.05). After treatment, the plasma TNF-a level in the two groups was lower than that before treatment (observation group: t=20.284, control group: t=12.049, P<0.05); after treatment, the plasma TNF-a level in the observation group was lower than that in the control group (t=14.252, P<0.05). The levels of serum OST in the two groups increased after treatment, while the levels of CTX and PINP decreased after treatment (observation group:t=17.152, 22.818, 13.844, control group:t=10.055, 10.261, 6.153, P<0.05); after treatment, the levels of serum OST in the observation group were higher than those in the control group, while the levels of CTX and P INP were lower than those in the control group (t=7.360, 12.557, 10.291, P<0.05). Conclusion: Guling Tongbi Pill and diclofenac sodium enteric-coated tablets have good clinical efficacy in the treatment of steroid-induced femoral head necrosis. They can improve hemorheology and bone metabolism, alleviate pain and reduce TNF-alpha level, which is worthy of clinical reference. |
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