| 114例中度地方性氟骨症患者X线分析 |
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投稿时间：2010-02-03 修订日期：2010-02-23
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
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| 基金项目:国家科技攻关计划 |
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| 中文摘要:〔摘要〕目的：观察中度地方性氟骨症患者骨骼损害的X 线表现特点以及郭氏中药疗法治疗前后X线的变化情况。方法：2007年12月至2009年8月，采用区组随机化方法，借助中央随机系统系统将114例中度氟骨症患者随机分为治疗组和对照组，其中治疗组60例，男26例,女34例,年龄39～60岁，平均51.68±4.98岁。对照组54例，男30例,女24例,年龄39～60岁，平均52.15±4.86岁。两组均采用基础治疗，包括补充钙剂和汤药准备阶段。补充钙剂采用口服钙尔奇D 600mg，每日一次，连续服用3个月。汤药准备阶段服用调节胃肠功能，促进消化吸收中药汤剂，服用3天。治疗组药物采用郭氏马钱汤，口服，分两次服用，每次200ml，连续服用8周。8周后改服骨康宁胶囊，规格0.44g一粒，每次2粒。每日3次，连续服用4周。疗程为12周。治疗后随访24周，总观察期36周。对照组药物采用汤药和胶囊安慰剂，服药方法和疗程与治疗组相同。治疗结束后，由7位骨科及放射学专家，采用事先根据地方性氟骨症X线征象和分度标准（WS192-2008）设计的专家评价表（包括骨质硬化、骨质疏松骨质软化、骨周关节改变及混合改变的发生和改变情况），评价治疗前后X线的情况并统计。结果：地方性氟骨症的各种X线征象在114例中度氟骨症的X线片中均可见发生。骨质硬化：前臂4例，小腿7例，骨盆4例，腰椎4例；骨质疏松软化：前臂23例，小腿23例，骨盆5例，腰椎8例；混合改变：前臂6例，小腿9例，骨盆10例，腰椎1例；骨周关节改变：前臂107例，小腿47例，骨盆28例，腰椎19例。对照组治疗前后各部位X线片上的各种表现对比均为无变化。治疗组仅有2例在骨周及关节改变情况发生治疗前后的变化，1例表现为小腿骨间膜骨化情况较治疗前好转，另1例表现为骨盆左髋臼外侧骨周增生消失。治疗组其余病例治疗前后各部位X线表现对比无变化。两组治疗前后X线变化情况的差异无统计学意义（P＞0.05）。结论：郭氏疗法在氟骨症的放射学方面无明显改善作用。
关键词：X线；地方性氟骨症；中药；治疗
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| 【关键词】氟骨症 X线 中药 治疗 |
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| 114 cases of X-ray analyses on the patients with moderate endemic fluorosis |
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| ABSTRACT 【abstract】 Objective：To observe the X-ray features of bone damage in patients with moderate endemic skeletal fluorosis and the changes of X-ray after treatment with herbal therapy. Methods：From 2007.12 to 2009.8，114 patients with moderate endemic skeletal fluorosis were randomly divided into treatment group and control group by central randomization system．Among 60 patients in treatment group，26 patients were male and 34 patients were female，ranging in age from 39 to 60 years，with an average of 51.68±4.98years．Among 54 patients in control group，30 patients were male and 24 patients were female，ranging in age from 39 to 60 years，with an average of 52.15±4.86years．Both treatment and control groups were dealed with basic treatment including calcium supplementation and preparation stage with herb decoction．Patients were orally given 600mg Caltrate everyday for calcium supplementation for 3 months. In preparation stage with herb water，patients were orally given herb decoction with the function of adjusting gastrointestinal function and promoting the digestion and absorption of herb decoction for 3 days．Patients in treatment group were orally given Guoshi Maqian Tang (200ml ，twice daily) for 8 weeks.8 weeks later, Guoshi Maqian Tang was replaced by Gukangning capsule(0.44g per cansule，2 capsules，three times daily) for 4 weeks．The treatment course lasted 12 weeks．The time for follow-up after treatment was 24 weeks．When the treatment finished，7 experts on orthopaedics and radiology evaluated and statistically analyzed the X-ray features pre and post treatment，using expert evaluation scale(include the appearance and changes about osteosclerosis，osteoporosis softening，joint changes close to the bone and mixed changes) designed referring Endemic skeletal fluorosis X-ray findings and sub-degree standard(WS192-2008)．Results：All X-ray features of endemic skeletal fluorosis appeared in the X-ray of the 114 patients with moderate endemic skeletal fluorosis．osteosclerosis：4 cases in forearm，7 in calf，4 in pelvis，4 in lumbar vertebrae；osteoporosis and bone softening：23 cases in forearm patients，23 in calf，5 in pelvis，8 in lumbar vertebrae；mixed changes：6 cases in forearm， 9 in calf，10 in pelvis，1 in lumbar vertebrae patients; joint changes：107 cases in forearm，47 in calf， 28 in pelvis，19 in lumbar vertebrae．There were no changes between pre and post treatment in X-ray of all parts in control group．In treatment group，there were extraperiostealin and joint changes between pre and post treatment in only 2 patients．One showed the ossification of interosseous membrane of leg got better than pre treatment，and another showed the lateral hyperplasia of the left pelvic acetabulum disappeared．There were no change between pre and post treatment in X-ray of all parts in the rest patiens of the treatment group．There was no significant difference between pre and after treatment in both groups(P>0.05)．Conclusion：There is no obvious improvement in radiology of patients with skeletal fluorosis treated by Guo therapy．
Keywords X-ray；endemic fluorosis；herbs； treatment
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| KEY WORDS X-ray endemic fluorosis herbs treatment |
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