电针刺激对绝经后骨质疏松性桡骨远端骨折术后患者骨密度的影响

The Effect of Electroacupuncture Stimulation on Bone Density in Postmenopausal Patients with Osteoporotic Distal Radius Fractures after Surgery

目的观察电针刺激对绝经后骨质疏松性桡骨远端骨折术后患者骨密度的影响。方法收集50例绝经后骨质疏松性桡骨远端骨折术后患者,随机分配到试验组和对照组。试验组行电针治疗+康复训练,电针频率为2 Hz,时间30 min,3次/周,持续6周,共计18次治疗;康复训练3次/周,45 min/次,持续6周,对照组仅行康复训练。评估分为3个时间点,即治疗前、治疗6周后、治疗结束后6周随访(第12周)。结局指标包括:疼痛视觉模拟评分(visual analog scale,VAS),骨密度值,骨折愈合情况。结果共有7名患者脱落,最终43名患者完成了试验(试验组,n=21;对照组,n=22)。治疗后及随访时,两组患者VAS评分均较前降低,组间虽无差异(P>0.05),但试验组变化值有高于对照组的趋势。治疗后,两组骨密度变化值具有显著组间差异(P<0.01),试验组骨密度值在治疗后增加,随访时下降;而对照组骨密度值在治疗后与随访时均呈下降趋势。在第6周及第10周,试验组骨折愈合例数显著多于对照组(P<0.05),随访时两组患者均已完全愈合。结论电针对绝经后骨质疏松性桡骨远端骨折术后患者骨密度的影响效果是明确的,但疗效难于长时间维持,对T值范围变化没有影响,在疾病定性上没有改变;对骨折愈合的影响该治疗方式可加速骨折愈合。

Objective To observe the effect of electroacupuncture stimulation on bone mineral density(BMD)of postmenopausal patients with osteoporotic distal radius fractures.Methods Fifty postmenopausal patients with osteoporotic distal radius fractures were randomly assigned to the experimental group and the control group.The experimental group received electroacupuncture treatment+rehabilitation training.The frequency of electroacupuncture was 2 Hz,lasting for 30 minutes,3 times/week,lasting for 6 weeks.There were 18 treatments in total.The rehabilitation training was performed 3 times/week,lasting for 45minutes/timeand for 6 weeks.The control group only received rehabilitation training 3 times/week,lasting for 30 minutes/time and for 6 weeks.The evaluation was made at 3 time points,i.e.before treatment,after 6 weeks of treatment,and 6 weeks of follow-up after treatment(i.e.the 12th week).The outcome indicators included:visual analog scale of pain(VAS)score,bone mineral density value,and fracture healing.Results A total of 7 patients fell off,and finally 43 patients completed the experiment(experimental group,n=21;control group,n=22).After treatment and during follow-up,the VAS scores of the two groups were lower than before.Although there was no significant difference between the two groups(P>0.05),the change value of the experimental group was higher than that of the control group.The BMD value of the experimental group increased after 6 weeks of treatment and at the 12th week of follow-up compared with that before treatment,but the BMD value at the time of follow-up showed a downward trend compared with that after 6 weeks of treatment.The BMD value of the control group showed a downward trend after treatment and during follow-up,and the difference between the groups was significant(P<0.05).At the time of follow-up(the 12th week),no cases of nonunion were found in both groups.There was a significant difference between the total number of cases of fracture healing after 6 weeks and 10 weeks of treatment(P<0.05).Conclusion The effect of electroacupuncture on bone mineral density in postmenopausal patients with osteoporotic distal radius fracture is clear,but the effect is difficult to maintain for a long time,and has no effect on the change of T value range and the disease characterization.Influence on fracture healing this treatment can accelerate fracture healing.