补肾健骨汤辅助治疗对腰椎骨折患者术后骨折愈合的影响

Effect of Bushen Jiangu Decoction on Lumbar Fracture Healing after Operation

目的探讨补肾健骨汤辅助治疗对腰椎骨折患者术后骨折愈合的影响。方法选择在我院接受治疗的85例腰椎骨折患者为研究对象,时间为2019年1月至2021年1月,采用随机数表法分为试验组(n=43)和对照组(n=42)。对照组给予经皮椎体成形术治疗,试验组加用补肾健骨汤治疗。比较两组临床疗效、后凸Cobb角、伤椎楔变角、伤椎前缘高度、胰岛素样生长因子1(IGF-1)、核因子κB受体活化因子配基(RANKL)、骨保护素(OPG)、骨碱性磷酸酶(BALP)、Ⅰ型前胶原羧基端肽(PICP)、骨钙素(BPG)、视觉模拟量表(VAS)评分及日本骨科协会腰痛(JOA)评分变化情况。结果治疗后,试验组总有效率95.35%显著高于对照组80.95%,差异显著(P<0.05)。治疗前,试验组和对照组后凸Cobb角、伤椎楔变角及椎体前缘丢失高度比较无显著差异;治疗后,试验组和对照组后凸Cobb角、伤椎楔变角及椎体前缘丢失高度均随着时间的推移而降低,且试验组均低于对照组(P<0.05)。治疗前,试验组和对照组血清IGF-1、RANKL及OPG比较无显著差异;治疗后,试验组和对照组血清IGF-1、OPG均随着时间的推移而升高,且试验组均高于对照组,RANKL均随着时间的推移而降低,且试验组低于对照组(P<0.05)。治疗前,试验组和对照组血清BALP、PICP及BPG比较无显著差异;治疗后,试验组和对照组血清BALP、PICP及BPG均随着时间的推移而升高,且试验组均高于对照组(P<0.05)。治疗前,试验组和对照组VAS、JOA评分比较无显著差异;治疗后,试验组和对照组VAS评分均随着时间的推移而降低,且试验组低于对照组,JOA评分均随着时间的推移而升高,且试验组高于对照组(P<0.05)。结论在腰椎骨折中应用补肾健骨汤辅助治疗的效果显著,可有效改善患者术后骨折愈合情况。

Objective To investigate the effect of bushen jiangu decoction on lumbar fracture healing after operation.Methods A total of 85 patients with lumbar spine fracture treated in our hospital from January 2019 to January 2021 were selected and divided into experimental group(n=43)and control group(n=42)by random number table method.The control group was treated with percutaneous vertebroplasty,and the experimental group was treated with bushen jiangu decoction.Clinical efficacy,kyphosis Cobb angle,wedge angle,anterior edge height,insulin-like growth factor 1(IGF-1)and nuclear factorκB,changes of receptor activating factor ligand(RANKL),osteoprotectin(OPG),bone alkaline phosphatase(BALP),carboxy-terminal peptide of typeⅠprocollagen(PICP),osteocalcin(BPG),visual analogue pain scale(VAS)and Japanese Orthopaedic Association low back pain score(JOA)were compared between the two groups.Results After treatment,the total effective rate of experimental group 95.35%was significantly higher than that of control group 80.95%,the difference was significant(P<0.05).Before treatment,there were no significant differences in kyphosis Cobb angle,wedge angle and anterior margin loss height between the experimental group and the control group.After treatment,Cobb angle of kyphosis,wedge Angle of injured vertebra and anterior margin loss height of vertebra in experimental group and control group decreased with time,and those in experimental group were lower than those in control group(P<0.05).Before treatment,there were no significant differences in serum IGF-1,RANKL and OPG between experimental group and control group.After treatment,serum IGF-1 and OPG in experimental group and control group increased with time,and the experimental group was higher than the control group,RANKL decreased with time,and the experimental group was lower than the control group(P<0.05).Before treatment,there were no significant differences in serum BALP,PICP and BPG between the experimental group and the control group.After treatment,serum BALP,PICP and BPG of experimental group and control group increased with time,and the experimental group was higher than the control group(P<0.05).Before treatment,there were no significant differences in VAS and JOA scores between experimental group and control group.After treatment,VAS score of experimental group and control group decreased over time,and JOA score of experimental group increased over time,and JOA score of experimental group was higher than control group(P<0.05).Conclusion The application of bushen jiangu decoction in the lumbar vertebra compromise has a significant therapeutic effect and can effectively improve the postoperative fracture healing of patients.