中华中医药学刊

目的 分析老年骨松方联合骨化三醇在治疗老年骨质疏松性股骨粗隆间骨折的疗效。方法 纳入2022年2月—2024年2月温州市中西医结合医院收治的160例老年骨质疏松性股骨粗隆间骨折患者，随机分为治疗组和对照组，每组80例。治疗组给予老年骨松方联合骨化三醇治疗，对照组仅给予骨化三醇治疗。治疗期为2个月，监测并评估两组患者的治疗疗效、疼痛缓解情况[视觉模拟评分(visual analogue scale, VAS)]、骨密度变化、骨代谢指标[胰岛素样生长因子-1 (insulin-like growth factor-1,IGF-1)、生长激素(growth hormone, GH)、骨钙素(bone gla protein, BGP)]、日常生活能力[Barthel指数(Barthel index, BI)]及并发症发生率。结果 治疗组的中医证候疗效总有效率为96.25%(77/80),显著高于对照组(77.50%,62/80),差异具有统计学意义(P<0.05)。BI评分和VAS评分方面，治疗组治疗后显著改善，BI评分从58.62提高至73.75,VAS评分从7.87降低至2.29,均优于对照组(P<0.05)。骨密度方面，治疗组在治疗后的大粗隆骨密度和股骨颈骨密度均显著提高，分别从0.19增至0.43和从0.43增至0.49(P<0.000)。骨质代谢指标如IGF-1、GH和BGP在治疗组中均有显著提升，进一步证实了治疗组在促进骨质代谢方面的效果(P<0.05)。并发症发生率方面，治疗组显著低于对照组，其中褥疮、感染、恶心等不良反应的总发生率为5.00%(4/80),远低于对照组的27.50%(22/80)(P<0.05)。结论 老年骨松方联合骨化三醇治疗老年骨质疏松性股骨粗隆间骨折患者，能显著提高骨密度，缓解疼痛，促进功能恢复，该联合治疗方案对于老年骨质疏松性骨折患者是一种有效的治疗策略。

Objective This study aims to assess the efficacy of Laonian Gusong Formula(老年骨松方) with calcitriol in treating the elderly patients with osteoporotic intertrochanteric fracture of the femur. Method A total of 160 elderly patients with osteoporotic intertrochanteric fractures of the femur were enrolled at the Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from February 2022 to February 2024. The patients were randomly divided into a treatment group(80 cases) receiving Laonian Gusen Formula combined with calcitriol and a control group(80 cases) receiving calcitriol alone. The treatment lasted for 2 months. The therapeutic efficacy, pain relief[visual analogue scale(VAS)],bone mineral density(BMD),bone metabolism markers[insulin-like growth factor-1(IGF-1),growth hormone(GH),bone gla protein(BGP)],daily living ability[Barthel index(BI)] and complication rates were monitored and evaluated. Results The treatment group exhibited a significantly higher efficacy in traditional Chinese medicine syndrome treatment with a total effectiveness rate of 96.25%(77/80),compared to 77.50%(62/80) in the control group(P<0.05). Improvements in BI scores from 58.62 to 73.75 and reductions in VAS scores from 7.87 to 2.29 in the treatment group were significantly better than those in the control group(P<0.05). Furthermore, the bone density significantly increased in the treatment group, with the density measurements at the greater trochanter and femoral neck rising from 0.19 to 0.43 and from 0.43 to 0.49,respectively(P<0.000). Markers of bone metabolism such as IGF-1,GH and BGP also improved markedly(P<0.05). Additionally, the incidence of complications including pressure ulcers, infections and nausea was significantly lower in the treatment group at 5.00%(4/80) compared to 27.50%(22/80) in the control group(P<0.05). Conclusion The integration of Laonian Gusong Formula with calcitriol significantly enhances the bone density, alleviates the pain and promotes the functional recovery in the elderly patients with osteoporotic intertrochanteric fractures, proving to be an effective treatment strategy for these conditions.