和营止痛汤辅助用于经椎旁肌间隙入路椎弓根螺钉内固定术后康复治疗临床评价

Clinical Evaluation of Heying Zhitong Decoction as an Adjunct for Postoperative Rehabilitation Treatment of Pedicle Screw Fixation via Paraspinal Intermuscular Approach

目的探讨和营止痛汤辅助用于行经椎旁肌间隙入路椎弓根螺钉内固定术胸腰椎骨折患者术后康复治疗的临床疗效。方法选取医院骨伤科2020年1月至2022年12月收治的胸腰椎骨折拟行经椎旁肌间隙入路椎弓根螺钉内固定术患者100例,按随机数字表法分为观察组和对照组,各50例。两组患者均予常规康复治疗,观察组患者加服和营止痛汤。两组患者均治疗4周,出院后随访6个月。结果与治疗前比较,两组患者治疗后的视觉模拟评分法评分均显著降低,日本骨科协会主观症状、日常活动、临床体征等项的胸腰椎功能评分,以及骨钙素、碱性磷酸酶、转化生长因子-β1、血管内皮细胞生长因子水平均显著升高,且观察组以上指标均显著优于对照组(P<0.05)。观察组不良反应发生率为4.00%,显著低于对照组的18.00%(P<0.05)。结论和营止痛汤辅助用于胸腰椎骨折患者经椎旁肌间隙入路椎弓根螺钉内固定术术后康复治疗,能有效减轻患者的疼痛,改善胸腰椎功能,促进骨代谢和骨生长因子表达,加快康复。

Objective To investigate the clinical efficacy of Heying Zhitong Decoction as an adjunct for postoperative rehabilitation treatment of patients with thoracolumbar fractures underwent the pedicle screw fixation via paraspinal intermuscular approach.Methods A total of 100 patients with thoracolumbar fractures planned to undergo the pedicle screw fixation via paraspinal intermuscular approach in the Department of Orthopedics and Traumatology of the hospital from January 2020 to December 2022 were selected and divided into the observation group and the control group by the random number table method,with 50 cases in each group.Both groups received routine rehabilitation treatment,on this basis,the observation group received Heying Zhitong Decoction.Both groups were treated for four weeks and followed up for six months after discharge.Results Compared with those before treatment,the Visual Analogue Scale(VAS)score in the two groups was significantly lower,the Japanese Orthopaedic Association(JOA)scores in subjective symptoms,daily activities and clinical signs were significantly higher,the osteocalcin(OC),alkaline phosphatase(ALP),transforming growth factor-β1(TGF-β1)and vascular endothelial growth factor(VEGF)levels were significantly higher,and the above indicators in the observation group were significantly better than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 4.00%,which was significantly lower than 18.00%in the control group(P<0.05).Conclusion Heying Zhitong Decoction as an adjunct for postoperative rehabilitation treatment of patients with thoracolumbar fractures underwent the pedicle screw fixation via paraspinal intermuscular approach can effectively alleviate pain,improve thoracolumbar function,promote bone metabolism and expression of bone growth factors,and accelerate recovery of patients.