五联疗法治疗胸腰椎压缩骨折疗效观察

Clinical Observation on Treating Thoracolumbar Vertebral Compression Fracture by Quintuple Combination Therapy

目的:观察五联疗法治疗胸腰椎压缩性骨折的疗效。方法:将单纯胸腰椎压缩性骨折患者81例采用随机数字表法分为2组,治疗组46例采用手法复位、腰部垫枕、药物治疗、物理治疗、功能锻炼五联疗法综合治疗;对照组35例采用单纯卧床、腰部垫枕并配合药物及物理治疗、功能锻炼综合治疗,观察2组患者治疗后至6个月随访时伤椎前缘高度,同时采用口述分级评分法评定患者腰背部疼痛情况,并评价疗效。结果:1)治疗组治愈37例(80.4%);好转7例(15.2%);未愈2例(4.3%)。对照组治愈25例(71.4%);好转6例(17.1%);未愈4例(11.4%)。2组疗效比较差异有统计学意义(P<0.05)。2)腰背部疼痛治疗组0级35例(76.1%)、1级8例(17.4%)、2级3例(6.5%),对照组0级27例(77.1%)、1级5例(14.3%)、2级2例(5.7%)、3级1例(2.9%),2组腰背部疼痛程度比较差异有统计学意义(P<0.05)。3)治疗组伤椎前缘高度恢复情况较对照组明显,差异有统计学意义(P<0.05)。结论:采用包括手法复位的胸腰椎五联疗法治疗胸腰椎压缩性骨折可有效恢复伤椎前缘高度,缓解患者腰背部疼痛症状,疗效优于单纯卧硬板床等常规方法。

Objective:To observe clinical effects of quintuple combination therapy in the treatment for thoracolumbar vertebral compression fracture.Methods:All 81 patients were allocated to two groups according to random number table method,46 cases of the treatment group adopted quintuple combination therapy which contained manipulative reduction,lumbar padding,medicinal therapy,physical therapy,functional exercise,and 35 cases of the control group received single bedrest,lumbar padding,medicinal therapy,physical therapy and functional exercise,both groups were followed for six months after treating,to observe the anterior edge height of the injured vertebral body in both groups,simultaneously,oral grading method was used to assess lumbar and back pain conditions of the patients,and evaluate clinical effects.Results:1)There were 37 cases cured in the treatment group,and they held 80.4%;seven cases improved and 15.2%;two cases uncured and 4.3%.25 cases cured in the control group and they occupied 71.4%;six cases improved and 17.1%;four cases uncured and 11.4%and the difference had statistical meaning between both groups(P<0.05).2)Lumbar and back pain.There were 35 cases at stage zero(76.1%),eight cases at stage one and three cases at stage two(6.5%)in the treatment group,and 27 cases at stage zero(77.1%),five cases at stage one(14.3%),two cases at stage two(5.7%)and one case at stage three(2.9%),and the difference could be found in lumbar and back pain between both groups(P<0.05).3)the anterior edge height of the injured vertebral body.The treatment group was more obvious compared with the control group in the anterior edge height of the injured vertebral body,and the difference showed statistical meaning(P<0.05).Conclusion:Quintuple combination therapy including manipulative reduction for the patient could effectively restore the anterior edge height of the injured vertebral body,relieve the symptoms of the patients,and its effects are superior to conventional method of hard bed.