补肾壮筋汤联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折临床研究
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Clinical Study on Bushen Zhuangjin Decoction Combined with Percutaneous Kypho⁃ plasty for Osteoporotic Vertebral Compression Fracture
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    摘要:

    目的:观察补肾壮筋汤联合经皮椎体后凸成形术(PKP) 治疗骨质疏松性椎体压缩骨折(OVCF) 患者的临床疗效。方法:选择96 例诊断为OVCF 的患者,按照随机数字表法分为2 组各48 例。2 组均予PKP 治疗,对照组术后予碳酸钙D3 片和骨化三醇丸;观察组在对照组治疗方案的基础上予补肾壮筋汤治疗。观察 2 组术后3 个月临床疗效; 比较2 组治疗前后日本矫形外科协会(JOA) 评分、Oswestry 功能障碍指 标(ODI)、骨代谢指标变化[降钙素、Ⅰ型胶原羧基末端肽(CTX -Ⅰ)、骨碱性磷酸酶(BALP),Ⅰ型前胶原 氨基末端肽(PⅠNP)]的变化;比较2 组治疗前后伤椎、髋关节、股骨颈骨密度的变化;比较2 组不良反应 发生率。结果:治疗后,观察组临床疗效明显高于对照组(P<0.05)。治疗后,2 组JOA 评分、降钙素、骨碱 性磷酸酶(BALP) 水平均高于治疗前(P<0.05),且观察组均高于对照组(P<0.05);治疗后,2 组ODI、 CTX-Ⅰ、PⅠNP 水平均低于治疗前(P<0.05),且观察组均低于对照组(P<0.05);治疗后,2 组伤椎、髋关 节、股骨颈骨密度均升高(P<0.05),且观察组均高于对照组(P<0.05);观察组JOA 评分、ODI 评分、骨代 谢指标及骨密度各项指标治疗前后差值均大于对照组(P<0.05);治疗过程中2 组不良反应发生率比较,差异 无统计学意义(P>0.05)。结论:PKP 术后联合补肾壮筋汤治疗OVCF,能够提高临床疗效,改善腰椎功能, 促进骨折愈合及椎体高度恢复,改善患者骨代谢水平,增强骨密度,且药物具有安全性。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Bushen Zhuangjin Decoction combined with percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF). Methods:A total of 96 cases of patients diagnosed with OVCF were selected and divided into two groups according to the random number table method, with 48 cases in each group. Both groups were treated with PKP; the control group was treated with Calcium Carbonate D3 Tablets and Guhua Sanchun Pills; the observation group was additionally treated with Bushen Zhuangjin Decoction based on the treatment of the control group. The clinical effects in three months after operation in the two groups were observed;the changes in Japanese Orthopaedic Association (JOA) scores, Oswestry Disability Index (ODI), and bone metabolism indexes [calcitonin,C-telopeptide of typeⅠcollagen (CTX -Ⅰ),bone alkaline phosphatase (BALP),typeⅠ procollagen amino terminal peptide (PⅠNP)] before and after treatment were compared between the two groups;the changes in bone mineral density of injured vertebra,hip joint,and femoral neck bone before and after treatment were compared between the two groups; the incidence of adverse reactions was compared between the two groups. Results:After treatment,the clinical effect in the observation group was significantly higher than that in the control group (P<0.05). After treatment,JOA scores,calcitonin, and BALP levels in the two groups were higher than those before treatment (P<0.05), and the above indexes in the observation group were higher than those in the control group (P<0.05). After treatment, the levels of ODI,CTX-Ⅰ,and PⅠNP in the two groups were lower than those before treatment (P< 0.05),and the above levels in the observation group were lower than those in the control group (P<0.05). After treatment, bone mineral density of injured vertebra, hip joint, and femoral neck bone in the two groups was increased (P<0.05), and the bone mineral density in the observation group was higher than that in the control group (P<0.05). The differences of JOA scores, ODI scores, bone metabolism indexes, and bone mineral density indexes before and after treatment in the observation group were greater than those in the control group (P<0.05). During treatment, there was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups (P>0.05). Conclusion:Bushen Zhuangjin Decoction for OVCF after PKP can improve the clinical effect,the lumbar function,and the levels of bone metabolism,promote fracture healing and vertebral height recovery,and enhance bone mineral density of patients,with medication safety.

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李松峰.补肾壮筋汤联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折临床研究[J].新中医,2023,55(6):11-16

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  • 在线发布日期: 2023-03-28
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