目的 探讨骨松宝颗粒联合注射用唑来膦酸治疗早中期股骨头坏死的临床疗效。方法 选取2018年4月-2020年1月在南阳市中心医院接受诊疗的108例股骨头坏死患者，采用双色球法将患者分为对照组和治疗组，每组各54例。对照组患者静脉滴注注射用唑来膦酸，4 mg加入0.9%氯化钠溶液100 mL中，于30 min内完成滴注，治疗1次。治疗组在对照组的基础上口服骨松宝颗粒，1袋/次，3次/d，以30 d为1个疗程，连续治疗12个月。观察两组临床疗效，比较两组视觉疼痛模拟评分（VAS）、Harris髋关节功能评分、骨代谢指标、血液流变学指标。结果 治疗后，治疗组的优良率（72.22%）明显高于对照组（51.85%）（P<0.05）。与治疗前相比，两组VAS评分下降，Harris髋关节功能评分升高（P<0.05）；与对照组治疗后相比，治疗组VAS评分更低，Harris髋关节功能评分更高（P<0.05）。与治疗前相比，两组全血黏度、红细胞压积、纤维蛋白原均下降（P<0.05）；与对照组治疗后相比，治疗组全血黏度、红细胞压积、纤维蛋白原更低（P<0.05）。与治疗前相比，两组治疗后骨钙素（OC）下降，25-羟基维生素D₃[25（OH）D₃]升高（P<0.05）；与对照组治疗后相比，治疗组OC更低，25（OH）D₃更高（P<0.05）。结论 骨松宝颗粒联合注射用唑来膦酸治疗早中期股骨头坏死患者可促进症状改善，调节血液流变学指标和骨代谢，具有较好的临床应用价值。

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

河南省科技计划项目（182102310466）