健骨方预防椎体成形术后再发骨折的疗效观察

The Effect of Jiangu Formula on Prevention of Recurrent Fracture after Vertebroplasty

目的:观察北京市怀柔区中医医院院内制剂健骨方对骨质疏松性椎体压缩骨折椎体成形术后再发骨折的预防效果。方法:选取2015年1月-2016年1月本院收治的单一椎体压缩骨折患者116例,随机将患者分为观察组和对照组,每组58例。对照组予经皮椎体后凸成形术治疗,观察组予经皮椎体后凸成形术治疗后结合健骨方加减治疗。对两组患者进行为期2年的随访,分别于术后1周、1年、2年对患者进行骨密度(BMD)检测,通过Oswestry功能障碍指数问卷表(ODI)评估功能障碍,WHO疼痛缓解程度标准评估治疗效果,对疼痛复发加重的患者,应用MRI检查确诊是否再发骨折。结果:最终纳入统计的患者111例,其中观察组56例、对照组55例。观察组患者术后1周、1年、2年的治疗总有效率虽均高于对照组,但差异均无统计学意义(P>0.05)。术后1、2年,对照组腰椎、髋部骨密度值均低于观察组,差异均有统计学意义(P<0.05)。术后2年,观察组再发骨折例数少于对照组,差异有统计学意义(P<0.05)。术后1年,观察组的日常生活自理能力、提物、疼痛评分均优于对照组,差异均有统计学意义(P<0.05);术后2年,观察组的日常生活自理能力、提物、睡眠、社会活动、旅行、疼痛评分均优于对照组,差异均有统计学意义(P<0.05)。结论:骨质疏松性椎体压缩骨折椎体成形术手术效果肯定,北京市怀柔区中医医院骨科院内制剂健骨方具有改善骨质疏松,降低椎体再发骨折的作用,可明显改善患者术后的远期功能。

Objective: To observe the preventive effect of Jiangu Formula in the Huairou District Hospital of Traditional Chinese Medicine on the recurrent fracture after vertebroplasty for osteoporotic vertebral compression fracture. Method: From January 2015 to January 2016, 116 patients with a single vertebal compression fracture were selected, they were randomly divided into observation group and control group, 58 cases in each group. The control group was treated with percutaneous kyphoplasty, and the observation group was treated with percutaneous kyphoplasty combined with Jiangu Formula. The patients in the two groups were followed up for 2 years. The BMD of the patients were measured at 1 week, 1 year and 2 years after the operation. The dysfunction was assessed by the Oswestry Disability Index questionnaire(ODI), and the treatment effect was assessed by the WHO pain relief standard. For the patients with pain recurrence and aggravation, MRI was used to check whether there was recurrent fracture. Result: 111 patients were included in the final statistics, include 56 patients in the observation group and 55 patients in the control group. Although the total effective rate of the observation group at 1 week, 1 year and 2 years after surgery were higher than those of the control group, but the differences were not statistically significant(P>0.05). 1 year and 2 years after operation, the BMD of lumbar vertebrae and hip in the control group were lower than those in the observation group, the differences were statistically significant(P<0.05). 1 year after the operation, the daily self-care ability, extract and pain of the observation group were all better than those of the control group, with statistically significant differences(P<0.05);2 years after the operation, daily life self-care ability, extract, sleep, social activities, travel and pain in the observation group were better than those of the control group, with statistically significant differences(P<0.05). Conclusion: The effect of vertebroplasty for osteoporotic vertebral compression fracture is positive, the preparation of Jiangu Formula in the orthopedic department of Huairou District Hospital of Traditional Chinese Medicine in Beijing has the effect of improving osteoporosis and reducing the recurrence fracture of vertebral body, which can significantly improve the long-term function of patients after operation.