补肾活血方治疗老年性骨质疏松性椎体压缩性骨折临床观察

来源:用户上传      作者:刘剑 王婷

　　 〔摘要〕 目的 研究a肾活血方联合经皮椎体后凸成形术（percutaneous kyphoplasty， PKP）治疗老年性骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fracture， OVCF）的疗效，探究中医药治疗老年性OVCF更为有效的治疗方案。方法 按随机对照设计，选取2019年1月至2019年12月在湖南中医药大学第一附属医院住院诊断为老年性OVCF患者60例，按随机表法分为观察组和对照组（每组30例）。两组患者均行PKP，术后常规抗骨质疏松治疗，观察组在对照组基础上服用补肾活血方，连续服用3月。比较两组术前、术后1周、1月、3月的疼痛视觉模拟评分表（visual analogue scale， VAS）和Oswestry功能障碍指数（Oswestry disability index， ODI）评分，比较两组术前和术后3月的中国人骨质疏松症生存质量（Chinese osteoporosis-targeted quality of Life， COQOL）评分及骨质疏松症T值，观察比较两组术后3月的临床疗效。结果 术后3月，观察组总有效率为90.00%，高于对照组的83.33%（P<0.05）。术后1周、1月、3月，两组VAS、ODI评分均低于术前（P<0.05）;术后1周，观察组VAS评分与对照组比较，差异无统计学意义（P>0.05）;术后1月、3月，观察组VAS评分均低于对照组（P<0.05）;术后同一时间节点，观察组ODI评分均低于对照组（P<0.05）。术后3月，对照组骨质疏松症T值与术前比较，差异无统计学意义（P>0.05），而观察组骨质疏松症T值低于术前（P<0.05），且观察组骨质疏松症T值低于对照组（P<0.05）。术后3月，两组COQOL 4个维度评分较术前均有下降（P<0.05），且观察组COQOL 4个维度评分均低于对照组（P<0.05）。结论 补肾活血方联合PKP治疗老年性OVCF疗效显著，安全有效，是老年性OVCF有效的治疗方法。
　　 〔关键词〕 压缩性骨折;骨质疏松;补肾活血方;老年;经皮椎体后凸成形术;骨质疏松性椎体压缩性骨折
　　 〔中图分类号〕R274.13 〔文献标志码〕B 〔文章编号〕doi：10.3969/j.issn.1674-070X.2022.02.026
　　Clinical study on Bushen Huoxue Recipe in the treatment of senile osteoporotic
　　vertebral compression fracture
　　LIU Jian， WANG Ting
　　（The First Affiliated Hospital of Hunan University of Chinese Medicine， Changsha， Hunan 410007， China）
　　〔Abstract〕 Objective To study the efficacy of Bushen Huoxue Recipe combined with percutaneous kyphoplasty （PKP） in the treatment of senile osteoporotic vertebral compression fracture （OVCF）， and to explore the effective treatment of senile OVCF. Methods A total of 60 patients with senile OVCF in The First Affiliated Hospital of Hunan University of Chinese Medicine from January 2019 to December 2019 were divided into treatment group （n=30） and control group （n=30） according to random table method. The patients in the two groups were treated with PKP and performed routine anti-osteoporosis therapy after operation. The patients in the treatment group were treated with Bushen Huoxue Recipe on the basis of the control group for 3 months. The pain visual analogue scale （VAS） and Oswestry disability index （ODI） were evaluated before operation， 1 week， 1 month and 3 months after operation. Chinese osteoporosis-targeted quality of life （COQOL） score and T value of osteoporosis were compared between the two groups before and 3 months after operation. The clinical efficacy of the two groups was evaluated before and 3 months after operation. Results Three months after operation， the total effective rate of the treatment group was 90.00%， higher than that of the control group 83.33% （P<0.05）. The VAS score， ODI index of 1 week， 1 month and 3 months of the two groups were lower than those before operation; one week after operation， there was no significant difference in VAS score between the observation group and the control group （P>0.05）; VAS score of observation group was lower than control group at 1 and 3 months after operation （P<0.05）; the ODI score of the observation group was lower than that of the control group at the same time after operation （P<0.05）. Three months after operation， there was no significant difference in the T value of osteoporosis in the control group compared with that before operation （P>0.05）， while the T value of osteoporosis in the observation group was lower than that before operation （P<0.05）， and the T value of osteoporosis in the observation group was lower than that in the control group （P<0.05）. Three months after operation， COQOL score of 4 dimensions in two groups decreased compared with that before operation （P<0.05）， and COQOL score of 4 dimensions in observation group was lower than that in control group （P<0.05）. Conclusion Bushen Huoxue Recipe combined with PKP is effective， safe and effective in the treatment of senile OVCF.
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