牛初乳对骨愈合、康复及术后并发症的治疗效果：一项前瞻性、随机、双盲对照试验

Therapeutic Effects of Bovine Colostrum on Bone Healing, Rehabilitation, and Postoperative Complications: A Prospective, Randomized, Double-Blinded Comparative Trial.

作者信息

Gouhari Faezeh, Shariatpanahi Zahra Vahdat, Talebi Shahin, Mehrvar Amir, Momeny Majid, Ehsani Akbar, Ahmadi-Abdashti Ahmadreza, Zandi Reza

机构信息

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Musculoskeletal Injuries Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Bone Joint Surg Am. 2025 Apr 18;107(12):1307-1315. doi: 10.2106/JBJS.24.00542.

DOI:10.2106/JBJS.24.00542

PMID:40249794

Abstract

BACKGROUND

Accelerated recovery from bone injuries is a paramount health-care goal with substantial impacts on physical status and overall well-being. The aim of this study was to evaluate the impact of colostrum supplementation on bone healing in patients with a traumatic extracapsular hip fracture (ECF).

METHODS

Patients with an ECF undergoing internal fixation were randomly assigned to receive either bovine colostrum or whey protein. Bone healing was assessed using the Radiographic Union Score for Hip (RUSH). Physical rehabilitation was evaluated using the Harris hip score (HHS) and the Short Musculoskeletal Functional Assessment (SMFA) within 3 months postoperatively. A generalized estimating equation (GEE) was used to assess the time-by-group interactions of these longitudinal variables. Patients were monitored for postoperative complications for 12 months, with the risk difference (RD) and risk ratio (RR) calculated.

RESULTS

A total of 116 patients with an ECF were included in the final analysis (colostrum group, n = 59; whey group, n = 57). Baseline characteristics, including age, gender, ethnicity, and body mass index, were similar between the groups (p > 0.05 for all). The colostrum group had a significantly greater increase in the RUSH score (β = 0.88; p = 0.001) and HHS (β = 1.2; p = 0.001) over time compared with the whey group. SMFA dysfunction and bother indices demonstrated significantly greater decreases over time in the colostrum group compared with the whey group (β = -1.2 and -2.4, respectively; p < 0.001 for both).

CONCLUSIONS

The present study provides preliminary evidence suggesting that colostrum may accelerate bone healing and enhance short-term physical rehabilitation outcomes more effectively than whey protein.

LEVEL OF EVIDENCE

Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

摘要

背景

加速骨损伤恢复是一项至关重要的医疗保健目标，对身体状况和整体健康有着重大影响。本研究的目的是评估补充初乳对创伤性髋关节囊外骨折（ECF）患者骨愈合的影响。

方法

接受内固定治疗的ECF患者被随机分配接受牛初乳或乳清蛋白。使用髋关节放射学愈合评分（RUSH）评估骨愈合情况。术后3个月内使用Harris髋关节评分（HHS）和简短肌肉骨骼功能评估（SMFA）评估身体康复情况。使用广义估计方程（GEE）评估这些纵向变量的组间时间交互作用。对患者进行12个月的术后并发症监测，并计算风险差异（RD）和风险比（RR）。

结果

共有116例ECF患者纳入最终分析（初乳组，n = 59；乳清组，n = 57）。两组间的基线特征，包括年龄、性别、种族和体重指数相似（所有p>0.05）。与乳清组相比，初乳组随时间推移RUSH评分（β = 0.88；p = 0.001）和HHS评分（β = 1.2；p = 0.001）的增加显著更大。与乳清组相比，初乳组的SMFA功能障碍和困扰指数随时间的下降显著更大（分别为β = -1.2和-2.4；两者p<0.001）。