抗骨质疏松胶囊治疗胸腰椎骨质疏松性压缩骨折的临床疗效观察

Clinical Observation of Kang-gu-zhi-shu-song capsule in the treatment of osteoporotic vertebral compression frac-ture in elder patients

目的:观察抗骨质疏松胶囊治疗胸腰椎骨质疏松性压缩骨折的临床疗效。方法:分析本院自2021年7月至2021年12月之间共100例因腰胸腰椎骨质疏松性压缩骨折于我科手术治疗的病例的临床资料。根据术后抗骨质疏松胶囊的使用情况,将患者随机分成实验组(50例)与对照组(50例),对比两组患者的腰疼数字评分(NRS评分)、骨密度、包括血清骨钙素(BGP)、总I型胶原氨基端延长肽(P1NP)、β-胶原特殊序列(β-CTX)、25-羟基维生素D(25(OH)-D)在内的骨代谢生化指标、术后伤椎Cobb角及术后再骨折发生率。结果:所有患者术后12月时NRS评分均显著改善,且实验组的NRS评分显著低于对照组(P<0.001)。术后随访期间,实验组的骨密度显著增加(P<0.001),对照组骨密度无显著改变(P=0.168)。两组的骨代谢指标在术前无显著差异。术后12月时,两组的骨代谢指标均获得显著的变化,实验组的β-CTX显著低于对照组(P<0.001),而BGP、25(OH)-D及P1NP显著高于对照组(P<0.001)。与术后1天相比,术后12月时实验组的伤椎Cobb角无显著改变(P=0.065),而对照组则显著减少(P<0.001)。两组患者术后12月内胸腰椎再骨折发生率无显著差异(P=0.240)。结论:抗骨质疏松胶囊应用于胸腰椎骨质疏松性压缩性骨折,可显著改善骨代谢指标,增加骨密度,促进骨折愈合,防止术后伤椎Cobb角丢失,缓解疼痛,获得良好的临床效果。

Object:To observe the clinical efficacy of the administration of Kang-gu-zhi-shu-song capsule in the treatment of osteoporotic vertebral compression fracture(OVCF)in elder patients.Method:One hundred patients who underwent vertebro-plasty for OVCF between July 2021and December 2021were reviewed.Patients were prescribed with bisphosphonates,calcium carbonate and vitamin D,and divided into two groups according to the combination with Kang-gu-zhi-shu-song capsule:study group(with)and control group(without).The bone mineral density(BMD)perioperative bone metabolism index including Bone gla-containing protein(BGP),Total type I collagen amino terminal lengthening peptide(P1NP),β-CrossLaps(β-CTX)and 25-(OH)-D,the radiological datum including the spinal refracture and the change of the Cobb angle of the operated vertebrae and the Numerical Rating Scale(NRS)of spine pain were compared between the two groups.Result:There were significant im-provements in NRS score at both groups(P<0.O01),and the NRS score was significantly lower in the study group than that in control group at 12months follow-up(P<0.001).During the postoperative follow-up period,bone mineral density increased sig-nificantly in the experimental group(P<0.001)and did not change significantly in the control group(P=0.168).There was no significant difference in bone metabolic indexes between the two groups before surgery.At 12months postoperatively,significant changes in bone metabolic indexes were obtained in both groups.Theβ-CTX in the study group was significantly lower than that in the control group(P<0.001),while BGP,25(OH)-D and PINP were significantly higher than in the control group(P<0.001).There was no significant difference in the Cobb of the operated vertebrae between the lday and 12months postoperative in study group(P=0.065),by contrast,there was a significant decrease in Cobb of the operated vertebrae during the 12months fol-low-up in the control group(P<0.001).There was no significant difference in the incidence of re-spinal fracture between two groups(P=0.240).Conclusion:The application of Kang-gu-zhi-shu-song capsule in the treatment of osteoporotic compression fracture of thoracolumbar spine can significantly improve bone metabolism,increase bone density,promote fracture healing,pre-vent the loss of Cobb angle of injured vertebra after operation,relieve pain,and achieve good clinical results.