益肾补骨汤治疗对老年骨质疏松性胸腰椎骨折患者经皮椎体成形术后疼痛、伤椎愈合及腰椎功能的影响

Effects of Yishen Bugu Decoction on the Pain,Wound Healing and Lumbar Function of Elderly Patients with Osteoporotic Thoracolumbar Fracture after Percutaneous Vertebroplasty

目的分析益肾补骨汤辅助经皮椎体成形术治疗老年骨质疏松性胸腰椎骨折患者的临床价值。方法回顾性分析2019年2月—2021年2月收治的老年骨质疏松性胸腰椎骨折119例。根据治疗方案分为常规组57例和中药组62例。常规组给予经皮椎体成形术及常规治疗,中药组在常规组基础上给予益肾补骨汤。比较2组临床疗效、骨密度、术后疼痛、伤椎恢复情况、腰椎功能及再骨折与并发症发生率。结果中药组总有效率高于常规组(P<0.05)。治疗后,中药组腰椎正位(L_(2~4))、右股骨颈骨密度高于常规组,视觉模拟评分法评分低于常规组(P<0.05)。治疗后,中药组伤椎楔变角及后凸Cobb角低于常规组,伤椎前缘高度高于常规组(P<0.05)。治疗后,中药组日本骨科协会评估治疗分数评分高于常规组,Oswestry功能障碍指数评分低于常规组(P<0.05)。中药组术后椎体再骨折发生率低于常规组(P<0.05)。结论益肾补骨汤有利于减轻老年骨质疏松性胸腰椎骨折经皮椎体成形术后疼痛,降低并发症发生率,促进伤椎愈合和改善椎体功能。

Objective To analyze the clinical value of Yishen Bugu Decoction-assisted percutaneous vertebroplasty(PVP)for elderly patients with osteoporotic thoracolumbar fracture(OTF).Methods A retrospective analysis was performed on 119 elderly patients with OTF admitted from February 2019 to February 2021.According to the treatment plan,they were divided into conventional group(n=57)and traditional Chinese medicine(TCM)group(n=62).The conventional group was given PVP and conventional treatment,while the TCM group was given Yishen Bugu Decoction on the basis of the conventional group.The clinical efficacy,bone mineral density(BMD),postoperative pain,healing of injured vertebral body,lumbar vertebral function,and the incidence of refracture and complications were compared between the two groups.Results The total effective rate in the TCM group was higher than that in the conventional group(P<0.05).After treatment,the lumbar vertebrae(L_(2-4))and the BMD of the right femoral neck in the TCM group were higher than those in the conventional group,and the visual analog scale(VAS)score was lower than that in the conventional group(P<0.05).After treatment,the wedge angle and kyphotic Cobb angle of the injured vertebra in the TCM group were lower than those in the conventional group,and the height of the anterior edge of the injured vertebra was higher than that in the conventional group(P<0.05).After treatment,the Japanese Orthopaedic Association Assessment(JOA)score in the TCM group was higher than that in the conventional group,while the Oswestry Disability Index(ODI)score was lower than that in the conventional group(P<0.05).The incidence of vertebral body refracture after operation in the TCM group was lower than that in the conventional group(P<0.05).Conclusion Yishen Bugu Decoction is conducive to improving the pain after PVP for elderly patients with OTF,reducing the incidence of complications,promoting the healing of injured vertebrae and improving vertebral body function.