固肾益精汤治疗骨质疏松性胸腰椎压缩性骨折的效果观察

Efficacy of the Gushen Yijing decoction on osteoporotic thoracolumbar compression fracture

目的:探讨应用中医固肾益精汤辅助治疗骨质疏松性胸腰椎压缩性骨折的效果。方法:选取2018年1月-2020年1月收治的80例骨质疏松性胸腰椎压缩性骨折患者为研究对象,随机分成试验组与对照组,每组40例,对照组单纯使用经皮穿刺球囊扩张椎体后凸成形术治疗,试验组采取经皮穿刺球囊扩张椎体后凸成形术联合固肾益精汤治疗,对比两组患者治疗效果、中医证候积分、血清骨代谢指标、胸腰椎功能恢复及随访6个月疾病复发情况。结果:试验组治疗总有效率显著高于对照组(P<0.05);两组治疗后各项中医证候积分均较治疗前降低,且试验组显著低于对照组(P<0.05);治疗后两组血清骨钙素、碱性磷酸酶均较治疗前提高,试验组高于对照组(P<0.05);治疗后骨保护素较治疗前降低,试验组低于对照组(P<0.05);治疗后两组患者Oswestry功能障碍指数评分、视觉模拟评分法评分及Cobb角均较治疗前降低,但试验组治疗后各项指标均显著低于对照组(P<0.05);随访6个月两组复发率对比差异有统计学意义(P<0.05)。结论:对骨质疏松性胸腰椎压缩性骨折应用固肾益精汤辅助治疗可取得满意的疗效,改善胸腰椎功能及缓解疼痛,同时降低术后疾病复发情况,值得推广。

Objective:To explore the Gushen Yijing decoction(固肾益精汤)on osteoporotic thoracolumbar compression fracture.Methods:80 cases from January 2018 to January 2020 were randomly divided into the test group and the control group,with 40 cases in each group.The control group was treated by percutaneous puncture kyphoplasty.The test group was treated by percutaneous puncture kyphoplasty plus the Gushen Yijing decoction.Results:The total efficiency in the test group was significantly higher than that in the control group(P<0.05).After treatment,the scores of various TCM syndromes in the two groups were lower than before treatment,and those in the test group were significantly lower than the control group(P<0.05).After treatment,the serum osteocalcin and alkaline phosphatase in the two groups increased compared with before treatment.Those in the test group was higher than the control group(P<0.05).After treatment,osteoprotegerin was lower than before treatment,and those in the test group were lower than the control group(P<0.05);after treatment,the Oswestry dysfunction index score,visual analog scale score and Cobb angle in the two groups were lower than before treatment.However,all indicators in the text group were significantly lower than those in the control group after treatment(P<0.05).There was a statistically significant difference in the recurrence rate between the two groups during the 6 month follow-up(P<0.05).Conclusion:The Gushen Yijing decoction on osteoporotic thoracolumbar compression fracture can achieve satisfactory results,improve the function of the thoracic and lumbar spine,relieve pain,and reduce the recurrence of postoperative disease.It is worthy of promotion.