目的:探讨老年股骨颈骨折人工股骨头置换术后应用迈之灵片联合鲑鱼降钙素治疗的临床效果和术后6个月患髋关节功能的影响因素。方法:采用前瞻性研究方法，收集华北理工大学附属医院于2017年1月至2019年6月行人工股骨头置换术治疗的老年股骨颈骨折患者84例，用随机数字表法分为治疗组(41例)和对照组(43例)。治疗组应用迈之灵片和鲑鱼降钙素鼻喷剂加基础钙剂治疗；对照组给予基础钙剂治疗。采用独立样本n t检验比较两组患者术后第5天疼痛视觉模拟评分(visual analogue score，VAS)、大腿部淤血完全消退时间、术后初次下地活动时间。采用重复测量方差分析比较两组患者术后14 d、3个月、6个月的健侧股骨颈骨密度值及患髋关节功能的Harris评分。采用多因素Logistic回归分析术后6个月患侧髋关节功能的影响因素。n 结果:术后第5天VAS评分：治疗组为(6.34±1.54)分，对照组为(7.02±1.50)分；大腿部淤血完全消退时间：治疗组为(12.12±2.27) d，对照组为(13.88±2.58) d；术后初次下地活动时间：治疗组为(5.93±1.52) d，对照组为(7.84±1.05) d；两组患者上述各指标比较差异均有统计学意义(n t值分别为2.051、3.313、6.673，n P均<0.05)。治疗组患者在术后14 d及术后3、6个月健侧股骨颈骨密度值分别为(0.543±0.123)、(0.561±0.119)、(0.606±0.105) g/cmn 2，对照组分别为(0.530±0.092)、(0.517±0.089)、(0.526±0.090) g/cmn 2；重复测量的方差分析结果表明，n F组内＝55.726、n P<0.01，n F组间＝4.206、n P<0.05，n F交互＝57.654、n P<0.01；治疗组术后3、6个月与组内术后14 d比较差异均有统计学意义(n P均<0.01)，术后3个月与术后6个月比较差异有统计学意义(n P<0.01)；对照组术后14 d与组内术后3个月比较差异有统计学意义(n P<0.01)，术后3个月与术后6个月比较差异有统计学意义(n P<0.01)；术后6个月组间比较差异有统计学意义(n P<0.01)。治疗组患者在术后14 d、3个月、6个月患髋关节Harris评分分别为(82.12±8.18)、(85.49±6.61)、(87.10±6.57)分，对照组分别为(78.91±5.75)、(81.44±6.42)、(83.67±6.97)分；重复测量的方差分析结果表明，n F组内＝64.526、n P<0.01，n F组间＝6.529、n P0.05；术后3个月、6个月与组内术后14 d比较差异均有统计学意义(n P均<0.01)，术后3个月与组内术后6个月比较差异均有统计学意义(n P均<0.05)；术后14 d、3个月、6个月组间比较差异均有统计学意义(n P<0.05或n P<0.01)。多因素Logistic回归分析发现，年龄(n OR＝1.318，95%n CI1.002~1.732，n P＝0.048)、治疗方法(n OR＝29.168，95%n CI 1.030~824.623，n P＝0.048)是置换侧髋关节功能的危险因素，术后14 d患髋关节功能Harris评分(n OR＝0.624，95%n CI 0.447~0.873，n P＝0.006)为术后6个月患髋关节功能的保护性因素。n 结论:老年股骨颈骨折人工股骨头置换术后应用迈之灵片和鲑鱼降钙素鼻喷剂治疗有良好的散瘀、止痛作用，有效提高骨密度，促进术后关节功能恢复。患者年龄低、术后应用迈之灵片联合鲑鱼降钙素治疗和术后14 d患髋关节功能恢复良好是术后6个月患髋功能良好的保护性因素。“,”Objective:To study the clinical effect of Maizhiling tablets combined with salmon calcitonin in the treatment of elderly femoral neck fracture after artificial femoral head replacement and the influencing factors of hip joint function 6 months after operation.Methods:Prospective research methods were used in this article.A total of 84 elderly patients with femoral neck fracture who underwent artificial femoral head replacement in the Affiliated Hospital of North China University of Science and Technology from January 2017 to June 2019 were selected and randomly divided into the treatment group (41 cases) and the control group (43 cases) by the random number table method.The treatment group was treated with Maizhiling tablet and salmon calcitonin nasal spray plus basic calcium; the control group was treated with basic calcium.Independent sample t test was used to compare the visual analogue score (VAS) on the 5th day after operation, the time of complete disappearance of congestion in thigh, and the time of first ambulation after operation between the two groups.The bone mineral density (BMD) of contralateral femoral neck and Harris score of hip joint function were compared between the two groups at 14 days, 3 months and 6 months after operation by repeated measurement variance analysis.Multivariate Logistic regression was used to analyze the influencing factors of hip joint function at 6 months after operation.Results:VAS score on the 5th day after surgery: (6.34±1.54) points in the treatment group and (7.02±1.50) points in the control group.Complete regression time of thigh congestion: (12.12±2.27) d in the treatment group and (13.88±2.58) d in the control group.The first postoperative activity time was (5.93±1.52) d in the treatment group and (7.84±1.05) d in the control group, and the differences of the above indexes between the two groups were statistically significant (n t value was 2.051, 3.313, 6.673, respectively, all n P<0.05). The BMD values of the contralateral femoral neck in the treatment group were (0.543±0.123), (0.561±0.119), (0.606±0.105) g/cmn 2 at 14 days, 3 months and 6 months after operation, and (0.530±0.092), (0.517±0.089), (0.526±0.090) g/cmn 2 in the control group.The results of variance analysis of repeated measurements showed that n Fintra-group=55.726, n P<0.01;n Finter-group=4.206, n P<0.05;n Finteraction=57.654, n P<0.01.There were significant differences between 3 months, 6 months and 14 days after operation in the treatment group (alln P<0.01), and between 3 months and 6 months after operation (n P<0.01). In the control group, there was significant difference between 14 days and 3 months (n P<0.01), and between 3 months and 6 months (n P<0.01); 6 months after operation, the difference was statistically significant (n P<0.01). The Harris scores of hip joint in the treatment group were (82.12±8.18), (85.49±6.61), (87.10±6.57) points and (78.91±5.75), (81.44±6.42), (83.67±6.97) points in the control group.The results of repeated measurement ANOVA showed thatn Fintra-group=64.526, n P<0.01;n Finter-group=6.529, n P0.05.There were significant differences between 3 months, 6 months and 14 days after operation (alln P<0.01). There were significant differences between 3 months and 6 months after operation (n P<0.05). There were significant differences between the groups 14 days, 3 months and 6 months after operation (n P<0.05 orn P<0.01). Multivariate logistic regression analysis showed that age(n OR=1.318, 95%n CI1.002-1.732, n P=0.048) and treatment method (n OR=29.168, 95%n CI 1.030-824.623, n P=0.048) were risk factors for hip function on the replacement side, and Harris score of hip function 14 days after surgery (n OR=0.624, 95%n CI 0.447-0.873, n P=0.006) were protective factors for hip function 6 months after surgery.n Conclusion:Maizhiling tablets and salmon calcitonin nasal spray have good effects on removing blood stasis, relieving pain, effectively improving bone mineral density and promoting the recovery of joint function after artificial femoral head replacement for senile femoral neck fracture.The younger age of patients, postoperative treatment with Maizhiling tablets combined with salmon calcitonin and good recovery of hip function in 14 days after operation are the protective factors of good hip function in 6 months after operation.