【摘要】 目的 观察补肾活血壮骨汤联合外科手术治疗骨质疏松性髋部骨折患者对血清转化生长因子-β1(Transforming growth factor-βone, TGF-β1)、成纤维细胞生长因子-2(Fibroblast growth factor-2,FGF-2)含量和骨折愈合的影响。方法 选取2019年10月—2021年3月期间湖北省钟祥市中医院收治的骨质疏松性髋部骨折患者94例，依据简单随机数字表法分为研究组与对照组，每组各47例。两组患者均采取动力髋螺钉内固定治疗，术后对照组口服迪巧维D钙咀嚼片，研究组在对照组基础上采取补肾活血壮骨汤。治疗8周后，观察比较两组患者骨折愈合时间、临床疗效、不良反应，治疗前后骨密度、骨代谢相关指标[骨钙素(Osteocalcin, BGP)、骨碱性磷酸酶(Bone alkaline phosphatase, BALP)、Ⅰ型胶原N末端肽(N-terminal peptide of type I collagen, NTX)]、血清TGF-β1、FGF-2含量、中医证候积分(主症积分、次症积分、总分)。结果 治疗后两组患者主症、次症、总分均较治疗前降低，差异有统计学意义(P<0.05);且研究组明显低于对照组，差异有统计学意义(P<0.05)。治疗后研究组治疗总有效率93.62%(44/47)明显高于对照组78.72%(37/47),差异有统计学意义(P<0.05)。治疗后两组患者骨密度水平较治疗前增加，差异有统计学意义(P<0.05);且研究组高于对照组，差异有统计学意义(P<0.05)。治疗后研究组骨折愈合时间明显短于对照组，差异有统计学意义(P<0.05)。治疗后两组患者血清BALP、BGP、NTX水平均较治疗前降低，差异有统计学意义(P<0.05);且研究组各指标水平明显低于对照组，差异有统计学意义(P<0.05)。治疗后两组患者血清TGF-β1、FGF-2含量均较治疗前升高，差异有统计学意义(P<0.05);且研究组明显高于对照组，差异有统计学意义(P<0.05)。治疗期间，两组不良反应发生率比较，差异无统计学意义(P>0.05)。结论 补肾活血壮骨汤联合外科手术治疗骨质疏松性髋部骨折，可改善患者症状，提高治疗效果，可能与该方案能有效增加骨密度、调节骨代谢状态及血清TGF-β1、FGF-2含量具有一定关联性，且安全性具有保证。更多还原

【Abstract】 Objective To explore the effect of Bushen Huoxue Zhuanggu Decoction combined with surgery on serum transforming growth factor-β1(TGF-β1)and fibroblast growth factor-2(FGF-2)content and fracture healing in patients with osteoporotic hip fracture.Methods A total of 94 patients with osteoporotic hip fracture in Zhongxiang Traditional Chinese Medicine Hospital from October 2019 to March 2021 were included and divided into a study group and a control group according to random number table, with 47 in each group.Both groups were treated with dynamic hip screw fixation.After operation, the control group took D-Calcalcium supplement with vitamin D chewable tablets orally, while the study group took Bushen Huoxue Zhuanggu Decoction on the basis of the control group.After 8 weeks of treatment, the fracture healing time, clinical efficacy, adverse reactions, and bone mineral density, bone metabolism related indexes[osteocalcin(BGP),bone alkaline phosphatase(BALP),N-terminal telopeptide of type I collagen(NTX)],serum TGF-β1 and FGF-2 content, and traditional Chinese medicine(TCM)syndrome scores(main symptom score, secondary symptom score, total score)before and after treatment were compared between the two groups.Results After treatment, the main symptomscore, secondary symptomscore, total score as well as the levels of serum BALP,BGP and NTX of the two groups were lower while the bone mineral density and the serum TGF-β1 and FGF-2 content were higher than those before treatment(all P<0.05),and the study group had more decrease or increase than the control group(P<0.05).The total effective rate of the study group was 93.62%(44/47)higher than 78.72%(37/47)of the control group(P<0.05),and the fracture healing time was shorter than that of the control group(P<0.05).There was no distinct difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Bushen Huoxue Zhuanggu Decoction combined with surgery in the treatment of osteoporotic hip fracture could alleviate the symptoms and improve the clinical efficacy, which might be related to the increase of bone mineral density, regulation of bone metabolism and serum TGF-β1 and FGF-2 content to a certain degree, and the safety was guaranteed.更多还原