目的 系统评估阿仑膦酸钠联合阿法骨化醇治疗绝经后骨质疏松症(PMOP)的有效性和安全性.方法 检索中国知网、重庆维普、万方、生物医学数据库、PubMed等数据库,纳入有关阿仑膦酸钠联合阿法骨化醇治疗PMOP的临床随机对照试验.筛选文献并进行质量评价后,采用RevMan 5.3软件进行Meta分析.结果 最终共纳入14篇文献.相比于单纯阿仑膦酸钠或单纯阿法骨化醇或基础治疗,采用阿仑膦酸钠联合阿法骨化醇治疗PMOP患者,能提高患者的临床疗效和血清骨钙素水平,改善患者的骨密度,降低患者的血清骨特异性碱性膦酸酶和Ⅰ型胶原交联羧基末端肽水平(均P<0.05).但两种治疗方案的不良反应发生情况差异无统计学意义(P>0.05).结论 阿仑膦酸钠联合阿法骨化醇能有效治疗PMOP,且相对安全.

目的:系统评估补肾活血类膏方治疗原发性骨质疏松症(Primary osteoporosis,PO)的有效性和安全性,为临床治疗提供参考依据.方法:检索CNKI、维普、万方、PubMed、Web of Science、生物医学数据库,检索时限截至2021年12月.纳入补肾活血类膏方(试验组)对比其他方式(西药、中成药及非补益肝肾方为对照组)治疗PO的临床随机对照试验,使用Jadad评定量表提取数据并对相关数据进行评分,采用Rev Man5.3统计软件进行Meta分析.结果:共纳入16篇符合统计标准的文献,涉及1297例患者.Meta分析显示:实验组在改善腰椎骨密度水平[MD-0.31,95％CI(-0.63,0.01,P 0.05]、血清骨钙素水平[MD 1.04,95％CI(-0.11,2.18),P 0.08]、改善血清钙水平[MD 0.17,95％CI(-0.19,0.53),P＜0.05]、血清碱性磷酸酶水平[MD 0.61,95％CI(-3.05,4.28),P 0.74]方面的疗效与对照组无明显差异;实验组在临床疗效[OR 3.99,95％CI(2.47,6.45),P＜0.05]、改善疼痛[MD-1.18,95％CI(-1.64,-0.72),P＜0.05]、改善中医症候[MD-3.56,95％CI(-5.46,-1.66),P＜0.05]方面优于对照组;补肾活血膏方与西药联合能协同提高腰椎骨密度水平[MD0.03,95％CI(0.01,0.06),P0.01].结论:补肾活血类膏方能有效治疗PO,改善PO患者的中医症候和降低患者疼痛视觉评分,在与西药联合时,能有效改善机体骨密度水平,从而达到改善PO患者的临床症状,受限于目前纳入的文献质量,还需要进行更深入的研究.

青少年特发性脊柱侧弯(adolescent idiopathic sco?liosis,AIS)是青少年时期排除其他器质性疾病的脊柱三维结构性畸形,其典型特征是Cobb角≥10°,发病率约为2％～4％,尤以女性患者多见[1-3].AIS的致病机制尚未明确,目前发现与遗传、营养、早期接触毒素和荷尔蒙失调等因素相关[4].随着生物力学临床应用的发展,AIS的临床模式和病理解剖的研究取得了新进展.在循证研究的推动下,AIS保守治疗和手术治疗的安全性、疗效大幅提高[5].本文围绕非手术治疗和手术治疗AIS进行阐述,以期在治疗方式上提供参考.

桃红四物汤是中医活血祛瘀的经典方剂,现代临床运用极其广泛,在内、外、妇、儿各科均有大量运用,近年来随着研究的深入,本方在骨伤科中临床应用及实验研究的报道较多,其在治疗多种骨伤科疾病均取得良好疗效,文章通过检索中国知网、维普网的文献报道对近5年桃红四物汤治疗骨伤科膝骨关节炎、腰椎间盘突出症、股骨头坏死、骨质疏松性胸腰椎压缩骨折、骨折及术后并发症及其他骨伤科疾病的临床应用及实验研究进展进行综述,以期为应用桃红四物汤治疗骨伤科疾病提供一些参考和依据.

腰椎间盘突出症是脊柱外科的常见病和多发病,好发于青壮年及体力劳动者,是临床上导致腰腿痛的主要原因之一.目前治疗上主要有手术治疗和非手术治疗,随着微创技术快速发展及其独特优势,而广泛受到患者欢迎.但术后的恢复及其并发症依然是广大医生和患者所担忧的问题.文章将近年腰椎间盘突出症术后不同的疗法对促进恢复和减少并发症的影响,结合文献进行汇总整理,为腰椎间盘突出症术后恢复提供借鉴和参考.

Objective:To understand the morphological characteristic of femoral head,neck,trochanter by the CT value of the normal hip,and guide to the orientation of DHS.Methods:Normal CT values of Hip in 80 cases were measured and the ratios were statistically calculated.80 cases with intertrochanteric fractures were randomly divided into the new group(the orientation of DHS were renewed) and the control group(the orientation of DHS were designed as usual).operative time、times of intraoperative imaging and the functional scores(according to Sanders standard assessment) were measured for all the patients.The effect were assessed by Pain、strength of muscle、daily activities、X-ray measurements and posture of walk.Results:There were significant differences in the CT value between the new group and the control group.All the patients were followed up for 1.5 years,the fine rate was 97.5% in the new group,and the fine rate was 85% in the control group.There were significant differences in the functional score between the two group(P0.05).The operative time was shorter in the new group than that in the control group,the number of intraoperative radiation were less than that in the control group,the functional scores were higher than that in the control group.Conclusions:Orientation of DHS guided by CT value was simplified,the surgical time was significantly shortened,the numbers of intraoperative radiation were significantly reduced,and the ability of daily activities was significant improved.