热敏灸联合加味身痛逐瘀汤对椎体成形术后腰椎功能及腰痛的疗效观察

Clinical Effect of Heat Sensitive Moxibustion Combined with Modified Shentong Zhuyu Decoction on Lumbar Function and Low Back Pain after Vertebroplasty

目的:观察热敏灸联合加味身痛逐瘀汤对椎体成形术后腰椎功能恢复及腰部疼痛缓解的临床疗效。方法:选取2019年1月—2020年8月于江西中医药大学附属医院脊柱骨科住院的骨质疏松伴病理性骨折患者120例,随机分为联合治疗组(热敏灸联合加味身痛逐瘀汤)、身痛逐瘀汤组(单服加味身痛逐瘀汤)、热敏灸组(单用热敏灸)及空白组(不采取任何内外治法),每组各30例,连续治疗14d,比较四组椎体成形术后患者视觉类评分(VAS评分)、腰椎活动功能评分(JOA评分)、中医辨证评分以及血清中促炎因子肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、碱性磷酸酶(ALP)等,以此评估各组临床疗效。结果:经过相关数据分析,与本组治疗前比较,联合治疗组JOA评分明显提升(P=0.000),VAS评分明显降低(P=0.000),中医证候积分明显降低、疼痛缓解率明显提升(均P=0.000)。四组数据比较,组间差异具有统计学意义(P<0.05)。结论:热敏灸联合加味身痛逐瘀汤对椎体成形术后腰椎功能及腰痛的临床疗效明确,一定程度上有利于老年患者改善骨质疏松情况、缓解PVP术后残余疼痛及恢复活动能力,提高患者生活质量,减少并发症,降低致残几率及死亡率,值得临床推广。

Objective:To observe the clinical effect of heat sensitive moxibustion combined with modified Shentong Zhuyu Decoction on lumbar function recovery and lumbar pain relief after vertebroplasty.Methods:One hundred and twenty patients with Osteoporosis were selected from the department of Orthopedics of the Affiliated Hospital of Jiangxi University of Chinese Medicine from January to August 2020,were randomly divided into 4 groups:heat sensitive moxibustion combined with Jiawei Shentong Zhuyu Decoction group,single oral administration of Jiawei Shentong Zhuyu Decoction group,single external heat sensitive moxibustion group and no internal and external treatment group,with 30 cases in each group.The VAS score,JOA score,TCM dialectical score and serum TNF-αwere compared among the four groups after vertebroplasty,IL-6 and ALP were used to evaluate the clinical efficacy.Results:After the analysis of relevant data,the JOA score of patients in the heat sensitive moxibustion combined with modified Shentong Zhuyu Decoction group was significantly higher than that before treatment(P=0.000),and the visual class score(VAS score)was significantly lower than that before treatment(P=0.000);after treatment,the TCM symptom score was significantly reduced,and the pain relief rate was increased(P=0.000)The difference was statistically significant(P<0.05).Conclusion:The clinical effect of heat sensitive moxibustion combined with modified Shentong Zhuyu Decoction on lumbar function and low back pain after vertebroplasty is clear.To a certain extent,it is conducive to the improvement of osteoporosis in elderly patients,relieve the residual pain and activity recovery ability after PVP,improve the quality of life of patients,reduce complications,reduce the probability of disability and mortality,which is worthy of clinical promotion.