热敏灸对骨质疏松性胸腰椎压缩性骨折患者术后康复的影响

Effect of Heat-sensitive Point Moxibustion on Postoperative Rehabilitation in Patients with Osteoporotic Thoracolumbar Compression Fracture

目的观察热敏灸对骨质疏松性胸腰椎压缩性骨折患者术后康复的影响。方法将80例骨质疏松性胸腰椎压缩性骨折患者随机分为对照组和观察组,每组40例。对照组予碳酸钙D3片、骨化三醇胶丸;观察组在此基础上予热敏灸干预。均治疗3个月。在治疗前后各时间段评定骨痂形成评分、视觉模拟量表(visual analogue scale,VAS)、功能障碍指数(oswestry disability index,ODI);比较两组患者术后半年内的椎体再骨折率;在治疗前及治疗后测定患者血清骨钙素(bone gal protein,BGP)及骨碱磷酸酶(bone alkaline phosphatase,BALP)水平。结果在治疗1个月、2个月、3个月后,观察组骨痂形成评分均高于对照组(P<0.05);在治疗1个月、2个月、3个月后,两组VAS、ODI评分均低于治疗前(P<0.05);在治疗1个月、2个月、3个月后,观察组VAS、ODI评分明显低于对照组(P<0.05);术后半年内,观察组再骨折率明显低于对照组(P<0.05);观察组治疗后血清BGP、BALP水平明显升高(P<0.05),且与对照组比较差异有统计学意义(P<0.05)。结论热敏灸骨质疏松性胸腰椎压缩性骨折术后患者,可明显改善骨代谢,促进骨痂形成,缓解疼痛,改善功能障碍,降低再骨折率。

Objective To investigate the effect of heat-sensitive point moxibustion on postoperative rehabilitation in patients with osteoporotic thoracolumbar compression fracture.Method Eighty patients with osteoporotic thoracolumbar compression fracture were randomized to control and observation groups,40 cases in each group.The control group received oral administration of calcium carbonate D3 tablets and calcitriol capsules and the observation group,heat-sensitive point moxibustion in addition.Both groups were treated for three months.The callus formation score,the Visual Analogue Scale(VAS)score and the Oswestry Disability Index(ODI)score were recorded before treatment and during various time periods after.The vertebral body re-fracture rates were compared between the two groups of patients in six months after surgery.Serum bone gal protein(BGP)and bone alkaline phosphatase(BALP)levels were measured in the patients before and after treatment.Result After one,two and three months of treatment,the callus formation score was higher in the observation group than in the control group(P<0.05);the VAS and ODI scores decreased in the two groups compared with before(P<0.05)and were significantly lower in the observation group than in the control group(P<0.05).In six months after surgery,the re-fracture rate was lower in the observation group than in the control group(P<0.05).After treatment,serum BGP and BALP levels increased significantly in the observation group(P<0.05)and had statistically significant differences compared with the control group(P<0.05).Conclusion Heat-sensitive point moxibustion can markedly improve bone metabolism,promote callus formation,relieve the pain,reduce dysfunction and decrease the re-fracture rate in treating postoperative patients with osteoporotic thoracolumbar compression fracture.