ABSTRACT
Objective::To observe the effect of modified Erxian decoction on the physical condition, pain in the lower back and joints, limb activity, bone density, bone metabolism and biochemical indexes in patients with osteoporosis caused by Yang deficiency, in order to explore the possible mechanism. Method::Totally 100 cases of osteoporosis with Yang deficiency were randomly divided into treatment group and control group, with 50 cases in each group. The control group was treated with basic anti-osteoporosis therapy, and the treatment group was give modified Erxian decoction combined with basic therapy for 6 weeks. Short physical performance battery (SPPB) scores of low back and joint pain and Yang deficiency symptom score before and after treatment were recorded and analyzed. before and after treatment, the changes of blood serum calcium (Ca), phosphorus (P), L1-4, femoral neck bone mineral density(BMD), osteocalcin (BGP) and type I collagen peptide amino end level (P1NP) were measured. Result::The scores of lumbar back and joint pain, Yang deficiency symptom score, limb function and activity, lumbar spine 1-4 (L1-4), femoral neck BMD, Ca, P, BGP and P1NP between two groups before treatment had no statistically significant difference. After 6 weeks of treatment, limb activity score, L1-4, femoral neck BMD, serum Ca and P levels in treatment group were significantly higher than those in control group (P<0.05). The scores of the pain in the lower back and joints, Yang deficiency symptom score, BGP and P1NP in treatment group were significantly lower than those in control group (P<0.05). Conclusion::Modified Erxian decoction can significantly alleviate the pain in the lower back and joints of patients with osteoporosis caused by Yang deficiency, enhance the limb function and activity status, improve the physical condition and bone density of patients, reduce bone conversion, with a good effect in treating and alleviating symptoms of osteoporosis caused by Yang deficiency.
ABSTRACT
<p><b>OBJECTIVE</b>To study the operative procedures, indicatrions and short-term effects of the artificial femoral head replacement for the treatment of unstable intertrochanteric fracture in aged patients.</p><p><b>METHODS</b>From January 2001 to October 2008, 40 patients with unstable intertrochanteric fractures were treated with artificial femoral head replacement. Among the patients, 9 patients were male and 31 patients were female, ranging in age from 75 to 95 years, averaged 81.1 years. The duration from injured to the hospitalization ranged from 3 to 48 hours, with a mean of 11.5 h. According to Evans classification, 8 patients were type II , 21 type III, and 11 type IV. The duration from hospitalization to operation ranged from 4 to 8 days, averaged 4.8 day. After the operation, the hip motion was observed and the preoperative and postoperative Harris scores were compared.</p><p><b>RESULTS</b>All the patients were operated successfully, and were kept in bed about 4 to 7 days, 5.9 days in average. Thirty-one patients were followed up for 6 months without loose or dislocation of prothesis, periprosthetic fractures. Fourteen patients resumed to normal activity of the hip joint while 17 patients showed the declination of hip movement. Their hip movements recovered to (66.67+/-26.35)% at 4 months after operations and (76.08+/-25.62)% at 6 months. Among 10 patients with normal ability of hip joints before their injuries were valuated with Harris system at 6 mouths after operations, the results were:5 excellent, 3 good and 2 poor.</p><p><b>CONCLUSION</b>Artificial femoral head replacement for unstable intertrochanteric fractures in aged patients is effective in the recovery of hip joint function in short time with earlier walking and decreased complications.</p>