艽活四物汤联合介入疗法治疗骨质疏松性椎体压缩性骨折临床研究

Clinical Study on Jiaohuo Siwu Tang Combined with Intervention Therapy for Osteoporotic Vertebral Compression Fracture

目的:观察艽活四物汤联合介入疗法治疗骨质疏松性椎体压缩性骨折的临床疗效。方法:选择157例骨质疏松性椎体压缩性骨折患者,按随机数字表法分为对照组78例与观察组79例。对照组予以常规西药联合介入治疗,观察组予以艽活四物汤联合介入治疗。治疗12周后观察2组椎体结构、疼痛评分、骨密度、骨代谢指标、椎体功能、生活质量以及骨折愈合情况。结果:与同组治疗前比较,治疗后2组Cobb角度、疼痛视觉模拟评分法(VAS)评分及血清人I型胶原交联氨基端肽(NTXI)、β-胶原羧基端肽(β-CTX)水平、Oswertry功能障碍指数(ODI)评分均减小(P<0.05);椎体前、后缘高度,腰椎1~4 (L1~4)、左股骨颈(FN)、股骨粗隆骨密度,血清25-羟基维生素(25-OHD)、骨钙素(BGP)水平,心理功能、社会功能、生理状态、生活总满意度等生活质量评分均升高(P<0.05)。与对照组治疗后比较,观察组治疗后Cobb角度、VAS评分及血清NTXI、β-CTX水平、ODI评分均减小(P<0.05),骨折愈合时间缩短(P<0.05);椎体前、后缘高度,L1~4、FN、股骨粗隆骨密度,血清25-OHD、BGP水平,心理功能、社会功能、生理状态、生活总满意度等生活质量评分均较高(P<0.05)。结论:采用艽活四物汤联合介入疗法治疗骨质疏松性椎体压缩性骨折患者,可显著恢复患者椎体生理结构,缓解疼痛,促进骨折愈合,增加骨密度,改善骨代谢指标,提高椎体功能和生活质量。

Objective: To observe the clinical effect of Jiaohuo Siwu tang combined with intervention therapy for osteoporotic vertebral compression fracture. Methods: A total of 157 cases of patients with osteoporotic vertebral compression fracture were selected and divided into the control group and the observation group according to the random number table method,78 and 79 cases in each group respectively. The control group was given routine western medicine combined with intervention therapy, and the observation group was given Jiaohuo Siwu tang combined with intervention therapy. After twelve-week treatment,vertebral structures,pain score,bone mineral density,bone metabolism index,vertebral function,quality of life,and bone fracture healing were observed in the two groups. Results:When compared with those before treatment in the same group,Cobb angle,visual analogue scale(VAS) score,and levels of Cross-linked aminoterminal peptide of human type I collagen(NTXI) and β-collagen carboxyterminal peptide(β-CTX) in serum and Oswertry dysfunction index(ODI) score in the two groups were decreased after treatment(P<0.05);heights of anterior and posterior edge of vertebral body,bone mineral density of lumbar 1~4(L1~4),the left fermoral neck(FN) and femoral trochanter,levels of25-hydroxyl vitamins(25-OHD) and bone gla protein(BGP) in serum,as well as scores of quality of life regarding psychology,society, physiological state, and the total life satisfaction were increased(P<0.05). After treatment, Cobb angle, VAS score,and levels of NTXI and β-CTX in serum,ODI score in the observation group were lower than those in the control group(P<0.05),the healing time of fractures was shorter(P<0.05);heights of anterior and posterior edge of vertebral body,bone mineral density of L1~4,FN,femoral trochanter,levels of 25-OHD and BGP in serum,as well as scores of quality of life regarding psychology,society,physiological state,and the total life satisfaction were higher(P<0.05). Conclusion:In the treatment of patients with osteoporotic vertebral compression fracture,the therapy of Jiaohuo Siwu tang combined with intervention therapy can significantly recover physiological structures of vertebral body, relieve pain, promote fracture healing,increase bone mineral density,improve bone metabolism index,enhance vertebral body function and quality of life.