马骨续筋胶囊联合可调背伸外固定支具治疗胸腰椎压缩性骨折临床评价

Clinical Evaluation of Magu Xujin Capsules Combined with Adjustable Dorsiflexion External Fixator in the Treatment of Thoracolumbar Vertebral Compression Fracture

目的探讨马骨续筋胶囊联合可调背伸外固定支具治疗胸腰椎压缩性骨折的临床疗效。方法选取医院2019年收治的胸腰椎压缩性骨折患者108例,按随机数字表法分为对照组和观察组,各54例。两组患者均在卧床和腰部垫枕等常规治疗基础上给予穿戴可调背伸外固定支具,不短于3个月;观察组患者加服马骨续筋胶囊,连续服用4个月。结果观察组优良率为92.59%,显著高于对照组的68.52%(P<0.05)。与治疗前比较,两组患者治疗后的Ⅰ型前胶原氨基端前肽、Ⅰ型胶原羟基端肽β降解产物水平,椎体压缩比及视觉模拟评分法(VAS)评分均明显降低,且观察组显著低于对照组(P<0.05);观察组治疗后的骨钙素(BGP)和25-羟维生素D3[25(OH)D3]水平及腰椎正位密度、股骨胫骨密度均明显高于对照组(P<0.05)。随访半年,观察组再次骨折发生率显著低于对照组(3.70%比18.52%,P<0.05)。对照组与观察组不良反应发生率相当(5.56%比3.70%,P>0.05)。结论马骨续筋胶囊联合可调背伸外固定支具治疗胸腰椎压缩性骨折,可改善患者的骨代谢水平,增加骨密度,缓解疼痛。

Objective To investigate the clinical efficacy of Magu Xujin Capsules combined with adjustable dorsiflexion external fixator in the treatment of thoracolumbar vertebral compression fracture.Methods A total of 108 patients with thoracolumbar compression fracture admitted to our hospital in 2019 were selected and divided into the control group and the observation group by the random number table method,54 cases in each group.On the basis of routine treatment such as receiving bed rest and bolstering the waist with a pillow,the patients in the two groups were treated with adjustable dorsiflexion external fixator for at least three months,and the patients in the observation group were additionally treated with Magu Xujin Capsules for four months.Results The excellent and good rate of the observation group was 92.59%,which was significantly higher than 68.52%of the control group(P<0.05).After treatment,the levels of procollagen typeⅠN-terminal propeptide(PINP)andβ-isomerized C-terminal telopeptides(β-CTX),the vertebral compression ratio and visual analogue scale(VAS)scores in the two groups were significantly lower than those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the level of bone gla-protein(osteocalcin,BGP)and 25-hydroxyvitamin D3[25(OH)D3],the bone mineral density(BMD)of lumbar spine and tibia in the observation group were significantly higher than those in the control group(P<0.05).After half a year of follow-up,the incidence of re-fracture in the observation group was significantly lower than that in the control group(3.70%vs.18.52%,P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(5.56%vs.3.70%,P>0.05).Conclusion Magu Xujin Capsules combined with adjustable dorsiflexion external fixator in the treatment of thoracolumbar vertebral compression fracture can improve the level of bone metabolism,increase BMD and relieve pain.