加味桃红四物汤治疗老年骨质疏松性胸腰椎压缩性骨折临床研究

Clinical Study on Modified Taohong Siwu Tang for Senile Osteoporotic Thoracolumbar Vertebral Compression Fractures

目的:探讨加味桃红四物汤治疗老年骨质疏松性胸腰椎压缩性骨折的临床效果及对患者血管表皮生长因子(VEGF)表达的影响。方法:选择骨质疏松性胸腰椎压缩性骨折患者94例,按随机数字表法分为对照组和观察组各47例。对照组给予常规西药配合过伸复位治疗,观察组在对照组基础上加用加味桃红四物汤治疗。比较2组临床疗效,分别于治疗前后采用视觉模拟评分法(VAS)评价患者疼痛情况、采用Oswestry功能障碍指数问卷表(ODI)评价患者胸腰椎功能情况,检测血清VEGF水平。结果:观察组总有效率为91.49%,高于对照组76.60%,差异有统计学意义(P<0.05)。治疗前,2组VAS评分及ODI评分比较,差异无统计学意义(P>0.05)。治疗后,2组VAS评分及ODI评分较治疗前降低(P<0.05),且观察组VAS评分及ODI评分均低于对照组(P<0.05)。治疗前,2组骨密度及血清VEGF水平比较,差异无统计学意义(P>0.05)。治疗后,2组骨密度和血清VEGF水平较治疗前增加(P<0.05),且观察组骨密度及血清VEGF水平高于对照组(P<0.05)。结论:在常规西药配合过伸复位治疗基础上加服加味桃红四物汤能提高老年骨质疏松性胸腰椎压缩性骨折治疗效果,改善骨密度和腰椎功能,减轻疼痛。

Objective:To discuss the clinical effect of modified Taohong Siwu tang for senile osteoporotic thoracolumbar vertebral compression fractures and its effect on the expression of vascular endothelial growth factor(VEGF).Methods:A total of 94 cases of patients with osteoporotic thoracolumbar vertebral compression fractures were divided into the control group and the observation group according to the random number table method,47 cases in each group.The control group was given routine western medicine combined with over-extension reduction,and the observation group was additionally given modified Taohong Siwu tang based on the treatment of the control group.The clinical effect was compared between the two groups.Before and after treatment,the pain of patients was evaluated via Visual Analogue Scale(VAS);their thoracolumbar vertebral function was evaluated via Oswestry Disability Index(ODI);the levels of VEGF in serum were detected.Results:The total effective rate was 91.49%in the observation group,higher than that of 76.60%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of the scores of VAS and ODI between the two groups(P>0.05).After treatment,the scores of VAS and ODI in the two groups were decreased when compared with those before treatment(P<0.05),and the two scores in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of bone mineral density and the levels of VEGF in serum between the two groups(P>0.05).After treatment,bone mineral density and the levels of VEGF in serum in the two groups were increased when compared with those before treatment(P<0.05),and the two indexes in the observation group were higher than those in the control group(P<0.05).Conclusion:Based on routine western medicine combined with over-extension reduction,the additional application of modified Taohong Siwu tang can increase the curative effect in treating senile osteoporotic thoracolumbar vertebral compression fractures,improve bone mineral density and lumbar vertebral function,and alleviate pain.