摘要
目的:观察自拟壮骨益髓汤辨证加减对骨质疏松性椎体压缩骨折患者术后骨愈合及骨密度水平的影响。方法:选取2017年1月-2019年11月于本院行椎体成形术(PVP)治疗的骨质疏松性椎体压缩骨折(OVCF)患者70例,随机数表法分为观察组(n=35)和对照组(n=35)。对照组行PVP治疗后给予常规术后治疗,观察组在对照组的基础上加服自拟壮骨益髓汤,连续治疗6个月,比较两组患者的骨愈合情况、骨密度、骨代谢水平及腰部功能恢复情况。结果:术后,两组患者的Cobb角明显降低,伤椎前缘、中央及后缘高度明显上升(均P<0.05),且观察组的Cobb角小于对照组,伤椎前缘、中央及后缘高度大于对照组(P<0.05);术后,两组患者腰椎L;、股骨颈和股骨大转子骨密度均明显上升(P<0.05),且观察组的骨密度水平高于对照组(P<0.05);术后,两组患者血清碱性磷酸酶(ALP)和尿脱氧吡啶酚(DPD)水平明显下降,骨钙素(BPG)水平明显上升(P<0.05),且观察组的ALP和DPD水平低于对照组,BPG水平高于对照组(P<0.05);术后,两组患者的日本骨科协会腰痛评价表(JOA)评分均上升(P<0.05),且观察组的JOA评分高于对照组,差异有统计学意义(P<0.05)。结论:OVCF患者在行PVP治疗后给予自拟壮骨益髓汤进行辅助治疗,可促进患者骨愈合,提高其骨密度,改善骨代谢水平与腰椎功能,值得临床推广与应用。
Objective: To explore the effect of Modified Self-made Zhuanggu Yisui Decoction on postoperative bone healing and bone mineral density(BMD) for patients with osteoporotic vertebral compression fractures(OVCF). Methods: A total of 70 OVCF patients who underwent percutaneous vertebroplasty(PVP) in the hospital from January 2017 to November 2019 were enrolled. They were divided into an observation groups(n=35) and a controlled group(n=35) by the random number table method. The controlled group was given routine postoperative treatment after PVP,while the observation group was additionally given Self-made Zhuanggu Yisui Decoction for 6-month continuous treatment. The bone healing status, BMD,bone metabolism level and recovery of waist function were compared between the two groups. Results: After surgery, Cobb angle was significantly decreased, while height of injured vertebraeanterior edge, center and posterior edge was significantly increased in both groups(P < 0.05). Cobb angle in the observation group was less than that in the controlled group, while height of injured vertebrae anterior edge, center and posterior edge was greater than that in control group(P < 0.05). After surgery, BMD of lumbar spine L;,femoral neck and femoral trochanter in both groups was significantly increased(P < 0.05),which was higher in the observation group than the controlled group(P < 0.05). After surgery, levels of serum alkaline phosphatase(ALP) and deoxypyridinoline(DPD) were significantly decreased, while level of osteocalcin(BPG) was significantly increased in both groups(P < 0.05). The levels of ALP and DPD in the observation group were lower than those in the controlled group, while BPG level was higher than that in the controlled group(P < 0.05). After surgery, scores of Japanese Orthopaedic Association(JOA) were increased in both groups(P < 0.05),which were higher of the observation group than the controlled group(P < 0.05). Conclusion: The application of Self-made Zhuanggu Yisui Decoction for adjuvant therapy in OVCF patients
作者
王海都
鲁兴周
司杨
WANG Haidu;LU Xingzhou;SI Yang(DepartmentⅠof Orthopedics,Jiange Hospital of Traditional Chinese Medicine,Jiange Sichuan 628300,China)
出处
《四川中医》
2021年第11期163-167,共5页
Journal of Sichuan of Traditional Chinese Medicine
基金
四川省中医药管理局项目(编号:2018JC073)。
关键词
质疏松性椎体压缩骨折
椎体成形术
壮骨益髓汤
骨愈合
骨密度
Osteoporotic vertebral compression fracture
Percutaneous vertebroplasty
Zhuanggu Yisui Decoction
Bone healing
Bone mineral density
