补肾活血壮骨汤对椎体压缩性骨折患者的临床疗效及骨代谢的影响研究

Study on Clinical Effect of Bushen Huoxue Zhuanggu Decoction(补肾活血壮骨汤)in Treatment of Vertebral Compression Fracture and Its Influence on Bone Metabolism

目的探讨补肾活血壮骨汤对椎体压缩性骨折患者的临床疗效及骨代谢的影响。方法将2015年3月—2018年1月该院椎体压缩性骨折患者68例,随机分两组,各34例,对照组采用复方骨肽注射液4 mL治疗;观察组采用补肾活血壮骨汤治疗,早晚口服,1剂/d,持续治疗6个月。比较两组患者的临床疗效,治疗前和治疗6个月评价血清骨碱性磷酸酶(bone alkaline phosphatase, B-ALP)、骨保护素(osteoprotegerin, OPG)、I型前胶原肽(collagen C-terminal peptide, CTX)水平,比较脊柱ODI评分、视觉模拟量表评分(visual analogue scale, VAS)、骨密度等,记录不良反应。结果两组患者性别、平均年龄、平均病程、骨折椎体数目及体质量指数比较,差异无统计学意义(P>0.05)。对照组有效率为76.47%(26/34),观察组有效率为94.12%(32/34),两组间有效率比较,差异具有统计学意义(P<0.05)。治疗后对照组和观察组血B-ALP为(60.01±9.67)U/L、(49.32±8.65)U/L,OPG为(1.75±0.57)pg/mL、(2.21±0.63)pg/mL,CTX为(0.52±0.15)ng/mL、(0.43±0.14)ng/mL,脊柱ODI评分为(37.86±7.06)、(26.92±6.75),VAS评分为(1.32±0.49)、(0.74±0.35),骨密度为(0.47±0.09)g/m2、(0.52±0.08)g/m2,对照组和观察组上述指标比较,差异具有统计学意义(P<0.05)。两组患者不良率比较,差异无统计学意义(P>0.05)。结论补肾活血壮骨汤对椎体压缩性骨折患者的疗效确切,可改善骨代谢指标,提高骨密度和日常生活能力,患者安全性高,值得推广。

Objective To investigate the clinical effect of Bushen Huoxue Zhuanggu Decoction(补肾活血壮骨汤,BSHZD) in the treatment of vertebral compression fracture and its influence on bone metabolism.Methods Sixty-eight patients with vertebral compression fracture in our hospital from March 2015 to January 2018 were randomly divided into two groups, 34 cases in each group.The control group received Compound Bone Peptide Injection(4 mL).The observation group received BSHZD,one dose daily for 6 months.The clinical efficacy was compared between the two groups.The levels of serum bone alkaline phosphatase(B -ALP),osteoprotegerin( OPG) and type I procollagen peptide( CTX) were evaluated before and 6 months after treatment. Spinal ODI score,visual analogue scale( VAS) score and bone mineral density were compared,and adverse reactions were recorded.Results There was no significant difference in gender,average age,average course of disease,number of vertebral fractures or body mass index between the two groups( P > 0. 05). The effective rate in the control group( 76. 47%,26/34) was lower than that( 94.12%,32/34) of the observation group. There was a significant difference between the two groups( P < 0. 05). After treatment,the blood B-ALP of control group and observation group after treatment were( 60. 01 ± 9. 67) U/L and( 49. 32 ± 8. 65) U/L,levels of OPG were( 1. 75 ± 0. 57) pg/mL and( 2. 21 ± 0. 63) pg/mL,levels of CTX were( 0. 52 ± 0. 15) ng/mL and( 0. 43 ± 0. 14) ng/mL,scores of ODI were( 37. 86 ± 7. 06) points and( 26. 92 ± 6. 75) points,scores of VAS were( 1. 32 ± 0. 49) points and( 0. 74± 0. 35) points,levels of bone mineral density were( 0. 47 ± 0. 09) g/m2 and( 0. 52 ± 0. 08) g/m2. All indexes above had significant differences( P < 0. 05). There was no significant differences in the adverse rate between the two groups( P > 0. 05). Conclusion BSHZD has definite curative effect on patients with vertebral compression fracture. It can improve bone metabolism,bone mineral density and daily living ability. It has high safety and is worthy of popularizing.