活血化瘀方结合手法复位治疗A型胸腰段骨折的效果及对骨代谢指标的影响

Effect of Huoxue Huayu Decoction combined with manual reduction on type A thoracolumbar fracture and its influence on bone metabolism indexes

目的观察活血化瘀方结合手法复位治疗A型胸腰段骨折的疗效及对骨代谢指标的影响。方法将我院收治的110例A型胸腰段骨折患者随机分为观察组与对照组各55例。对照组接受常规对症治疗,观察组采用手法复位联合中药方剂活血化瘀方治疗,对比两组治疗效果及治疗前后骨代谢指标变化情况。结果治疗后,观察组治疗总有效率明显高于对照组(P<0.05);观察组视觉模拟评分(VAS)及功能障碍指数(Oswestry)均明显低于对照组(P<0.05);观察组血清总Ⅰ型胶原氨基端延长肽(TPⅠNP)、β-胶原特殊序列(β-CTX)以及骨保护素(OPG)明显低于对照组(P<0.05),而25羟基维生素D[25-(OH)D]、骨钙素(BGP)、碱性磷酸酶(ALP)水平明显高于对照组(P<0.05);随访观察组治疗后1年骨密度明显高于对照组(P<0.05)。结论采用活血化瘀方结合手法复位治疗A型胸腰段骨折疗效可靠,能够有效缓解患者疼痛症状,改善患者骨代谢指标,促进骨折的快速康复具有应用及推广价值。

Objective To observe the effect of Huoxue Huayu Decoction combined with manual reduction on type A thoracolumbar fracture and its influence on bone metabolism indexes.Methods A total of 110 patients with type A thoracolumbar fracture were randomly divided into observation group and control group,55 cases each.Control group received routine symptomatic treatment,while observation group received manual reduction and Huoxue Huayu Decoction.The treatment effect and changes of bone metabolism indexes before and after treatment were compared between the two groups.Results After treatment,the total effective rate in observation group was significantly higher than control group(P<0.05);the scores of Visual analogue scale(VAS)and dysfunction index(Oswestry)in observation group were significantly lower than control group(P<0.05);serum total typeⅠcollagen amino terminal extender peptide(TPⅠNP),β-Collagen specific sequence(β-CTX),and osteoprotegerin(OPG)in control group were significantly lower than control group(P<0.05),while the levels of 25 hydroxyvitamin D[25-(OH)D],osteocalcin(BGP),and alkaline phosphatase(ALP)in control group were significantly higher than control group(P<0.05);the bone mineral density in observation group was significantly higher than control group one year after treatment(P<0.05).Conclusion The treatment of type A thoracolumbar fracture with Huoxue Huayu Decoction combined with manual reduction is reliable,which can effectively relieve the pain symptoms of patients,improve the bone metabolism index of patients,and promote the rapid recovery of fracture with application and promotion value.