中西医结合治疗骨质疏松性椎体压缩性骨折的研究进展

A review on treating osteoporotic vertebral compression fracture in the integrative medicine

随着我国人口的老龄化,骨质疏松症成为影响老年人生活质量的主要疾病之一,尤其是骨质疏松性椎体压缩性骨折(Osteoporotic Vertebral Compression Fracture,OVCF)的发病率呈逐年增高的趋势,严重影响老年人的生活质量和生活水平。西医认为主要是由于激素水平的失调、营养状况、免疫因素等原因引起的骨量丢失而导致骨的脆性增加。中医认为OVCF的病因病机主要与肝、脾、肾有关。目前OVCF的治疗包括传统保守治疗和手术治疗,传统保守治疗可以有效地减缓骨质流失、恢复机体功能、减少手术带来的创伤,在一定程度上恢复椎体的高度,但存在见效缓慢、卧床时间过长以及褥疮、肺部感染等问题。手术治疗见效快,但是存在手术创伤大等问题,如经皮椎体成形术(Percutaneous Vertebroplasty,PVP)虽然能够有效地缓解疼痛,但是存在骨水泥渗漏等问题。椎体后凸成形术(Percutaneous Kyphoplasty,PKP)可以有效地避免骨水泥渗漏的问题,目前在临床上得到了广泛的应用。随着医学技术的发展,尤其是数字化骨科技术的不断推广,有望得到一个更加安全、精准、有效、快速的OVCF治疗方案。文章就该病的治疗做一个简单的综述,希望可以为该病的临床诊治做一些贡献。

With the aging of the population in our country,osteoporosis has become one of the main diseases affecting the quality of life of the elderly,especially the incidence of osteoporotic vertebral compression fracture(OVCF)is increasing year by year,which seriously affects the quality of life and living level of the elderly.Western medicine believes that the increase in bone fragility is mainly due to the loss of bone mass caused by the imbalance of hormone levels,nutritional status,and immune factors.TCM believes that the etiology and pathogenesis of OVCF are mainly related to the liver,spleen and kidney.At present,the treatment methods of OVCF include traditional conservative treatment and surgical treatment.Traditional conservative treatment can effectively decelerate bone loss,restore body function,reduce the trauma caused by surgery,and restore the height of the vertebral body to a certain extent.However,there are disadvantages such as slow curative efficacy,chronic bedrest,bedsores,and lung infection.Surgical treatment is effective,but there are disadvantages such as large surgical trauma.For example,percutaneous vertebroplasty(PVP)can effectively relieve pain,but there are problems such as bone cement leakage.Percutaneous kyphoplasty(PKP)can effectively avoid the problem of bone cement leakage,and has been widely used in clinical practice.With the development of medical technology,especially the continuous promotion of digital orthopedic technology,it is expected to obtain a safer,more accurate,more effective and faster treatment plan for OVCF.In this paper,a brief review on the treatment of this disease is given,hoping to provide some contributions to the clinical diagnosis and treatment of the disease.