Abstract：Objective To evaluate the clinical efficacy of Guyanping No.1 Prescription (GNP) combined with tobramycin bone cement chain beads (TBC) against chronic osteomyelitis (CO) among elderly patients.Methods Seventy-two elderly patients with CO treated in the Department of Orthopaedics between May 2015 and May 2018 were randomly divided into the control group (treated with TBC and antibiotics) and GNP group (treated with TBC and GNP). After 8 weeks of treatment, the blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and levels of interleukin (IL)-1β, IL-4, IL-6 and IL-10 were detected in both groups. Within a year of treatment, the recurrence in all the cured cases was monitored by follow-up visits.Results The clinical efficacy rate in the GNP group (86.11%) was significantly higher than in the control group (58.33%) (P<0.05). The infection indexes (WBC, ESR and CRP) and serum levels of proinflammatory cytokines (IL-1β and IL-6) were significantly decreased after treatment (P<0.01) while the serum levels of anti-inflammatory cytokines (IL-4 and IL-10) were significantly elevated (P<0.01). Compared with the control group, WBC, ESR, CRP and IL-1β and IL-6 levels in the GNP group were significantly reduced (P<0.05) while IL-4 and IL-10 levels were significantly enhanced (P<0.05)after treatment. The recurrence rate in the GNP group (9.52%) was significantly lower than that of the control group (35.71%, P<0.05) within a year of treatment.Conclusions The severity of CO in elderly patients can be mitigated by GNP combined with TBC, and the main mechanism may involve the inhibition of infections, improvement of inflammatory responses and modulation of proinflammatory/anti-inflammatory cytokine balance.
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2021, Vol. 32 
