补肾活血汤治疗骨质疏松性胸腰椎压缩性骨折临床研究

Clinical Study on the Treatment of Osteoporotic Thoracolumbar Vertebral Compression Fractureswith Bushen Huoxue Decoction

目的探究补肾活血汤治疗骨质疏松性胸腰椎压缩性骨折的临床疗效。方法将120例骨质疏松性胸腰椎压缩性骨折患者随机分为对照组和试验组,每组60例。2组均予以经皮穿刺脊柱椎体成形术(percutaneous vertebroplasty,PVP)治疗,对照组术后给予阿仑膦酸钠治疗,试验组在此基础上加用补肾活血汤,2组均治疗3个月。比较2组临床总有效率、骨密度、椎体前缘高度、Cobb角、椎体功能、疼痛评分、骨转化指标和血钙、血磷等水平。结果治疗后,2组总有效率比较,差异无统计学意义(P>0.05)。试验组骨密度、椎体前缘高度、骨钙素(osteocalcin,OC)、骨保护素(osteoprotegerin,OPG)及血磷均高于对照组(P均<0.05);Cobb角、Oswestry功能障碍指数(Oswestry disability index,ODI)、疼痛视觉模拟量表(visual analogue scale,VAS)评分、骨碱性磷酸酶(bone alkaline phosphatase,BALP)及血钙均低于对照组(P均<0.05)。结论应用补肾活血汤治疗骨质疏松性胸腰椎压缩性骨折可恢复椎体高度,提高骨密度,改善椎体活动能力,缓解疼痛,并有效调节骨代谢指标水平,值得推广。

Objective To explore the clinical efficacy of Bushen Huoxue decoction in the treatment of osteoporotic thoracolumbar vertebral compression fractures.Methods A total of 120 patients with osteoporotic thoracolumbar vertebral compression fractures were randomly divided into the control group and the trial group,with 60 cases in each group.Both groups were treated with percutaneous vertebroplasty(PVP).The control group received postoperative treatment with alendronate sodium,while the trial group received additional treatment with Bushen Huoxue decoction.Both groups were treated for three months.The clinical total effective rate,bone density,anterior vertebral height,Cobb angle,vertebral function,pain scores,bone transformation indicators,and levels of blood calcium and phosphorus in the two groups were compared.Results After treatment,there was no statistically significant difference in the total effective rate between the two groups(P>0.05).The bone density,anterior vertebral height,osteocalcin(OC),osteoprotegerin(OPG)and blood phosphorus in the trial group were all higher than those in the control group(all P<0.05).Cobb angle,Oswestry disability index(ODI)and visual analogue scale(VAS)scores,bone alkaline phosphatase(BALP)and blood calcium in the trial group were all lower than those in the control group(all P<0.05).Conclusion The application of Bushen Huoxue decoction in the treatment of osteoporotic thoracolumbar vertebral compression fractures could restore vertebral height,increase bone density,improve vertebral mobility,alleviate pain,and effectively regulate bone metabolism index levels,which is worthy of promotion.