桃红四物汤辅助经皮椎体成形术治疗老年骨质疏松性椎体压缩性骨折临床研究

Effect of Taohong-Siwu decoction combined with percutaneous vertebroplasty on elderly patients with osteoporotic vertebral compression fractures

目的 评价桃红四物汤辅助经皮椎体成形术治疗老年骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fractures, OVCF）的疗效。方法 将符合入选标准的60例老年OVCF患者，采用随机数字表法分为2组，每组30例。对照组实施经皮椎体成形术，研究组在对照组基础上给予桃红四物汤治疗。2组均治疗4周。分别于治疗前后行Oswesty功能障碍指数（Oswesty Dysfunction Index, ODI）评分与VAS评分，采用ELISA法检测TNF-a、IL-6，采用免疫组化法检测ALP、骨钙素（bone gla protein, BGP）。结果 治疗后，研究组ODI评分[（21.1±1.7）分比（22.5±1.9）分，t＝3.111]、VAS评分[（1.2±0.7）分比（1.6±0.8）分，t＝2.101]均低于对照组（P＜0.05）。研究组血清TNF-a[（367.67±87.11）ng/L比（415.93±72.62）ng/L，t＝2.331]、IL-6[（71.47±16.83）mg/L比（81.43±17.24）mg/L，t＝2.266]水平均低于对照组（P＜0.05）；ALP[（70.27±7.96）U/L比（65.77±8.45）U/L，t＝2.123]、BGP[（10.29±2.37）U/L比（9.01±2.23）U/L，t＝2.127]水平均高于对照组（P＜0.05）。结论 桃红四物汤可缓解经皮椎体成形术后老年OVCF患者的疼痛症状，提高日常生活能力，减轻术后炎性反应，提高ALP、BGP水平。

Objective To analyze the effect of Taohong-Siwu decoction combined with percutaneous vertebroplasty on elderly patients with osteoporotic vertebral compression fractures. Methods A total of 60 elderly patients with osteoporotic vertebral compression fractures, from March 2015 to March 2017, were randomly divided into two groups（30 patients in each group）. The patients in the control group were treated with percutaneous vertebroplasty, and the patinets in the study group received Taohong-Siwu decoction combined with percutaneous vertebroplasty. Before treatment and at 4 weeks after treatment, the ODI scores, VAS scores were recorded, and the inflammatory reaction （TNF-a, IL-6） and bone metabolism （ALP, BGP） were compared between two groups. Results The scores of ODI （21.1 ± 1.7 vs. 22.5 ± 1.9, t=3.111） and VAS scores （1.2 ± 0.7 vs. 1.6 ± 0.8, t=2.101） in the study group were significantly lower than those in the control group （P〈0.05）. The TNF-α （367.67 ± 87.11 vs. 415.93 ± 72.62 ng/L, t=2.331） and IL-6 （71.47 ± 16.83 vs. 81.43 ± 17.24 mg/L, t=2.266） in the study group were significantly lower than those in the control group （P〈0.05）. The ALP （70.27 ± 7.96 vs. 65.77 ± 8.45 U/L, t=2.123） and BGP （10.29 ± 2.37 vs. 9.01 ± 2.23 g/L, t=2.127） in the study group weresignidicantly higher than those in the control group （P〈0.05）. Conclusions The Taohong-Siwu decoction could relieve the pain, improve the function of daily life, relieve the inflammatory reaction and increase the level of ALP and BGP in the elderly patients with osteoporotic vertebral compression fractures.