Abstract:

Objective　To observe the therapeutic effect of the Shenling Yihua Zhuanggu prescription on patients with femoral neck fractures who underwent total hip arthroplasty. Methods　Eighty patients with femoral neck fractures who underwent total hip replacement surgery at Xi'an International Medical Center Hospital from January 2017 to December 2020 were selected as the research subjects. Using the simple randomization method, the patients were divided into the control group (40 cases) and the observation group (40 cases). There were 24 males and 16 females in the control group, aged (57.85±9.22) years. There were 21 males and 19 females in the observation group, aged (58.47±10.05) years. The control group received conventional treatment, while the observation group was treated with the Shenling Yihua Zhuanggu prescription in addition to the treatment of the control group. Both groups were treated continuously for 14 days. The occurrence of deep vein thrombosis (DVT) in the lower limbs, complications and adverse reactions were compared between the two groups, as well as the traditional Chinese medicine syndrome scores, Harris scores, pain factors [β-endorphin (β-EP), substance P (SP), prostaglandin E2 (PGE2)], and blood rheological indicators [plasma viscosity, whole blood viscosity (high, medium, low shear), D-dimer] before and after treatment. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After treatment, the traditional Chinese medicine syndrome score of the observation group was lower than that of the control group [(6.89±1.04) points vs. (9.25±1.14) points], and the Harris score was higher than that of the control group [(68.96±6.41) points vs. (56.85±5.89) points] (both P<0.05); the levels of β-EP, SP, and PGE2 in the observation group were all lower than those in the control group [(97.52±11.08) ng/L vs. (131.54±13.42) ng/L, (137.48±23.51) ng/L vs. (187.85±26.33) ng/L, (114.58±18.53) μg/L vs. (194.55±26.43) μg/L] (all P<0.05); the plasma viscosity, whole blood viscosity (high, medium, and low shear), and D-dimer levels in the observation group were all lower than those in the control group (all P<0.05). The incidence of lower limb DVT after surgery in the observation group was lower than that in the control group [2.50% (1/40) vs. 15.00% (6/40)] (P<0.05). During the treatment period, no complications or adverse reactions occurred in either group. Conclusion　The Shenling Yihua Zhuanggu prescription is used to treat patients with spleen deficiency with dampness syndrome after total hip arthroplasty for femoral neck fractures. It can improve the hypercoagulable state of the blood, reduce postoperative lower limb DVT, alleviate pain, and promote the recovery of hip joint function.

Key words:

Femoral neck fracture, Shenling Yihua Zhuanggu , prescription, Total hip arthroplasty, Spleen deficiency with dampness syndrome,  , Hypercoagulable state of blood

摘要：

目的　观察参苓益化壮骨方治疗股骨颈骨折全髋关节置换术后患者的效果。方法　选取2017年1月至2020年12月在西安国际医学中心医院行全髋关节置换术治疗的80例股骨颈骨折患者作为研究对象。采用简单随机法，将患者分为对照组（40例）和观察组（40例）。对照组男24例，女16例；年龄（57.85±9.22）岁。观察组男21例，女19例；年龄（58.47±10.05）岁。对照组采用常规治疗，观察组在对照组基础上采用参苓益化壮骨方治疗。两组均连续治疗14 d。比较两组治疗前后中医证侯积分、Harris评分、疼痛因子［β内啡肽（β-EP）、P物质（SP）、前列腺素E2（PGE2）］、血液流变学指标［血浆黏度、全血黏度（高、中、低切）、D-二聚体］，下肢深静脉血栓（DVT）、并发症和不良反应发生情况。采用独立样本t检验、配对t检验和χ²检验进行统计学分析。结果　治疗后，观察组中医证侯积分低于对照组［（6.89±1.04）分比（9.25±1.14）分］，Harris评分高于对照组［（68.96±6.41）分比（56.85±5.89）分］（均P<0.05）；观察组β-EP、SP、PGE2水平均低于对照组［（97.52±11.08）ng/L比（131.54±13.42）ng/L、（137.48±23.51）ng/L比（187.85±26.33）ng/L、（114.58±18.53）μg/L比（194.55±26.43）μg/L］（均P<0.05）；观察组血浆黏度、全血黏度（高、中、低切）、D-二聚体水平均低于对照组（均P<0.05）。观察组术后下肢DVT发生率低于对照组［2.50%（1/40）比15.00%（6/40）］（P<0.05）。治疗期间，两组均未发生并发症和不良反应。结论　参苓益化壮骨方治疗股骨颈骨折全髋关节置换术后患者脾虚夹湿证，可改善血液高凝状态，减少术后下肢DVT，减轻疼痛，促进髋关节功能恢复。

关键词:

股骨颈骨折, 参苓益化壮骨方, 全髋关节置换术, 脾虚夹湿证, 血液高凝状态