养元健骨汤对胸腰椎骨质疏松性爆裂骨折皮球囊扩张椎体后凸成形术术后再骨折的疗效

Effects of Yangyuan Jiangu Decoction on refracture of thoracolumbar osteoporotic burst fracture after PVP/PKP operation

目的研究养元健骨汤对胸腰椎骨质疏松性爆裂骨折采用椎体成形术(PVP)和皮球囊扩张椎体后凸成形术(PKP)术后对骨修复及再骨折的影响。方法选取190例胸腰椎骨质疏松性爆裂骨折患者,随机分为2组进行治疗,每组各95例患者。对照组采用PVP或PKP手术治疗,术后给予西药常规抗骨质疏松治疗。研究组在对照组治疗的基础上联合养元健骨汤进行治疗。观察2组的伤椎高度、后凸角(Cobb角)度、Cobb角恢复情况及各时间段骨密度和骨代谢情况,评估视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分、中医症状积分、临床治疗效果和再骨折发生率。结果治疗前2组伤椎高度、后凸角度、骨密度和骨代谢比较差异无统计学意义(P>0.05),治疗后2组的伤椎高度、Cobb角度、骨密度和骨代谢比较差异有统计学意义(P<0.05);2组术前VAS评分和ODI指数评分差异无统计学意义(P>0.05),术后30 d、60 d研究组VAS评分、ODI指数均低于对照组(P<0.05);2组术前中医症状积分差异无统计学意义(P>0.05),术后中医症状积分低于对照组(P<0.05);2组的疗效差异有统计学意义(P<0.05);研究组相较于对照组的再骨折发生率降低(P<0.05)。结论养元健骨汤联合PVP/PKP手术治疗胸腰椎骨质疏松性爆裂骨折,可促进伤口愈合,增加骨的密度,恢复患者的腰椎功能,减轻患者疼痛程度,为胸腰椎骨质疏松性爆裂骨折的治疗提供了新的方向。

Objective To investigate the effect of Yangyuan Jiangu Decoction on bone repair and refrac-ture after vertebroplasty(PVP)and kyphoplasty(PKP)for thoracolumbar osteoporotic burst fractures.Methods A total of 190 patients with thoracolumbar osteoporotic burst fractures were selected and divided into a control group and a study group,with 95 cases in each group.The control group was treated with PVP or PKP surgery,and was given conventional anti-osteoporosis treatment with Western medicine after surgery.The study group was treated with Yangyuan Jiangu Decoction on the basis of the control group.The recovery of vertebral height,kyphosis an-gle,Cobb angle,bone density and metabolism at different time periods,visual analog scale(VAS),functional im-pairment index(ODI)score,traditional Chinese medicine symptom score,clinical treatment effect,and incidence of recurrent fractures were observed and compared between the two groups.Results Before treatment,the height of injured vertebrae,the degree of kyphotic Angle(Cobb Angle),bone mineral density and bone metabolism of the two groups had no statistical significance(P>0.05),and there were significant differences in the height of injured vertebrae,Cobb angle,bone mineral density and bone metabolism between the two groups after treatment(P<0.05).There was no significant difference in VAS score and ODI index between the two groups before surgery(P>0.05).VAS score and ODI index of the study group 30 and 60 days after surgery were lower than those of the control group(P<0.05).There was no significant difference in TCM symptom score between the two groups before surgery(P>0.05),but the TCM symptom score after surgery was lower than that of the control group(P<0.05).There was significant difference in clinical treatment effect between the two groups(P<0.05).The incidence of refracture in the study group was significantly lower than that in the control group(P<0.05).Conclusion Yangyuan Jiangu Decoction combined with PVP/PKP has a significant effect on the treatment of thoracolumbar osteoporotic burst fractures,promoting wound healing,increasing bone density,restoring lumbar function,reducing pain,and provid-ing a new practical direction for the treatment of thoracolumbar osteoporotic burst fractures.