手术联合参茸痨疽丸治疗虚寒型慢性骨髓炎的临床研究

目的：观察手术联合参茸痨疽丸治疗虚寒型慢性骨髓炎的临床疗效.方法：将186例虚寒型慢性骨髓炎患者随机分为2组,每组93例.A组采用常规手术抗生素治疗,B组采用常规手术抗生素联合参茸痨疽丸治疗.比较2组患者的治疗后1年的临床疗效、治疗1个疗程后的生化指标和治疗4个疗程后免疫指标.结果：①临床疗效.治疗后1年A组治愈31例、好转37例、无效25例,B组治愈62例、好转25例、无效6例.B组临床疗效优于A组（Z=-2.405,P=0.019）.②生化指标.治疗1个疗程后A组患者的白细胞计数、红细胞沉降率、超敏C反应蛋白均高于B组,差异有统计学意义（8.83±2.54） 109个·L-1,（5.92±1.64）109个·L-1,t=6.362,P=0.042;（14.16±2.75）mm·h-1,（6.27±3.24）mm·h-1,t=7.238,P =0.034;（2.74±0.78）mg·L-1,（1.76±0.56）mg·L-1,t=5.149,P=0.027].③免疫指标.治疗4个疗程后A组患者的血清白细胞介素2、白细胞介素6及免疫球蛋白G含量均低于B组,差异均有统计学意义（1.96±0.27）ng·mL-1,（3.46±0.33）ng·mL-1,t=-7.127,P=0.026;（13.64±2.49）pg· mL-1,（25.08±3.36）pg· mL-1,t=-5.536,P=0.035;（3.75±1.61）mg· mL-1,（5.95±1.76）mg· mL-1,t=-4.268,P=0.028].结论：手术联合参茸痨疽丸可有效降低虚寒型慢性骨髓炎患者白细胞数量、红细胞沉降率和超敏C反应蛋白,提高白细胞介素2、白细胞介素6及免疫球蛋白G含量,其临床疗效优于常规手术抗生素治疗.

Clinical study on the curative effect of surgery combined with SHENRONG LAOJU pill in the treatment of chronic osteomyelitis of yang-deficiency cold type

Objective： To observe the clinical effects of surgery combined with SHENRONG LAOJU pill in the treatment of chronic osteomyelitis of yang-deficiency cold type.Methods： One hundred and eighty-six patients with chronic osteomyelitis of yang-deficiency cold type were randomly divided into group A and group B,93 cases in each group.The patients in group A were treated with antibiotics,while the others in group B were treated with antibiotics combined with SHENRONG LAOJU pill.Then the clinical effects after one-year treatment,the biochemical criterion after one-course treatment and the immune indices after four-course treatment were compared between the 2 groups.Results：After one-year treatment,31 patients obtained an excellent result,37 good and 25 poor in group A;while 62 patients obtained an excellent result,25 good and 6 poor in group B.The group B surpassed the group A in the clinical effects （Z =-2.405,P =0.019）.After one-course treatment,the number of white blood cells （WBC）,the erythrocyte sedimentation rate （ESR） and the high sensitivity C-Reactive Protein（h-CRP）in group A were all higher than that of group B,and there was statistical difference between the 2 groups（8.83 ＋/-2.54 vs 5.92 ＋/-1.64 109/L,t =6.362,P =0.042;14.16 ＋/-2.75 vs 6.27 ＋/-3.24 mrn/h,t =7.238,P =0.034;2.74 ＋/-0.78 vs 1.76 ＋/-0.56 mg/L,t =5.149,P =0.027）.After four-course treatment,the content of serum interleukin-2 （IL-2）,IL-6 and immunoglobulin G（IgG） in group A were all lower than that of group B,and there was statistical difference between the 2 groups （1.96 ＋/-0.27 vs 3.46 ＋/-0.33 ng/mL,t =-7.127,P =0.026 ; 13.64 ＋/-2.49 vs 25.08 ＋/-3.36 pg/mL,t =-5.536,P =0.035;3.75 ＋/-1.61 vs 5.95 ＋/-1.76 mg/mL,t =-4.268,P =0.028）.Conclusion：The method of surgery combined with SHENRONG LAOJU pill can reduce the number of WBC,ESR and h-CRP,and increase the content of IL-2,IL-6 and IgG in the treatment of chronic osteomyelitis of yang-deficiency cold type,which curative effect is better than that of antibiotics.