目的 探究舒筋活血片聯(lián)合阿侖膦酸鈉治療早期激素性股骨頭壞死的臨床效果。方法 選取2021年10月—2023年3月在聊城市第二人民醫(yī)院進行治療的早期激素性股骨頭壞死患者80例，根據(jù)患者治療方案之間的差異將其分成對照組和治療組，每組各40例。對照組晨起空腹口服阿侖膦酸鈉片，70 mg/次，1次/周；治療組在對照組基礎上口服舒筋活血片，5片/次，3次/d。兩組患者均治療24周。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)證候評分、世界衛(wèi)生組織生存質量測定簡表（WHOQOL-BREF）評分與Harris評分及血清脂聯(lián)素（ADPN）、白細胞介素-1β（IL-1β）和抗酒石酸酸性磷酸酶-5b（TRACP-5b）水平。結果 治療后，對照組和治療組臨床總有效率分別為80.00%和95.00%，兩組比較差異具有統(tǒng)計學意義（P＜0.05）。治療后，兩組患者中醫(yī)證候評分顯著下降，而WHOQOL-BREF評分和Harris評分顯著上升（P＜0.05），且治療組評分明顯好于對照組（P＜0.05）。治療后，兩組患者血清IL-1β和TRACP-5b水平顯著下降，而血清ADPN水平顯著上升（P＜0.05），且治療組指標改善明顯好于對照組（P＜0.05）。結論 舒筋活血片聯(lián)合阿侖膦酸鈉片治療早期激素性股骨頭壞死療效顯著，不僅能夠顯著改善患者臨床癥狀、髖關節(jié)功能和生存質量，同時還能夠促進血清學指標的恢復且并未增加明顯不良反應。

Objective To explore the therapeutic effects of Shujin Huoxue Tablets combined with alendronate sodium in treatment of early steroid induced femoral head necrosis. Methods Patients (80 cases) with early steroid induced femoral head necrosis in Liaocheng Second People’s Hospital from October 2021 to March 2023 were divided into control and treatment group based on different treatments, and each group had 40 cases. Patients in the control group were po administered with Alendronate Sodium Tablets, 70 mg/time, once weekly. Patients in the treatment group were po administered with Shujin Huoxue Tablets on the basis of the control group, 5 tablets/time, three times daily. Patients in two groups were treated for 24 weeks. After treatment, the clinical evaluations were evaluated, the scores of TCM syndrome, WHOQOL-BREF, and Harris, and the levels of ADPN, IL-1β and TRACP-5b in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 80.00% and 95.00%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the TCM syndrome scores of patients in two groups were significantly decreased, while the WHOQOL-BREF scores and Harris scores were significantly increased (P < 0.05), and the scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum IL-1β and TRACP-5b levels in two groups were significantly decreased, while the serum ADPN levels were significantly increased (P < 0.05), and the improvement of indicators in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion The curative effect of Shujin Huoxue Tablets combined with alendronate sodium in treatment of early steroid induced femoral head necrosis is remarkable, which not only can significantly improve the patient's clinical symptoms, hip joint function and quality of life, but also promote the recovery of serological indicators without increasing obvious adverse reactions.

R977

山東省中醫(yī)藥科技發(fā)展項目（2017-495）