经皮椎弓根钉联合壮骨汤在胸腰椎骨折患者术后早期康复中的疗效观察

Observation on the curative effect of percutaneous pedicle screw combined with Zhuanggudecoction in early postoperative rehabilitation of patients with thoracolumbar fractures

目的探讨经皮椎弓根钉联合壮骨汤在胸腰椎骨折患者术后早期康复中的临床疗效。方法选择2019年6月~2020年5月安阳市中医院收治的无神经损伤胸腰椎骨折患者80例,均行经皮椎弓根钉内固定手术,采用随机数字表法分为两组:对照组术后给予常规治疗,观察组在对照组的基础上给予中药壮骨汤。随访比较两组术后相关疗效指标。结果与术前相比,两组术后VAS评分、RDQ功能障碍评分均明显降低(P<0.05),且观察组术后1、3、6个月的两项指标数据均显著低于对照组(P<0.05)。两组术后椎体前缘高度比值及Cobb角均较术前显著改善(P<0.05),但观察组术后3、6个月的矫正度维持效果显著优于对照组(P<0.05)。结论经皮椎弓根钉内固定术联合壮骨汤治疗胸腰椎骨折,能有效减轻患者康复早期疼痛症状,减轻术后功能障碍、促进日常生活能力恢复,远期也可有效维持椎体高度及Cobb角。

Objective To explore the clinical effect of percutaneous pedicle screw combined with Zhuanggu decoction in early postoperative rehabilitation of patients with thoracolumbar fractures.Methods Eighty patients with thoracolumbar fractures without nerve injury who admitted to Anyang Hospital of Traditional Chinese Medicine from June 2019 to May 2020 were selected.All patients underwent percutaneous pedicle screw internal fixation.They were divided into two groups by random number table method.The control group was given conventional treatment after operation,and the observation group was given traditional Chinese medicine Zhuanggu decoction on the basis of the control group.The patients were followed up and the postoperative related efficacy indicators were compared between the two groups.Results Postoperative VAS scores and RDQ dysfunction scores were significantly lower in both two groups compared with before operation(P<0.05),and the data of both two indicators at 1,3,and 6 months after surgery in the observation group were significantly lower than those of the control group(P<0.05).In both two groups,the height ratio of the anterior margin of the vertebral body and the Cobb angle were significantly improved compared with before operation(P<0.05),but the maintenance of the correction in the observation group was significantly better than that in the control group at 3 and 6 months after surgery(P<0.05).Conclusion Percutaneous pedicle screw internal fixation combined with Zhuanggu decoction in the treatment of thoracolumbar fractures can effectively alleviate the early pain symptoms of patients during rehabilitation,reduce postoperative dysfunction,and promote the recovery of daily life ability.It can also effectively maintain the vertebral body height and Cobb angle in the long term.