自拟中药汤剂在屈曲型胸腰椎压缩性骨折患者术后的应用效果

Application Effect of Self-Made Traditional Chinese Medicine Decoction in Patients with Flexion Type Thoracolumbar Compression Fracture After Operation

目的研究自拟中药汤剂在屈曲型胸腰椎压缩性骨折术后的应用效果。方法选取2017年5月至2020年5月于淅川县人民医院接受手术治疗的86例屈曲型胸腰椎压缩性骨折患者,采用随机数表法分为观察组(43例)与对照组(43例)。对照组术后进行康复锻炼,观察组在康复锻炼基础上加用自拟中药汤剂辅助治疗。比较两组疗效、骨愈合情况、骨代谢情况、日常生活能力、疼痛、胸腰椎功能。结果观察组治疗总有效率高于对照组(95.35%比79.07%,P<0.05)。治疗后观察组伤椎前缘高度、骨密度、骨钙素、骨源性碱性磷酸酶(BALP)、骨保护素水平均高于对照组,伤椎楔变角及后凸Cobb角均小于对照组,瘦素水平低于对照组(P<0.05)。治疗后观察组日本骨科协会(JOA)、日常生活活动能力(ADL)评分均高于对照组,视觉模拟评分法(VAS)评分低于对照组(P<0.05)。结论对于屈曲型胸腰椎压缩性骨折术后患者,在康复锻炼的基础上加用自拟中药汤剂可进一步提高疗效,促进患者骨愈合、代谢及脊柱功能恢复,减轻疼痛,改善患者日常生活能力。

Objective To study the application effect of self-made traditional Chinese medicine decoction on flexion-type thoracolumbar compression fractures after surgery.Methods A total of 86 patients with flexion-type thoracolumbar compression fractures who underwent surgical treatment at Xichuan County People’s Hospital from May 2017 to May 2020 were divided into observation group(43 cases)and control group(43 cases)by random number table.The control group received rehabilitation exercise after operation,and the observation group was supplemented with self-made Chinese medicine decoction on the basis of rehabilitation exercise.The efficacy,bone healing,bone metabolism,daily living ability,pain,thoracolumbar function were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group(95.35%vs.79.07%,P<0.05).After treatment,the height of the anterior edge,bone density,osteocalcin,bone alkaline phosphatase(BALP),and osteoprotegerin levels of the observation group were higher than those of the control group(P<0.05).The wedge angle of the injured vertebrae and the Cobb angle of the kyphosis in the observation group were smaller than those of the control group,and the leptin level was lower than that of the control group(P<0.05).After treatment,the scores of the Japanese Orthopaedic Association(JOA)and Activities of Daily Living(ADL)in the observation group were higher than those of the control group,and the visual analogue scale(VAS)score was lower than that of the control group(P<0.05).Conclusion For patients with flexion compression fractures of the thoracic and lumbar spine after surgery,the addition of self-made Chinese medicine decoction on the basis of rehabilitation exercise could further improve the curative effect,promote bone healing,metabolism and spinal function recovery,relieve pain,and improve the patient’s ability of daily living.