化瘀接骨汤联合碳酸钙D_(3)片对骨质疏松性胸腰椎骨折患者术后骨密度、骨代谢的影响

Effects of Huayu Jiegu Decoction with calcium carbonate D_(3) tablets on the bone metabolism and bone healing indexes in patients with osteoporotic thoracolumbar fracture after surgery

目的探讨化瘀接骨汤对骨质疏松性胸腰椎骨折患者术后骨代谢及骨愈合指标的影响。方法选取广州中医药大学惠州医院在2020年9月-2022年12月收治的100例骨质疏松性胸腰椎骨折患者,按照随机数表法将患者分为观察组(碳酸钙D_(3)片+化瘀接骨汤加减口服治疗,50例)和对照组(碳酸钙D_(3)片治疗,50例)。比较2组患者的治疗效果,比较2组患者治疗前后腰酸背痛、痿软乏力、舌质暗红、乏力且无法负重等的中医症状积分,比较2组患者治疗前后的股骨颈、腰椎、粗隆间骨密度水平,比较2组患者治疗前后的骨保护素(OPG)、碱性磷酸酶(ALP)、骨钙素(BGP)水平。结果观察组总有效率92.00%明显高于对照组70.00%(P<0.05);化瘀接骨汤治疗后与对照组比较,观察组腰酸背痛、痿软乏力、舌质暗红、乏力且无法负重的积分较低(P<0.05);化瘀接骨汤治疗后与对照组比较,观察组股骨颈、腰椎、粗隆间骨密度水平较高(P<0.05);化瘀接骨汤治疗后与对照组比较,观察组OPG、ALP、BGP水平较高(P<0.05)。结论化瘀接骨汤可有效缓解骨质疏松性胸腰椎骨折术后患者的临床症状,提高骨密度水平,改善骨代谢状态,促进骨愈合,值得临床推广。

Objective To investigate the effects of Huayu Jiegu Decoction on the bone metabolism and bone healing indexes in patients with osteoporotic thoracolumbar fracture after surgery.Methods A total of 100 patients with osteoporotic thoracolumbar fracture admitted to our hospital from September 2020 to December 2022 were selected and divided into an observation group(treated with calcium carbonate D_(3) tablets plus modified Huayu Jiegu Decoction,50 cases)and a control group(treated with calcium carbonate D_(3) tablets,50 cases)according to the random number table method.The therapeutic effects of the two groups were compared,and the scores of traditional Chinese medicine symptoms including back pain,flaccidity,weakness,dark red tongue,and inability to carry weight were compared between the two groups before and after treatment.The bone density levels of femoral neck,lumbar spine and intertrochanteric bone were compared between the two groups before and after treatment.The levels of osteoprotegerin(OPG),alkaline phosphatase(ALP)and osteocalcin(BGP)were compared between the two groups before and after treatment,and the effect of fracture healing was compared between the two groups.Results The total effective rate in the observation group(92.00%)was significantly higher than that in the control group(70.00%)(P<0.05).After treatment with Huayu Jiegu Decoction,the scores of back pain,flaccidity,weakness,dark red tongue,inability to carry weight were lower in the observation group than those in the control group(P<0.05).After treatment with Huayu Jiegu Decoction,the bone density levels of femoral neck,lumbar spine and intertrochanteric bone in the observation group were higher than those in the control group(P<0.05).The OPG,ALP and BGP levels were higher in the observation group than those in the control group after treatment with Huayu Jiegu Decoction(P<0.05).Compared with the control group,the fracture healing effects of gradeⅠandⅡin the observation group were lower,while the fracture healing effects of gradeⅢandⅣwere higher(P<0.05).Conclusion Huayu Jiegu Decoction can effectively relieve the clinical symptoms of patients with osteoporotic fracture after operation,improve the levels of bone density,improve bone metabolism,promote bone healing,worthy of clinical promotion.