消疽汤联合抗生素骨水泥治疗慢性骨髓炎的临床疗效及对血清骨成型蛋白-2、血沉表达的影响

李铁军; 文华军; 郑铁钢; 张朋; 马林; 韩胜义; 王继孟

doi:10.14009/j.issn.1672-2124.2021.05.011

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消疽汤联合抗生素骨水泥治疗慢性骨髓炎的临床疗效及对血清骨成型蛋白-2、血沉表达的影响

论著 | 更新时间：2022-10-08

- 消疽汤联合抗生素骨水泥治疗慢性骨髓炎的临床疗效及对血清骨成型蛋白-2、血沉表达的影响
- Clinical Efficacy of Xiaoju Decoction Combined with Antibiotic Bone Cement in the Treatment of Chronic Osteomyelitis and its Effect on the Expression of Serum Bone Morphogenetic Protein-2 and Erythrocyte Sedimentation Rate
- 中国医院用药评价与分析 2021年21卷第5期页码：556-559
- 作者机构：
  
  1. 中国人民解放军陆军第八十一集团军医院骨科
  2. 张家口市第一医院骨科
- 作者简介：
- 基金信息：
  
  河北省医学科学研究课题计划项目（No.20191801）;张家口市重点研发计划项目（No.1921113D）
- DOI：10.14009/j.issn.1672-2124.2021.05.011
  中图分类号： R551.3
- 纸质出版日期：2021，
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[1]李铁军,文华军,郑铁钢,张朋,马林,韩胜义,王继孟.消疽汤联合抗生素骨水泥治疗慢性骨髓炎的临床疗效及对血清骨成型蛋白-2、血沉表达的影响[J].中国医院用药评价与分析,2021,21(05):556-559.

LI Tiejun, WEN Huajun, ZHENG Tiegang, et al. Clinical Efficacy of Xiaoju Decoction Combined with Antibiotic Bone Cement in the Treatment of Chronic Osteomyelitis and its Effect on the Expression of Serum Bone Morphogenetic Protein-2 and Erythrocyte Sedimentation Rate[J]. 2021,21(5):556-559.
[1]李铁军,文华军,郑铁钢,张朋,马林,韩胜义,王继孟.消疽汤联合抗生素骨水泥治疗慢性骨髓炎的临床疗效及对血清骨成型蛋白-2、血沉表达的影响[J].中国医院用药评价与分析,2021,21(05):556-559. DOI： 10.14009/j.issn.1672-2124.2021.05.011.

LI Tiejun, WEN Huajun, ZHENG Tiegang, et al. Clinical Efficacy of Xiaoju Decoction Combined with Antibiotic Bone Cement in the Treatment of Chronic Osteomyelitis and its Effect on the Expression of Serum Bone Morphogenetic Protein-2 and Erythrocyte Sedimentation Rate[J]. 2021,21(5):556-559. DOI： 10.14009/j.issn.1672-2124.2021.05.011.

摘要

目的:探讨消疽汤联合抗生素骨水泥治疗慢性骨髓炎的临床疗效及对血清骨成型蛋白-2（BMP-2）、血沉（ESR）表达的影响。方法:按随机数字表法将中国人民解放军陆军第八十一集团军医院于2017年4月至2019年9月收治的慢性骨髓炎患者98例分为两组。对照组患者（49例）采用抗生素骨水泥治疗

观察组患者（49例）在对照组的基础上联合消疽汤治疗。观察两组患者治疗前、治疗4周后血清肿瘤坏死因子α（TNF-α）、白细胞介素1（IL-1）、BMP-2水平和血常规情况

分析其临床疗效、治疗期间不良反应发生情况和随访1年的复发情况。结果:观察组患者的总有效率明显高于对照组[95.92%（47/49） vs. 81.63%（40/49）]

