俞春生　赵义荣　李继川　吕志宇　许德志

[摘要] 目的 分析益肾健脾方联合鲑鱼降钙素用于老年髋部骨质疏松性骨折手术治疗患者中的价值。 方法 按本研究各项标准纳入70例老年髋部骨质疏松性骨折行手术治疗的患者，用双盲法分为两组，给予对照组阿仑膦酸钠，观察组加用鲑鱼降钙素和益肾健脾方。对比术前术后两组骨代谢指标，以及术前术后Wards、（L2～4、大转子）股骨颈骨BMD；对比术前术后两组髋关节功能；记录不良反应。 结果 术后观察组Ca2+水平高于对照组；治疗后观察组ACP与ALP均升高，与对照组差异明显；观察组术后CT、PTH低于对照组，BGP高于对照组；术后观察组股骨颈骨 BMD值明显高于对照组；治疗后观察组Harris分值较对照组高（P均<0.05）。两组不良反应发生率无显著差异（P>0.05）。 结论 益肾健脾方联合鲑鱼降钙素能改善老年髋部骨质疏松性骨折患者骨代谢指标；改善个别骨密度指标，促进康复，提高髋关节功能，且不增加不良反应，值得推广。

[关键词] 益肾健脾方；鲑鱼降钙素；老年患者；骨质疏松；髋部骨折

[中图分类号] R683 [文献标识码] B [文章编号] 1673-9701（2017）14-0113-04

[Abstract] Objective To analyze the value of Yishen Jianpi decoction combined with salmon calcitonin in the treatment of the elderly patients after osteoporotic hip fracture surgery. Methods 70 patients with osteoporotic hip fracture who underwent surgery were enrolled according to standards of this study.The patients were divided into two groups by double blindness. The control group was treated with alendronate and the observation group was given salmon calcitonin and Yishen Jianpi decoction. The Wards， （L2-4， large rotor） and BMD of femur and neck bones between the two groups before and after treatment were compared.The hip function between the two groups before and after treatment was recorded. And the adverse reactions were recorded. Results The level of Ca in the observation group was higher than that in the control group after treatment.And the ACP and ALP in the observation group after treatment increased， which was significantly different from that of the control group. The postoperative CT and PTH of the observation group were lower than those in the control group and BGP was higher than that in the control group. The BMD of the femoral bone and neck bone was significantly higher than that of the control group. Harris score in the observation group was higher than that in the control group after treatment（P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusions Yishen Jianpi decoction combined with salmon calcitonin can improve the bone regression index，the individual bone density index， promote rehabilitation and improve hip function. And the treatment do not increase the adverse reaction， which is worthy of promotion.

[Key words] Yishen Jianpi decoction； Salmon calcitonin； Elderly patients； Osteoporosis； Hip fracture

髖部骨折是老年人群常发骨折的一种，以绝经后女性多见。近年来相关流行病学发现50岁以上的老年人群中骨折发病率为26.8%，其中髋骨骨折占2.1%[1]。外科手术治疗是髋部骨折后主要治疗方法，具有显著临床效果，但容易引起其他副反应。骨质疏松主要发生在老年人群中，患者骨结构改变、骨量减少、骨头脆弱，临床主要表现为骨折、骨痛、佝偻、身体变小[2]，是老年髋部骨折发生的独立危险因素。……