壮骨汤联合合经皮椎体后凸成形术治疗老年性骨质疏松性脊柱压缩性骨折的临床疗效及对患者骨代谢的影响  

Efficacy of Zhuanggu Decoction Combined with Percutaneous Kyphoplasty on Elderly Osteoporotic Spinal Compression Fracture and its Effects on Bone Metabolism Indexes

作　　者：王春虎 莫南文 莫方良 邓行行[1] Wang Chunhu;Mo Nanwen;Mo Fangliang;Deng Xingxing(Orthopedics Department of Qionghai Hospital of Traditional Chinese Medicine,Qionghai 571400,China)

机构地区：[1]海南省琼海市中医院骨伤科

出　　处：《世界中医药》2019年第5期1262-1265,共4页World Chinese Medicine

基　　金：2017年度市科技计划医疗类项目(2017-13)

摘　　要：目的:探讨壮骨汤联合经皮椎体后凸成形术(PKP)治疗老年性骨质疏松性脊柱压缩性骨折的临床疗效,并分析其对患者骨代谢指标的影响。方法:选取2016年9月至2018年2月琼海市中医院收治的老年性骨质疏松性脊柱压缩性骨折患者66例作为研究对象,根据治疗方法不同将所有患者分为对照组(n=28)和观察组(n=38)。2组患者均实施PKP治疗,观察组术后增加壮骨汤治疗,连续服用1个月。比较2组治疗后临床疗效、骨折愈合情况及腰部功能恢复情况,检测并比较2组治疗前后骨代谢的变化。结果:治疗后观察组总有效率高达94.74%,高于对照组的89.29%,差异无统计学意义(P>0.05)。与治疗前比较,治疗后2组患者伤椎前缘高度均明显升高,伤椎楔变角及后凸Cobb角均明显降低,且2组差异有统计学意义(P<0.05);治疗后2组患者骨密度(BMD)、血清骨钙素(BGP)及骨碱性磷酸酶(BALP)水平和日本骨科协会腰痛评价表(JOA)评分均明显增加,且观察组明显高于对照组,差异有统计学意义(P<0.05)。结论:壮骨汤联合PKP治疗老年性骨质疏松性脊柱压缩性骨折,可明显抑制骨丢失,改善骨代谢,促进骨折愈合,改善临床症状,提高总体治疗效果。Objective: To investigate the clinical efficacy of Zhuanggu Decoction combined with percutaneous kyphoplasty (PKP) in the treatment of elderly osteoporotic spinal compression fracture,analyze its effects on bone metabolism indexes of patients. Methods: A total of 66 patients with elderly osteoporotic spinal compression fracture who were treated in Qionghai Hospital of Traditional Chinese Medicine from September 2016 to February 2018 were selected.All patients were divided into a control group ( n =28) and an observation group ( n =38) according to different treatment methods.Patients in the 2 groups were treated with PKP,and the observation group added Zhuanggu Decoction after surgery and took 1 month continuously.The clinical efficacy,fracture healing and recovery of lumbar function were compared between the 2 groups after treatment.The changes of bone metabolism indexes levels were detected and compared before and after treatment. Results: The total effective rate was 94.74% in the observation group,which was higher than 89.29% in the control group ( P >0.05).Compared with before treatment,the height of anterior margin of the injured significantly rose in the 2 groups after treatment,vertebral wedge angle and Cobb angle significantly decreased,and the difference between the 2 groups was significant ( P <0.05).After treatment,the levels of bone metabolism markers such as BMD,serum BGP,BALP and JOA scores significantly increased in the 2 groups after treatment,and the observation group was significantly higher than those of the control group ( P <0.05). Conclusion: Zhuanggu Decoction combined with PKP in the treatment of elderly osteoporotic spinal compression fracture can significantly inhibit bone loss,improve bone metabolism,promote fracture healing,improve clinical symptoms and overall treatment efficacy.

关 键 词：老年性骨质疏松性脊柱压缩性骨折 壮骨汤 经皮椎体后凸成形术 骨代谢指标 

分 类 号：R289.4[医药卫生—方剂学] R683[医药卫生—中药学]