活血补肾汤辅助治疗骨质疏松性胸腰椎压缩性骨折患者的短期随访研究

Short Term Follow-Up Study on Auxiliary Treatment of Patients with OVCF after Treatment with Huoxue Bushen Decoction(活血补肾汤)

目的探讨骨质疏松性胸腰椎压缩性骨折(osteoporotic thoracolumbar vertebral compression fracture,OVCF)患者经活血补肾汤治疗后功能障碍程度及神经功能变化。方法采用随机数字表法将于2018年9月—2021年9月开封市人民医院收治的150例OVCF患者分为A组、B组,各75。A组采用常规治疗,B组在A组基础上给予活血补肾汤。两组治疗时间均为1个月,治疗后均随访6个月。比较两组治疗后6个月的临床疗效,治疗前、治疗1个月后、治疗后6个月的疼痛评分,治疗前、治疗后6个月的功能障碍程度、神经功能评分、竖脊肌软组织张力位移情况、矢状面后凸Cobb角及椎前缘高度百分比及生活质量。结果B组和A组治疗后6个月的总有效率分别为94.67%(71/75)、84.00%(63/75),与A组比较,B组较高(P<0.05)。两组治疗后6个月的视觉模拟评分(visual analogue scale,VAS)均比治疗前、治疗1个月后低,治疗1个月后比治疗前低,且治疗1个月、治疗后6个月,与A组比较,B组较低(P<0.05)。两组治疗后6个月的Oswestry功能障碍指数(Oswestry disability index,ODI)、矢状面后凸Cobb角及生活质量各项评分均比治疗前低,且与A组比较,B组较低;两组神经功能各项评分及椎前缘高度百分比比治疗前高,且与A组比较,B组较高(P<0.05);两组竖脊肌软组织张力位移情况均比治疗前长,但两组间比较,差异没有统计学意义(P>0.05)。结论OVCF患者经活血补肾汤治疗后,其解剖学结构及运动障碍可得到有效恢复,并有效缓解患者疼痛程度,进一步促进患者神经功能得到改善,进而提高临床疗效,提高患者生活质量。

Objective To investigate the changes of the changes of degree of dysfunction and neurological function in patients with osteoporotic thoracolumbar vertebral compression fracture(OVCF)after treatment with Huoxue Bushen Decoction(活血补肾汤).Methods A total of 150 patients with OVCF admitted to the hospital from September 2018 to September 2021 were divided into the group A and the group B by random number table method,75 cases in each group.The group A was given routine treatment,while the group B was given Huoxue Bushen Decoction on the basis of the group A.The treatment time of both groups was 1 month,and all patients were followed up for 6 months after treatment.The clinical efficacy of the two groups 6 months after treatment,the score of pain before treatment,after 1 month treatment and 6 months after treatment,the dysfunction index,score of neurological function,the tension displacement of the soft tissue of the erector spinal muscle,the percentage of Cobb angle of sagittal kyphosis,the height of the anterior vertebral edge,and the quality of life before treatment and 6 months after treatment between two groups were compared.Results At 6 months after treatment,the rates of total effective in the group B and the group A were 94.67%(71/75)and 84.00%(63/75),respectively.And compared with that of the group A,the rate of group B was higher(P<0.05).At 6 months after treatment,the scores of visual analogue scale(VAS)of both groups were lower than that before treatmentand after 1 month of treatment.The VAS score after 1 month of treatment was lower than that before treatment,and the VAS score after 1 month of treatment and at 6 months after treatmentin group B was lower compared with that in the group A(P<0.05).At 6 months after treatment,the scores of Oswestry disability index(ODI),sagittal kyphosis Cobb angle and scores of quality of life in the two groups were lower than those before treatment,and compared with those of the group A,the scores of ODI index,sagittal kyphosis Cobb angle and scores of quality of life of the group B were lower.The scores of nerve function and percentage of anterior vertebral edge height in the two groups were higher than those before treatment,and compared with those of the group A,the scores of nerve function and percentage of anterior vertebral edge height of group B were higher(P<0.05).Erector spinae′s soft tissue tension displacement in both groups were longer than those before treatment,but there was no significant difference between the two groups(P>0.05).Conclusion After being treated with Huoxue Bushen Decoction,OVCF patients′anatomical structure and movement disorder could be effectively recovered,and the degree of pain could be effectively alleviated,further promoting the improvement of patients′neurological function,and then improve the clinical efficacy and quality of life of patients.