身痛逐瘀汤联合艾瑞昔布片治疗骨质疏松性椎体压缩性骨折患者术后残余痛的效果

Effects of Shentong Zhuyu decoction combined with Imrecoxib tablets on postoperative residual pain in patients with osteoporotic vertebral compression fractures

目的:探讨身痛逐瘀汤联合艾瑞昔布片治疗骨质疏松性椎体压缩性骨折(OVCF)患者经皮穿刺椎体成形术(PVP)后残余痛的效果。方法:选取2019年10月至2022年1月于该院行PVP的88例OVCF患者进行前瞻性研究,采用随机数字表法将患者分为对照组和观察组各44例。两组均行PVP治疗,对照组术后口服艾瑞昔布片治疗,观察组在对照组基础上加用身痛逐瘀汤治疗。比较两组临床疗效、治疗前后中医证候积分(包括刺痛、肢体麻木、肌肤甲错、皮下瘀斑)、疼痛程度[视觉模拟评分法(VAS)]评分、腰椎功能[Oswestry功能障碍指数(ODI)]、血液流变学指标(全血高切黏度、全血低切黏度和血浆黏度)水平,以及不良反应发生率。结果:观察组治疗总有效率为95.45%(42/44),高于对照组的81.82%(36/44),差异有统计学意义(P<0.05);治疗后,观察组中医证候积分、VAS评分、ODI评分、全血高切黏度、全血低切黏度及血浆黏度均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:身痛逐瘀汤联合艾瑞昔布片治疗OVCF患者PVP术后残余痛可提高治疗总有效率,加快症状缓解,减轻疼痛程度,改善腰椎功能及血液流变学指标水平,效果优于单用艾瑞昔布片。

Objective:To investigate effects of Shentong Zhuyu decoction combined with Imrecoxib tablets on residual pain after percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fractures(OVCF).Methods:A prospective study was conducted on 88 patients with OVCF who underwent PVP in the hospital from October 2019 to January 2022.These patients were divided into control group and observation group by using the random number table method,44 cases in each.Both groups were treated with PVP.The control group was treated with oral Imrecoxib tablets after the surgery,while the observation group was treated with Shentong Zhuyu decoction on the basis of that of the control group.The clinical efficacy,the TCM syndrome scores(including stabbing pain,limb numbness,scaly skin,subcutaneous ecchymosis),the pain degree[visual analogue scale(VAS)],the lumbar function[Oswestry dysfunction index(ODI)],the hemorheology index levels(whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity),and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the observation group(95.45%,42/44)was higher than that of the control group(81.82%,36/44),and the difference was statistically significant(P<0.05).After the treatment,the TCM syndrome score,the VAS score,the ODI score,the whole blood high shear viscosity,the whole blood low shear viscosity and the plasma viscosity in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Shentong Zhuyu decoction combined with Imrecoxib tablets in the treatment of residual pain after PVP in the patients with OVCF can improve the total effective rate of treatment,accelerate the relief of symptoms,reduce the degree of pain,improve the lumbar function and the hemorheology index levels.Moreover,it is superior to single Imrecoxib tablets.