补肾活血汤对骨质疏松性椎体压缩性骨折的疗效

Efficacy of Bushen Huoxue Decoction in patients with osteoporotic vertebral compression fracture

目的 探索骨质疏松性椎体压缩性骨折(OVCF)患者术后应用补肾活血汤疗效及药理学机制。方法将2019年1月至2021年1月南京医科大学附属江宁医院收治的124例OVCF患者按随机数表法分为两组,对照组62例给予西医抗骨质疏松治疗,观察组62例加用中药补肾活血汤。比较用药前后血液流变学、血清学、骨代谢、骨密度及影像学指标变化情况,评估临床疗效。结果 观察组用药后全血比黏度(ηb)、血浆比黏度(ηp)、红细胞比容(HCT)、血沉(ESR)、可溶性细胞间黏附分子-1(sICAM-1)、Ⅰ型胶原交联羟基末端肽(CTX-Ⅰ)、矢状面Cobb角和椎体压缩率均显著低于对照组(P<0.01),骨钙素(BGP)、骨保护素(OPG)、碱性磷酸酶(ALP)、血管内皮生长因子(VEGF)、股骨颈和腰椎的骨密度和椎体前缘高度均显著高于对照组(P<0.01)。观察组总有效率显著高于对照组(93.55%vs. 80.65%)(P<0.05)。结论 OVCF术后患者用补肾活血汤疗效确切,其能显著改善临床指标。

Objective To explore the efficacy and pharmacological mechanism of Bushen Huoxue Decoction in patients with osteoporotic vertebral compression fracture(OVCF) after operation. Methods A total of 124 OVCF patients admitted to the Affiliated Jiangning Hospital of Nanjing Medical University from January 2019 to January 2021 were divided into two groups according to the random number table method. 62 patients in the control group received anti-osteoporosis therapy based on Western medicine, while 62 patients in the observation group received Bushen Huoxue Decoction on the basis of the same treatment in the control group. The changes of hemorheology,serology, bone metabolism, bone mineral density and imaging indexes before and after treatment were compared to evaluate the clinical efficacy. Results After treatment, the whole blood specific viscosity(ηb), plasma specific viscosity(ηp), hematocrit(HCT), erythrocyte sedimentation rate(ESR), soluble intercellular adhesion molecule-1(sICAM-1), type I collagen cross-linked hydroxy terminal peptide(CTX-Ⅰ), sagittal Cobb angle and vertebral compression ratio of the observation group were all significantly lower than those of the control group(P< 0.01).The bone gla-protein(BGP), osteoprotegerin(OPG), alkaline phosphatase(ALP), vascular endothelial growth factor(VEGF), and bone mineral density and anterior vertebral height of femoral neck and lumbar spine of the observation group were all significantly higher than those of the control group(P< 0.01). The total effective rate in the observation group was significantly higher than that in the control group(93.55% vs. 80.65%)(P< 0.05). Conclusion Bushen Huoxue Decoction is effective for OVCF patients after operation, and it can significantly improve clinical indexes.