温肾补阳法联合PVP、PKP对骨质疏松性脊柱骨折患者骨折愈合的影响  

Effect of warming kidney and tonifying yang method combined with PVP and PKP on fracture healing in patients with osteoporotic spinal fractures

作　　者：杜薛平 张海峰 董大勇[1] 陈伟 黄凯健[1] 徐波 DU Xue-ping;ZHANG Hai-feng;DONG Da-yong;CHEN Wei;HUANG Kai-jian;XU Bo(JiangsuQidongHospital of TCM,Qidong226200)

机构地区：[1]江苏省启东市中医院,江苏启东226200

出　　处：《湖北中医药大学学报》2022年第5期101-103,共3页Journal of Hubei University of Chinese Medicine

基　　金：江苏省南通市科技计划项目(项目编号:MSZ21036)。

摘　　要：目的 观察温肾补阳法联合经皮椎体成形术(PVP)、经皮椎体后凸成形术(PKP)治疗骨质疏松性脊柱骨折(OSF)患者的疗效及对骨折愈合的影响。方法 将我院80例OSF患者按治疗方式分为对照组与观察组各40例。对照组予PVP、PKP治疗,观察组在对照组治疗基础予温肾补阳法治疗。比较两组疼痛视觉模拟量表(VAS)、Oswestry功能障碍指数(ODI)、日常活动能力Barthel指数(BI)评分,脊柱前缘、中线、后缘高度、Cobb角,胰岛素样生长因子-1(IGF-1)、骨钙素(BGP)水平。结果 治疗后,观察组临床总有效率显著高于对照组(P<0.05);两组VAS、ODI评分、Cobb角均较治疗前下降,BI评分、脊柱前缘高度、中线高度、后缘高度、IGF-1、BGP水平均较治疗前升高,观察组VAS、ODI评分、Cobb角均低于对照组,BI评分、脊柱前缘高度、中线高度、后缘高度、IGF-1、BGP水平均高于对照组(P<0.05)。结论 温肾补阳法联合PVP、PKP调节OSF患者骨代谢,降低疼痛,提高生活能力,促进骨折愈合,作用机制与IGF-1、BGP水平上调有关。Objective To observe the effect of warming kidney and nourishing yang method combined with percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in treatment of osteoporotic spinal fracture(OSF)and its influence on fracture healing. Methods Eighty OSF patients were divided into control group and observation group according to treatment methods,40 cases in each group. Control group was treated with PVP and PKP,and treatment group was treated with warming kidney and yang method on the basis of control group. The Visual Analogue Scale(VAS),Oswestry Disability Index(ODI),Barthel Index(BI)scores of daily activities,anterior spine height,midline height,posterior edge height,Cobb angle,insulinlike growth factor-1(IGF-1)and bone gla protein(BGP)levels were compared between the two groups. Results After treatment,the total effective rate in treatment group was higher than that in control group( P<0.05);the VAS,ODI scores,and Cobb angle scores of both groups were decreased compared with those before treatment,and the BI scores,anterior spine heights,midline heights,posterior edge heights,IGF-1 and BGP levels increased;the VAS,ODI,Cobb angle scores were lower than in control group,and the BI score,anterior spine height,midline height,posterior edge height,IGF-1 and BGP levels were higher than those in control group( P<0.05). Conclusion Warming kidney and tonifying yang method combined with PVP and PKP can regulate bone metabolism,reduce pain,improve living ability,and promote fracture healing in patients with OSF. The mechanism may be related to the up-regulation of IGF-1 and BGP levels.

关 键 词：骨质疏松 脊柱骨折 骨折愈合 温肾补阳法 

分 类 号：R274.1[医药卫生—中医骨伤科学]