目的 探討骨松寶顆粒聯(lián)合注射用唑來(lái)膦酸治療早中期股骨頭壞死的臨床療效。方法 選取2018年4月-2020年1月在南陽(yáng)市中心醫(yī)院接受診療的108例股骨頭壞死患者，采用雙色球法將患者分為對(duì)照組和治療組，每組各54例。對(duì)照組患者靜脈滴注注射用唑來(lái)膦酸，4 mg加入0.9%氯化鈉溶液100 mL中，于30 min內(nèi)完成滴注，治療1次。治療組在對(duì)照組的基礎(chǔ)上口服骨松寶顆粒，1袋/次，3次/d，以30 d為1個(gè)療程，連續(xù)治療12個(gè)月。觀察兩組臨床療效，比較兩組視覺(jué)疼痛模擬評(píng)分（VAS）、Harris髖關(guān)節(jié)功能評(píng)分、骨代謝指標(biāo)、血液流變學(xué)指標(biāo)。結(jié)果 治療后，治療組的優(yōu)良率（72.22%）明顯高于對(duì)照組（51.85%）（P<0.05）。與治療前相比，兩組VAS評(píng)分下降，Harris髖關(guān)節(jié)功能評(píng)分升高（P<0.05）；與對(duì)照組治療后相比，治療組VAS評(píng)分更低，Harris髖關(guān)節(jié)功能評(píng)分更高（P<0.05）。與治療前相比，兩組全血黏度、紅細(xì)胞壓積、纖維蛋白原均下降（P<0.05）；與對(duì)照組治療后相比，治療組全血黏度、紅細(xì)胞壓積、纖維蛋白原更低（P<0.05）。與治療前相比，兩組治療后骨鈣素（OC）下降，25-羥基維生素D₃[25（OH）D₃]升高（P<0.05）；與對(duì)照組治療后相比，治療組OC更低，25（OH）D₃更高（P<0.05）。結(jié)論 骨松寶顆粒聯(lián)合注射用唑來(lái)膦酸治療早中期股骨頭壞死患者可促進(jìn)癥狀改善，調(diào)節(jié)血液流變學(xué)指標(biāo)和骨代謝，具有較好的臨床應(yīng)用價(jià)值。

Objective To investigate the clinical value of Gusongbao Granules combined with Zoledronic Acid for injection in treatment of early and middle stage osteonecrosis of femoral head. Methods Patients (108 cases) with early and middle stage osteonecrosis of femoral head in Nanyang Central Hospital from April 2018 to January 2020 were divided into control and treatment groups according to two-color ball method, and each group had 54 cases. Patients in the control group were iv administered with Zoledronic Acid for injection, 4 mg added into 0.9% sodium chloride solution 100 mL, the drip was completed within 30 min, and the treatment was performed once. Patients in the treatment group were po administered with Gusongbao Granules on the basis of the control group, 1 bag/time, 30 d as a course of treatment, continuous treatment for 12 months. After treatment, the clinical efficacies were evaluated, and VAS scores, Harris hip function score, bone metabolism index, and hemorheology index in two groups were compared. Results After treatment, the excellent and good rate of the treatment group (72.22%) was significantly higher than that of the control group (51.85%) (P<0.05). Compared with before treatment, the VAS score in two groups were decreased, but the Harris hip function score in two groups were increased (P<0.05). Compared with the control group, the VAS score of the treatment group was lower, but the Harris hip function score was higher (P<0.05). Compared with before treatment, the whole blood viscosity, hematocrit, and fibrinogen in two groups were decreased (P<0.05). Compared with the control group, the whole blood viscosity, hematocrit, and fibrinogen in the treatment group were lower (P<0.05). Compared with before treatment, the OC were decreased, but 25(OH)D₃ in two groups were increased (P<0.05). Compared with the control group, the OC in the treatment group was lower, but 25(OH)D₃ was higher (P<0.05). Conclusion Gusongbao Granules combined with Zoledronic Acid for injection in treatment of early and middle stage osteonecrosis of femoral head can promote the improvement of symptoms, regulate hemorheological indexes and bone metabolism, which has good clinical application value.

R977

河南省科技計(jì)劃項(xiàng)目（182102310466）