椎体成形球囊扩张术联合针灸治疗骨质疏松性腰椎骨折的疗效观察  

The clinical outcome of vertebroplasty balloon dilatation combined with acupuncture in the treatment of osteoporotic lumbar fracture

作　　者：樊展[1] 熊元[2] 陈朗 闫晨晨 刘国辉[2] FAN Zhan;XIONG Yuan;CHEN Lang(Department of Acupuncture and Moxibustion,Wuhan NO.1 hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院针灸科,430022 [2]华中科技大学同济医学院附属协和医院骨科

出　　处：《临床外科杂志》2021年第4期314-317,共4页Journal of Clinical Surgery

摘　　要：目的观察椎体成形球囊扩张术(PKP)联合针灸治疗骨质疏松性腰椎骨折的疗效。方法接受PKP治疗的骨质疏松性腰椎骨折病人47例,按照是否联合针灸治疗分为针灸组(23例)和单独PKP组(24例)。针灸组病人在PKP手术后,选取肾俞穴、脾俞穴、委中穴和阿是穴,并结合辨证取穴针刺;PKP组病人仅接受PKP治疗,术后未行针灸治疗。采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)和脊柱后凸角(KA)进行临床疗效评价。结果所有病人均获得完整随访,随访时间为12~17个月,平均随访时间(12.73±3.17)个月。两组病人术前与术后KA角比较,差异有统计学意义(P<0.05),两组病人KA角在术后各个随访时间点比较,差异无统计学意义(P>0.05);两组病人术后与术前比较,VAS和ODI差异有统计学意义(P<0.05)。在术后6个月以内的随访中,针灸组VAS评分优于单独PKP组,差异有统计学意义(P<0.05),在术后6个月之后的随访中,两组病人的VAS评分比较差异无统计学意义(P>0.05),术后各个随访时间点针灸组的ODI均优于单独PKP组,差异有统计学意义(P<0.05)。结论针灸治疗联合PKP可以在腰椎骨质疏松骨折的治疗中获得比单独PKP治疗更加满意的临床疗效。Objective To observe the therapeutic effect of vertebroplasty balloon dilatation combined with acupuncture on patients with osteoporotic lumbar spine fracture who received PKP.Methods Retrospective analysis was performed on 47 patients with osteoporotic lumbar spine fracture treated by PKP,and they were divided into acupuncture group(23 cases)and separate PKP group(24 cases)according to whether combined acupuncture treatment was available.After the PKP operation,the acupuncture group patients were given acupuncture therapy,Yaoshu point,Pishu point.Weizhong point and Ashi point were selected;Patients in the PKP group only received PKP treatment,and no acupuncture therapy was performed postoperatively.Visual analogue scale(VAS),functional impairment index(ODI),and kyphosis angle(KA)were used to evaluate the clinical efficacy.Results All patients were successfully followed up for 12-17 months,with an average follow-up time of(12.73±3.17)months.There was statistically significant differences in preoperative and postoperative KA angle between the two groups(P<0.05),KA angle was not significantly different between the two groups at each follow-up time point after operation(P>0.05).VAS and ODI were significantly different between the two groups after surgery and before surgery(P<0.05).Compared with VAS scores from 1 month to 6 months after surgery,the acupuncture group was significantly better than the PKP group alone(P<0.05).During the follow-up 6 months after surgery,there was no statistically significant difference in VAS scores between the two groups(P>0.05).ODI of the acupuncture group was significantly better than that of the PKP group alone(P<0.05).Conclusion Acupuncture combined with PKP can achieve more satisfactory clinical efficacy than PKP alone in the treatment of lumbar osteoporosis fracture.

关 键 词：针灸 椎体成形球囊扩张术 骨质疏松 腰椎骨折 

分 类 号：R687.3[医药卫生—骨科学]