应用补肾壮骨汤降低椎体成形术后再发骨折的临床疗效分析

Clinical effect analysis of Bushen Zhuanggu Decoction on reducing recurrent fracture after vertebroplasty

目的研究补肾壮骨汤辅以椎体成形术在骨质疏松骨折患者中的应用效果。方法选取南昌市洪都中医院骨十科2017年5月至2018年5月收治的120例骨质疏松骨折患者作为研究对象,按照随机数字表法分为治疗组和对照组,各60例。对照组给予经皮椎体成形术治疗,治疗组在经皮椎体成形术的基础上联合补肾壮骨汤治疗。比较两组患者治疗后的Cobb角、骨密度、视觉模拟评分法(VAS)、椎体前缘高度、椎体中线高度以及3、6、12、24个月骨折发生率。结果治疗组治疗后的Cobb角、骨密度小于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05);治疗组治疗后的椎体前缘高度、椎体中线高度高于对照组,差异有统计学意义(P<0.05);两组的术后3个月再发椎体骨折发生率比较,差异无统计学意义(P>0.05);治疗组的术后6、12、24个月骨折发生率低于对照组,差异有统计学意义(P<0.05)。结论经皮椎体成形术联合中药可改善骨质疏松骨折患者的骨密度、Cobb角,减轻患者疼痛程度,降低治疗后骨折发生率,效果安全可靠。

Objective To study the application effect of Bushen Zhuanggu Decoction combined with vertebroplasty in patients with osteoporotic fractures.Methods A total of 120 cases of osteoporotic fracture patients treated in the Tenth Department of Orthopedics of Hongdu Hospital of Traditional Chinese Medicine of Nanchang City from May 2017 to May 2018 were selected as the study objects.All cases were divided into the treatment group and the control group according to random number table method,60 cases in each group.The control group was treated with percutaneous vertebroplasty,and the treatment group was treated with Bushen Zhuanggu Decoction on the basis of percutaneous vertebroplasty.The Cobb angle,bone mineral density,visual analogue scale(VAS),the height of the anterior vertebral body,the height of the middle vertebral body and the incidence of fractures at 3,6,12 and 24 months were compared between the two groups.Results The Cobb angle and bone mineral density in the treatment group were lower than those in the control group,and the VAS score in the treatment group was lower than that in the control group,the differences were statistically significant(P<0.05).The height of anterior body and the height of the midline vertebral body in the treatment group after treatment were higher than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference between the two groups in the incidence of recurrent vertebral fractures at 3 months after surgery(P>0.05).The incidence of fracture at 6,12 and 24 months after surgery in the treatment group was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion Percutaneous vertebroplasty combined with traditional Chinese medicine can improve bone mineral density and Cobb angle of osteoporotic fracture patients,reduce the degree of pain,reduce the incidence of fracture after treatment,and the effect is safe and reliable.