差异有统计学意义（χ2=5.018

P=0.025）。治疗后

两组患者血清TNF-α、IL-1水平均较治疗前明显降低

BMP-2水平明显升高;与对照组比较

观察组患者血清TNF-α、IL-1水平明显更低

BMP-2水平明显更高

差异均有统计学意义（P<0.05）。治疗后

两组患者白细胞计数（WBC）、中性粒细胞百分比（NEU%）和ESR水平均较治疗前明显降低;与对照组比较

观察组患者WBC、NEU%和ESR水平明显更低

差异均有统计学意义（P<0.05）。观察组患者的不良反应发生率明显低于对照组[4.08%（2/49） vs. 22.45%（11/49）]

差异有统计学意义（χ2=7.184

P=0.007）;且观察组患者的复发率明显低于对照组[4.08%（2/49） vs. 20.41%（10/49）]

差异有统计学意义（χ2=6.078

P=0.014）。结论:消疽汤联合抗生素骨水泥治疗慢性骨髓炎能够获得较佳的临床疗效

可有效降低患者血清炎症因子水平

提高BMP-2水平

改善血常规指标

降低不良反应发生率和复发率。

Abstract

OBJECTIVE: To probe into the clinical efficacy of Xiaoju decoction combined with antibiotic bone cement in the treatment of chronic osteomyelitis and its effect on the expression of serum bone morphogenetic protein-2（ BMP-2） and erythrocyte sedimentation rate（ ESR）. METHODS: Totally 98 patients with chronic osteomyelitis admitted into the 81 st Army Group Hospital of PLA from Apr. 2017 to Sept. 2019 were divided into two groups via random number tablet. Patients in the control group（ 49 cases） was given antibiotics bone cement

while patients in the observation group was given Xiaoju decoction based on the control group. The serum tumor necrosis factor-α（ TNF-α）

interleukin-1（ IL-1）

BMP-2 levels and blood routine examination of both groups before treatment and at 4 weeks after treatment were observed. The clinical efficacy

incidences of adverse drug reactions during treatment and recurrence rate in 1-year follow-up were analyzed. RESULTS: The total effective rate of patients in the observation group was significantly higher than that of the control group [95. 92%（ 47/49） vs. 81. 63%（ 40/49） ]

with statistically significant differences（ χ2= 5. 018

P = 0. 025）. After treatment

the serum TNF-α and IL-1 levels of patients in both groups were significantly lower than those of before treatment

while the BMP-2 levels were significantly increased;compared with the control group

the serum TNF-α and IL-1 levels of patients in the observation group were significantly lower

while the BMP-2 level was significantly higher

with statistically significant differences（ P<0. 05）.After treatment

the white blood cell count（ WBC）

neutrophilic granulocyte percentage（ NEU%） and ESR levels of patients in both groups were significantly lower than those of before treatment; compared with the control group

the WBC

NEU% and ESR levels of patients in the observation group were significantly lower than those in the control group

with statistically significant differences（ P <0. 05）. The incidence of adverse drug reactions of patients in the observation group was significantly lower than that of the control group [4. 08%（ 2/49） vs. 22. 45%（ 11/49） ]

with statistically significant differences（ χ2= 7. 184

P = 0. 007）; and the recurrence rate of patients in the observation group was significantly lower than that of the control group [4. 08%（ 2/49） vs. 20. 41%（ 10/49） ]

with statistically significant differencs（ χ2= 6. 078

P = 0. 014）. CONCLUSIONS: The treatment of chronic osteomyelitis with Xiaoju decoction combined with antibiotic bone cement can achieve good clinical efficacy

which can effectively reduce serum inflammatory factor level

increase BMP-2 level

improve routine blood index

reduce the incidence of adverse drug reactions and recurrence rate.

关键词

消疽汤抗生素骨水泥慢性骨髓炎骨成型蛋白-2血沉

Keywords

Xiaoju decoctionAntibiotic bone cementChronic osteomyelitisBone morphogenetic protein-2Erythrocyte sedimentation rate

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