唑来膦酸联合补肾活血汤加味方对骨质疏松性椎体压缩性骨折术后恢复期患者骨密度、骨代谢生化指标的影响

Effects of Zoledronic Acid Combined with Bushen Huoxue Decoction on Bone Mineral Density and Biochemical Markers of Bone Metabolism in Patients with OVCF during Recovery Period

目的:探讨骨质疏松性椎体压缩性骨折(OVCF)患者术后联合使用唑来膦酸、中药补肾活血汤加味方对患者术后康复的影响。方法:选取2019年3月—2020年5月在本院接受手术治疗80例OVCF患者作为对象。根据随机数字表法进行分组,术后在常规处理再给予对照组(40例)患者唑来膦酸,再给予观察组(40例)患者唑来膦酸+补肾活血汤加味方。观察患者腰背疼痛、腰部功能障碍改善情况及骨密度、骨代谢生化指标变化情况。结果:观察组术后30天的疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)指数均低于对照组,差异有统计学意义(P<0.05);观察组术后30天股骨颈、腰椎骨密度均大于对照组,(椎体后凸角度)Cobb角小于对照组,伤椎前缘高度明显更大,差异有统计学意义(P<0.05);观察组术后30天的骨钙素(BGP)、骨特异性碱性磷酸酶(BALP)水平均高于对照组,I型胶原交联氨基端肽(NTX I)、CTX I(I型胶原交联羧基端肽)水平均低于对照组,差异有统计学意义(P<0.05)。结论:OVCF患者术后在常规处理基础上再使用唑来膦酸及中药补肾活血汤加味方,可明显提高患者疼痛缓解效果,提高腰部功能障碍改善程度,同时可有效促进患者术后骨密度增加,改善骨代谢状况,有助于患者术后更好地康复。

Objective To evaluate the effect of zoledronic acid(zoledronic acid)and Bushen Huoxue decoction on postoperative rehabilitation of patients with osteoporotic vertebral compression fracture(OVCF).Methods In this study,80 patients with OVCF underwent surgery from March 2019 to May 2020.According to the method of random number table,40 patients in control group were given zoledronic acid after operation,and 40 patients in observation group were given zoledronic acid+Bushen Huoxue decoction.The changes of bone mineral density(BMD),bone metabolism and biochemical indexes were observed.Results The visual analogue scale(VAS)and Oswestry dysfunction index(ODI)of 30 days after operation in the observation group were lower than those in the control group(P<0.05).At 30 days after operation,the BMD of the femoral neck and lumbar vertebrae in the observation group were higher than those in the control group,and the COBB angle was lower than that in the control group(P<0.05).The levels of Osteocalcin(BGP)and bone specific Alkaline phosphatase(BGP)in the observation group were higher than those in the control group at 30 days after operation.The levels of type I collagen cross-linked Amino Terminal Peptide(NTX I)and type I collagen cross-linked carboxyl Terminal Peptide(CTX I)in the observation group were lower than those in the control group,which the differences were statistically significant(P<0.05).Conclusion The OVCF patients were treated with zoledronic acid and Chinese herbs Bushen Huoxue decoction after operationcan could obviously improve the effect of pain relief,improve the degree of LUMBAR dysfunction,promote the increase of bone density,improve the bone metabolism and help the patients to get better rehabilitation.