骨愈复原汤辅助PKP治疗骨质疏松性胸腰椎压缩性骨折临床研究

Clinical Study on Guyu Fuyuan Tang Assisting PKP for Osteoporotic Thoracolumbar Vertebral Compression Fractures

目的:观察骨愈复原汤辅助经皮椎体后凸成形术(PKP)治疗骨质疏松性胸腰椎压缩性骨折的临床疗效。方法:选取216例骨质疏松性胸腰椎压缩性骨折患者,采用随机数字表法分为对照组和观察组各108例。对照组行PKP治疗,观察组在对照组基础上加用骨愈复原汤治疗。比较2组治疗前后中医证候评分、日本骨科协会评估治疗分数评分(JOA评分)、骨密度(BMD),并评价临床疗效及不良反应发生情况。结果:观察组总有效率为91.67%,高于对照组83.33%,差异有统计学意义(P<0.05)。治疗后,2组各项中医证候评分较治疗前降低,且观察组各项中医证候评分低于对照组,差异有统计学意义(P<0.05)。治疗后,2组椎体前缘高度升高,椎体后凸Cobb角度降低(P<0.05),且观察组椎体前缘高度高于对照组,椎体后凸Cobb角度低于对照组(P<0.05)。治疗后,2组JOA评分、椎体L;BMD较治疗前升高,且观察组JOA评分、椎体L;BMD高于对照组(P<0.05)。观察组不良反应发生率为2.78%,低于对照组14.81%,差异有统计学意义(P<0.05)。结论:骨愈复原汤辅助PKP治疗骨质疏松性胸腰椎压缩性骨折可提高患者腰椎功能,改善骨密度,降低中医证候评分和不良反应发生率,促进椎体前缘高度恢复,减轻脊柱侧弯严重程度,缓解疼痛,疗效显著。

Objective:To observe the clinical effect of the therapy of Guyu Fuyuan tang assisting percutaneous kyphoplasty(PKP)on osteoporotic thoracolumbar vertebral compression fractures.Methods:A total of 216 patients with osteoporotic thoracolumbar vertebral compression fractures were selected and divided into the control group and the observation group according to the random number table method,with 108 cases in each group.The control group was treated with PKP,and the observation group was additionally treated with Guyu Fuyuan tang based on the treatment of the control group.The Chinese medicine syndrome scores,Japanese Orthopaedic Association(JOA)scores and bone mineral density were compared between the two groups before and after treatment,and the clinical effects and adverse reactions were evaluated.Results:The total effective rate was 91.67%in the observation group,higher than that of 83.33%in the control group,the difference being significant(P<0.05).After treatment,the Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment,and the Chinese medicine syndrome scores in the observation group were lower than those in the control group,the difference being significant(P<0.05).After treatment,the anterior vertebral heights in the two groups were increased and kyphosis Cobb angles were decreased(P<0.05),and the anterior vertebral height in the observation group was higher than that in the control group,and kyphosis Cobb angle was smaller(P<0.05).After treatment,the JOA scores and L;BMD of vertebra in the two groups were higher than those before treatment,and the above two indexes in the observation group were higher than those in the control group(P<0.05).The incidence of adverse reactions was 2.78%in the observation group,lower than that of 14.81%in the control group,the difference being significant(P<0.05).Conclusion:The therapy of Guyu Fuyuan tang assisting PKP for osteoporotic thoracolumbar vertebral compression fractures can enhance the lumbar function of patients,improve the bone mineral density,reduce the Chinese medicine syndrome score and the incidence of adverse reactions,promote the recovery of the anterior vertebral height,reduce the severity of scoliosis and relieve the pain,with a remarkable curative effect.