补肾活血汤联合骨化三醇治疗骨质疏松性脊椎骨折的疗效及对患者骨密度、骨代谢的影响

Efficacy of Using Bushen Huoxue Decoction Combined with Calcitriol in the Treatment of Osteoporotic Vertebral Fractures and Its Effect on Bone Mineral Density and Bone Metabolism

目的:观察补肾活血汤联合骨化三醇治疗骨质疏松性脊椎骨折的疗效及对患者骨密度、骨代谢的影响。方法:将2016年6月~2017年6月间收治的104例骨质疏松性脊椎骨折患者应用随机数表法分为观察组和对照组,每组52例。观察组应用补肾活血汤联合骨化三醇,对照组应用骨化三醇。比较2组临床疗效,评估治疗前、治疗3月后疼痛程度[疼痛模拟评分(VAS)、Oswestry功能障碍指数问卷表(ODI)]、骨密度(BMD)、骨代谢[骨碱性磷酸酶(BALP)、Ⅰ型胶原羧基末端肽片段(β-CTX)、N端骨钙素(N-MID)],随访6个月记录2组再骨折率。结果:①治疗3月后,观察组总有效率高于对照组(P<0.05);②治疗3月后,2组疼痛(VAS、ODI得分)、骨代谢指标(BALP、β-CTX、N-MID)水平均低于治疗前(P<0.05),观察组降幅大于对照组(P<0.05);③治疗3月后,2组腰椎、股骨近端、桡骨远端水平均高于治疗前(P<0.05),观察组腰椎、桡骨远端BMD增幅大于对照组(P<0.05);2组股骨近端BMD水平组间对比差异无统计学意义(P>0.05)。结论:补肾活血汤联合骨化三醇治疗骨质疏松性脊椎骨折疗效良好,对改善患者骨密度、疼痛和骨代谢均产生积极作用。

Objective:To explore the efficacy of using Bushen Huoxue Decoction combined with calcitriol in the treatment of osteoporotic vertebral fractures and its effect on bone mineral density and bone metabolism.Methods:104cases of patients with osteoporotic vertebral fractures treated between June 2016 and June 2017were divided into observation group and controlled group with 52cases in each group.The observation group was treated with Bushen Huoxue Decoction combined with calcitriol,and the controlled group was treated with calcitriol.The clinical efficacy was compared between the two groups,and the pain degree[Visual Analogue Scale(VAS),Oswestry Disability Index(ODI)],bone mineral density(BMD)and bone metabolism[bone alkaline phosphatase(BALP),collagen I telopeptide fragment(p-CTX),N-mid fragment of osteocalcin(N-MID)]were evaluated before treatment and after 3months of treatment,and the re-fracture rate was recorded in the two groups at 6months of follow-up.Results:After 3months of treatment,the total effective rate in the observation group was higher than that in the controlled group(P<0.05).After 3months of treatment,the pain(VAS and ODI scores)and bone metabolism indexes levels(BALP,p-CTX,N-MID)were lower than those before treatment(P<0.05),and the decrease in the observation group was larger than that in the controlled group(P<0.05).After 3months of treatment,the BMD levels of proximal lumbar vertebrae and femur,and distal radius in the two groups were higher than those before treatment(P<0.05),and the increase of BMD in lumbar vertebrae and distal radius of the observation group was greater than that of the controlled group(P<0.05),and there was no significant difference in the BMD level in proximal femur between the two groups(P>0.05).Conclusion:Bushen Huoxue Decoction combined with calcitriol has a good efficacy on osteoporotic vertebral fractures,and it has a positive effect on improving bone mineral density,pain and bone metabolism.