目的 探究舒筋活血片联合阿仑膦酸钠治疗早期激素性股骨头坏死的临床效果。方法 选取2021年10月—2023年3月在聊城市第二人民医院进行治疗的早期激素性股骨头坏死患者80例，根据患者治疗方案之间的差异将其分成对照组和治疗组，每组各40例。对照组晨起空腹口服阿仑膦酸钠片，70 mg/次，1次/周；治疗组在对照组基础上口服舒筋活血片，5片/次，3次/d。两组患者均治疗24周。观察两组患者临床疗效，比较治疗前后两组患者中医证候评分、世界卫生组织生存质量测定简表（WHOQOL-BREF）评分与Harris评分及血清脂联素（ADPN）、白细胞介素-1β（IL-1β）和抗酒石酸酸性磷酸酶-5b（TRACP-5b）水平。结果 治疗后，对照组和治疗组临床总有效率分别为80.00%和95.00%，两组比较差异具有统计学意义（P＜0.05）。治疗后，两组患者中医证候评分显著下降，而WHOQOL-BREF评分和Harris评分显著上升（P＜0.05），且治疗组评分明显好于对照组（P＜0.05）。治疗后，两组患者血清IL-1β和TRACP-5b水平显著下降，而血清ADPN水平显著上升（P＜0.05），且治疗组指标改善明显好于对照组（P＜0.05）。结论 舒筋活血片联合阿仑膦酸钠片治疗早期激素性股骨头坏死疗效显著，不仅能够显著改善患者临床症状、髋关节功能和生存质量，同时还能够促进血清学指标的恢复且并未增加明显不良反应。

Objective To explore the therapeutic effects of Shujin Huoxue Tablets combined with alendronate sodium in treatment of early steroid induced femoral head necrosis. Methods Patients (80 cases) with early steroid induced femoral head necrosis in Liaocheng Second People’s Hospital from October 2021 to March 2023 were divided into control and treatment group based on different treatments, and each group had 40 cases. Patients in the control group were po administered with Alendronate Sodium Tablets, 70 mg/time, once weekly. Patients in the treatment group were po administered with Shujin Huoxue Tablets on the basis of the control group, 5 tablets/time, three times daily. Patients in two groups were treated for 24 weeks. After treatment, the clinical evaluations were evaluated, the scores of TCM syndrome, WHOQOL-BREF, and Harris, and the levels of ADPN, IL-1β and TRACP-5b in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 80.00% and 95.00%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the TCM syndrome scores of patients in two groups were significantly decreased, while the WHOQOL-BREF scores and Harris scores were significantly increased (P < 0.05), and the scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum IL-1β and TRACP-5b levels in two groups were significantly decreased, while the serum ADPN levels were significantly increased (P < 0.05), and the improvement of indicators in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion The curative effect of Shujin Huoxue Tablets combined with alendronate sodium in treatment of early steroid induced femoral head necrosis is remarkable, which not only can significantly improve the patient's clinical symptoms, hip joint function and quality of life, but also promote the recovery of serological indicators without increasing obvious adverse reactions.

R977

山东省中医药科技发展项目（2017-495）