补肾益脾壮骨汤对老年骨质疏松性椎体压缩性骨折PKP术后康复的影响

Effect of Bushen Yipi Zhuanggu Decoction on Rehabilitation of Patients After PKP for Senile Osteoporotic Vertebral Compression Fracture

目的:观察补肾益脾壮骨汤对老年骨质疏松性椎体压缩性骨折(OVCF)患者经皮球囊扩张椎体后凸成形术(PKP)术后康复的影响。方法:选取120例行PKP治疗的老年OVCF患者,采用随机数字表法分为对照组和观察组各60例。对照组术后给予唑来膦酸及碳酸钙D3片治疗,观察组在对照组基础上联合补肾益脾壮骨汤治疗。2组均治疗6周,随访至术后12个月。比较2组视觉模拟评分法(VAS)、日本矫形外科学会(JOA)评分,疼痛缓解疗效、腰椎功能改善疗效,以及椎体再骨折发生率。结果:2组术后12周VAS评分均低于同组术后1周、2周及6周,2组术后6周VAS评分均低于同组术后1周及2周,2组术后2周VAS评分均低于同组术后1周,观察组术后2周、6周、12周VAS评分均低于同期对照组,差异均有统计学意义(P<0.05)。术后12周,观察组疼痛缓解总有效率100%,与对照组96.67%比较,差异无统计学意义(P>0.05)。2组术后12周JOA评分均高于同组术后1周、2周及6周,2组术后6周JOA评分均高于同组术后1周及2周,2组术后2周JOA评分均高于同组术后1周,观察组术后2周、6周、12周JOA评分均高于同期对照组,差异均有统计学意义(P<0.05)。术后12周,观察组腰椎功能改善总有效率98.33%,高于对照组86.67%,差异有统计学意义(P<0.05)。术后3个月、6个月、12个月,椎体再骨折发生率观察组分别为0、4.35%、6.45%,对照组分别为1.67%、9.30%、13.79%,2组比较,差异均无统计学意义(P>0.05)。结论:补肾益脾壮骨汤能促进老年OVCF患者PKP术后康复,有效缓解术后疼痛、改善腰椎功能,但对椎体再骨折的影响还需后续研究的进一步验证。

Objective:To observe the effect of rehabilitation of patients who had undergone percutaneous kyphoplasty(PKP) for senile osteoporotic vertebral compression fracture(OVCF).Methods:A total of 120 senile patients who had undergone PKP for OVCF were selected and divided into the control group and the observation group according to the random number table method,with 60 cases in each group.The control group was given Zoledronic Acid and Calcium Carbonate and Vitamin D3Tablets for treatment after PKP,and the observation group was additionally treated with Bushen Yipi Zhuanggu Decoction based on the treatment of the control group.The two groups were treated for 6 weeks and followed up for 12 months after PKP.The scores of Visual Analogue Scale(VAS) and Japanese Orthopaedic Association(JOA),curative effects on pain relief,improvement of lumbar vertebral function and incidence of vertebral refracture were compared between the two groups.Results:Twelve weeks after PKP,the VAS scores in both groups were lower than those in the same group one week,two weeks and six weeks after PKP;six weeks after PKP,the VAS scores in both groups were lower than those in the same group one week and two weeks after PKP;two weeks after PKP,the VAS scores in both groups were lower than those in the same group one week after PKP;two weeks,six weeks and twelve weeks after PKP,the VAS scores in the observation group were respectively lower than those in the control group in the same period,differences being significant(P<0.05).Twelve weeks after PKP,the total effective rate of pain relief was 100% in the observation group,and the comparison with that of 96.67% in the control group showed no significance in the difference(P>0.05).Twelve weeks after PKP,the JOA scores in both groups were higher than those in the same group one week,two weeks and six weeks after PKP;six weeks after PKP,the JOA scores in both groups were higher than those in the same group one week and two weeks after PKP;two weeks after PKP,the JOA scores in both groups were higher than those in the same group;two weeks,six weeks and twelve weeks after PKP,the JOA scores in the observation group were higher than those in the control group in the same period,differences being significant(P<0.05).Twelve weeks after PKP,the total effective rate of improvement of lumbar vertebral function was98.33% in the observation group,higher than that of 86.67% in the control group,the difference being significant(P<0.05).Three months,six months and twelve months after PKP,the incidence of vertebral refracture was respectively 0,4.35% and 6.45% in the observation group,and 1.67%,9.30% and13.79% in the control group,there being no significant differences(P>0.05).Conclusion:Bushen Yipi Zhuanggu Decoction can accelerate the rehabilitation of senile patients who had undergone PKP for OVCF,effectively mitigate the postoperative pain and improve the lumbar vertebral function.However,its effect on the incidence of vertebral refracture still needs further verification by future study.