热敏灸联合椎体成形术治疗骨质疏松性椎体骨折远隔部位疼痛临床观察

Heat-sensitive Moxibustion Combined with Vertebroplasty in the Treatment of Distant Pain of Osteoporotic Vertebral Fractures

目的研究热敏灸联合椎体成形术治疗骨质疏松性椎体骨折远隔部位疼痛的效果。方法选取江西中医药大学附属医院100例骨质疏松性胸椎骨折远隔部位疼痛患者,随机分为对照组(椎体成形术)和试验组(热敏灸联合椎体成形术)。观察2组入院第1天、术后1 d、术后3 d、术后1周远隔部位的疼痛程度(VANS评分)、下腰痛程度(改良ODI)及血清生化因子。结果治疗后,2组入院第1天、术后1 d的VANS评分及改良ODI评分比较,差异无统计学意义(P>0.05),试验组术后3 d、术后1周VANS评分及改良ODI评分均低于对照组(P<0.05);且2组血清生化因子TNF-α、IL-6、IL-1β、TLR2、NF-κB、RANKL水平均呈下降趋势,OPG水平呈上升趋势;术后1周,试验组OPG水平高于对照组,其余指标水平低于对照组(P<0.05)。结论热敏灸联合椎体成形术用于骨质疏松性椎体骨折远隔部位疼痛的效果显著,值得推广。

Objective To study the effect of heat-sensitive moxibustion combined with vertebroplasty on distal pain of osteoporotic vertebral fracture.Methods A total of 100 patients with distant pain of osteoporotic vertebral fractures were randomly divided into control group(vertebroplasty)and experimental group(heat-sensitive moxibustion and vertebroplasty).The pain degree(VANS score),low back pain degree(modified ODI)and serum biochemical factors of the two groups were observed on the 1st day after admission,the 1st day after surgery,the 3rd day after surgery,and the 1st week after surgery.Results There was no significant difference in VAS score and improved ODI score on the first day after admission and 1 day after surgery(P>0.05),and the scores of the test group on the third day and 1 week after surgery were lower than those of the control group(P<0.05).The levels of serum biochemical factors TNF-α,IL-6,IL-1β,TLR2,NF-κB and RANKL showed a decreasing trend,while the levels of OPG showed an increasing trend.One week after surgery,the OPG level of experimental group was higher than that of control group,and the other indexes were lower than that of control group(P<0.05).Conclusion Heat-sensitive moxibustion and vertebroplasty on distal pain of osteoporotic vertebral fracture has significant effect,and is worthy of promotion.