复元活血汤联合经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折32例

Fuyuan Huoxue Decoction combined with percutaneous kyphoplasty in the treatment of 32 cases of thoracolumbar vertebral compression fractures

目的 探讨复元活血汤联合经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性胸腰椎压缩性骨折的临床疗效。方法 选择2020年11月—2021年11月首都医科大学附属北京中医医院骨科收治的64例胸腰椎压缩性骨折患者,采用区组随机化分组法分为观察组32例和对照组32例。对照组采用PKP手术治疗;观察组给予PKP手术联合复元活血汤治疗,连服1周。对比2组临床疗效、治疗前后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分、中医证候积分、伤椎前缘及中线高度。结果 观察组显效率[25.00%(8/32)]高于对照组(0),差异有统计学意义(P<0.05);2组总有效率比较差异无统计学意义(P>0.05)。治疗1周后,2组VAS、ODI评分均较治疗前降低(P<0.05),且观察组VAS、ODI评分低于对照组(P<0.05);2组中医证候积分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);2组伤椎前缘及中线高度均较治疗前升高(P<0.05),但2组间差异均无统计学意义(P>0.05)。结论 复元活血汤联合PKP治疗胸腰椎压缩性骨折的疗效确切,可减轻患者疼痛,促进腰椎功能恢复,减轻临床症状。

Objective To investigate the clinical effect of Fuyuan Huoxue Decoction combined with percutaneous kyphoplasty(PKP)in the treatment of thoracolumbar compression fractures.Methods A total of 64 patients with thoracolumbar vertebral compression fractures,who visited Department of Orthopedics,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from November 2020 to November 2021,were divided into experimental group and control group by block randomization method.32 patients in the control group were treated with PKP surgery,and 32 in the experimental group was treated with Fuyuan Huoxue Decoction orally for one week on the basis of the control group.The clinical efficacy,visual analogue scale(VAS),Oswestry dysfunction index(ODI)score,TCM syndrome score,the height of anterior and midline of injured vertebra were compared between the two groups.Results The effective rate of the experimental group was 25.00%(8/32),which was significantly higher than that of the control group,0.00%(0/32),and the difference was statistically significant(P<0.05).There was no significant difference in the total effective rate between the two groups(P>0.05).After one week of treatment,VAS and ODI scores of the two groups of patients were significantly lower than those before treatment(P<0.05),and the scores of the experimental group were significantly lower than those of the control group,and the difference was significant(P<0.05).After treatment,the scores of TCM syndromes in both groups were lowered than those before treatment(P<0.05),and the scores of TCM syndromes in the observation group were lowered than those in the control group(P<0.05).The height of the anterior edge of the injured vertebrae and the height of the midline of the injured vertebrae in the two groups were higher than those before treatment(P<0.05),while the recovery degree of the injured vertebral height in the experimental group was not significantly different from that in the control group(P>0.05).Conclusion Fuyuan Huoxue Decoction combined with PKP is effective in the treatment of thoracolumbar compression fractures,which can significantly reduce pain,help promote the recovery of lumbar vertebtral function and alleviate clinial symptoms.