中华中医药学刊

目的 观察养元健骨汤对老年骨质疏松症骨折患者疗效、骨密度及骨折愈合速度影响。方法 纳入90例老年骨质疏松症骨折患者，随机分为观察组及对照组，每组45例。对照组给予骨化三醇软胶囊，观察组在对照组基础上给予养元健骨汤治疗，两组均治疗8周。比较两组患者的临床疗效、骨代谢指标、骨密度及骨折愈合速度。结果 两组患者治疗8周后，观察组总有效率为86.67%(39/45),显著高于对照组66.67%(30/45)(P<0.05);两组患者治疗后血清Ⅰ型原胶原氨基端前肽(procollagen I N-terminal peptide, PINP)水平均较治疗前显著降低(P<0.05),血清骨钙素(osteocalcin, OC)均较治疗前显著升高(P<0.05),观察组β-胶原特殊序列(β-isomerized C-terminal telopeptides, β-CTX)较治疗前显著降低(P<0.05),对照组β-CTX与治疗前相比有降低趋势但无统计学意义(P>0.05)。且观察组指标降低或升高幅度均显著优于对照组(P<0.05);两组患者经治疗后骨密度均较治疗前显著提高(P<0.05),且观察组骨密度变化显著优于对照组(P<0.05);两组患者治疗后，观察组肱骨骨折愈合时间为(7.5±1.2)周、股骨骨折愈合时间为(10.2±2.1)周、胫骨骨折愈合时间为(10.1±1.3)周，对照组肱骨骨折愈合时间为(8.6±1.1)周、股骨骨折愈合时间为(11.9±2.3)周、胫骨骨折愈合时间为(12.4±1.4)周，观察组骨折愈合时间均短于对照组，差异有统计学意义(P<0.05)。结论 养元健骨汤显著提高老年骨质疏松症骨折患者临床疗效，改善患者骨代谢，提高骨密度，促进骨折愈合。

Objective To observe the effect of Yangyuan Jiangu Decoction(养元健骨汤) on the curative effect, bone mineral density and fracture healing speed of elderly patients with osteoporotic fractures. Methods Ninety elderly patients with osteoporosis fractures were included and randomly divided into an observation group and a control group, with 45 cases in each group. The control group was given calcitriol soft capsules, and the observation group was given Yangyuan Jiangu Decoction on the basis of the control group, both groups were treated for 8 weeks. The clinical efficacy, bone metabolism indexes, bone mineral density, and fracture healing speed were compared between the two groups. Results After 8 weeks of treatment in the two groups, the total effective rate of the observation group was 86.67%(39/45),which was significantly higher than that of the control group 66.67%(30/45)(P<0.05). Procollagen I N-terminal peptide(PINP) levels were significantly lower than those before treatment(P<0.05). The levels of osteocalcin(OC) were significantly higher than those before treatment(P<0.05). The levels of β-isomerized C-terminal telopeptides(β-CTX) were significantly lower than those before treatment(P<0.05) and β-CTX in the control group had a decreasing trend compared with that before treatment, but there was no statistical significance(P>0.05). The decrease or increase of the indexes in the observation group was significantly better than that in the control group(P<0.05). The bone mineral density of the two groups after treatment was significantly increased compared with that before treatment(P<0.05),and the change of the bone mineral density of the observation group was significantly better than that of the control group(P<0.05). After treatment in the observation group, the healing time of humerus fractures was(7.5±1.2) weeks, the healing time of femoral fractures was(10.2±2.1) weeks and the healing time of tibia fractures was(10.1±1.3) weeks. In the control group, the healing time of humerus fractures was(8.6±1.1) weeks, the healing time of femoral fractures was(11.9±2.3) weeks and the healing time of tibia fractures was(12.4±1.4) weeks. The fracture healing time of the observation group was shorter than that of the control group and the difference was statistically significant(P<0.05). Conclusion Yangyuan Jiangu Decoction significantly improves the clinical efficacy and bone metabolism, increases bone density and promotes fracture healing of elderly patients with osteoporosis and fractures.