温肾通络方联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折临床研究

Clinical Study on Wenshen Tongluo Formula Combined with Percutaneous Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures

目的探讨温肾通络方联合经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)对急性骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)肾虚血瘀型患者的临床疗效。方法选取2022年1月—2022年12月在本院骨科接受PKP治疗的80例急性OVCF肾虚血瘀型患者,采用随机数字表法随机分为观察组及对照组,每组40例。对照组予以PKP和抗骨质疏松治疗,观察组则在对照组的基础上联合服用温肾通络方。治疗1个月后,对比2组患者治疗前后的中医证候积分、视觉模拟评分法(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)、日本骨科协会(Japanese Orthopaedic Association,JOA)评分,血清钙(Calcium,Ca)、碱性磷酸酶(alkaline phosphatase,ALP)和25-羟维生素D_(3)[25-hydroxyvitamin D_(3),25-(OH)D_(3)]水平变化及临床疗效、不良反应发生率。结果治疗后,观察组患者总有效率为95.0%,明显高于对照组的75.0%(P<0.05)。观察组中医证候积分、ODI评分、VAS评分、血清ALP水平明显低于对照组(P<0.05),观察组JOA评分、血清25-(OH)D_(3)水平明显高于对照组(P<0.05)。结论温肾通络方联合PKP治疗急性OVCF肾虚血瘀型患者可显著缓解患者临床症状,减轻腰背疼痛,提高胸腰椎功能,改善骨代谢指标,临床疗效显著。

Objective To investigate the clinical efficacy of Wenshen Tongluo formula combined with percutaneous kyphoplasty(PKP)in the treatment of patients with acute osteoporotic vertebral compression fracture(OVCF)of kidney deficiency and blood stasis type.Methods Eighty patients with acute OVCF of kidney deficiency and blood stasis type who received PKP treatment in the orthopedics department of our hospital from January 2022 to December 2022 were randomly divided into observation group and control group using a random number table method,with 40 patients in each group.The control group was treated with PKP and anti osteoporosis treatment,while the observation group was treated with Wenshen Tongluo formula on the basis of the control group treatment.After one month of treatment,the scores of traditional Chinese medicine syndromes,visual analogue scale(VAS),Oswestry disability index(ODI),Japanese Orthopaedic Association(JOA)score,serum calcium(Ca),alkaline phosphatase(ALP)and 25-hydroxyvitamin D_(3)[25-(OH)D_(3)]before and after treatment and clinical efficacy,incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate of the observation group patients was 95.0%,significantly higher than the control group's 75.0%(P<0.05).The traditional Chinese medicine syndrome score,ODI score,VAS score,and serum ALP level in the observation group were significantly lower than those in the c ontrol group(P<0.05),while the JOA score and serum 25-(OH)D_(3)level in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Wenshen Tongluo formula combined with PKP in the treatment of patients with acute OVCF of kidney deficiency and blood stasis type could significantly alleviate clinical symptoms,alleviate back pain,improve thoracolumbar function,improve bone metabolism indicators,and has a significant clinical efficacy.