补肾活血汤加味联合唑来膦酸对老年胸腰椎压缩性骨折PKP/PVP后骨质疏松的影响  

Effect of Bushen Huoxue Decoction Flavored Combined with Zoledronic Acid on Osteoporosis after PKP/PVP for Elderly Thoracolumbar Compression Fractures

作　　者：王岩 吴学文[1] 丁陆 WANG Yan;WU Xuewen;DING Lu(Pizhou Hospital of Traditional Chinese Medicine,Pizhou 221300,China;不详)

机构地区：[1]邳州市中医院,江苏邳州221300

出　　处：《中外医学研究》2023年第4期30-35,共6页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究补肾活血汤加味联合唑来膦酸对老年胸腰椎压缩性骨折经皮球囊扩张椎体后凸成形术(percutaneous kyphoplasty,PKP)/经皮椎体成形术(percutaneous vertebroplasty,PVP)后骨质疏松的影响。方法:回顾性选取2021年1—12月邳州市中医院收治的90例行PKP/PVP的老年胸腰椎压缩性骨折患者为研究对象。根据术后不同治疗方法将其分为研究组(n=39)和对照组(n=51)。两组在PKP/PVP手术后次日服用碳酸钙D3片,对照组在术后3 d静脉输注唑来膦酸注射液,研究组在对照组的治疗基础上给予补肾活血汤加味治疗。比较两组治疗前后疼痛、功能障碍、中医症候评分、骨密度、骨折椎体高度、脊椎侧弯Cobb角度、血清指标及临床疗效。结果:治疗后,两组视觉模拟法(visual analogue scales,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)、中医症候评分、骨碱性磷酸酶(bone alkaline phosphatase,BALP)、甲状旁腺激素(parathyroid hormone,PTH)水平均比治疗前低,骨钙素(bone gla protein,BGP)、Ⅰ型前胶原氨基末端前肽(typeⅠprocollagen amino terminal propeptide,PⅠNP)水平均比治疗前高,且研究组VAS、ODI、中医症候评分、BALP、PTH水平均低于对照组,BGP、PⅠNP水平均高于对照组(P<0.05)。治疗后,两组骨密度比治疗前高,脊椎侧弯Cobb角度比治疗前小,且研究组骨密度高于对照组,脊椎侧弯Cobb角度小于对照组(P<0.05)。对照组治疗后骨折椎体高度降低(P<0.05),研究组治疗前后骨折椎体高度无明显变化(P>0.05),治疗后研究组骨折椎体高度高于对照组(P<0.05)。研究组治疗后临床疗效明显优于对照组(P<0.05)。结论:补肾活血汤加味联合唑来膦酸治疗老年胸腰椎压缩性骨折PKP/PVP后骨质疏松有显著效果,能有效提高骨质量,改善血清指标及功能障碍。Objective: To investigate the effect of Bushen Huoxue Decoction Flavored combined with Zoledronic Acid on osteoporosis after percutaneous kyphoplasty(PKP)/percutaneous vertebroplasty(PVP) for elderly thoracolumbar compression fractures.Method: From January to December 2021, 90 elderly patients with thoracolumbar compression fractures who underwent PKP/PVP in Pizhou Hospital of Traditional Chinese Medicine were retrospectively selected as the research objects. According to different postoperative treatment methods, they were divided into study group(n=39) and control group(n=51). The two groups were given Calcium Carbonate and Vitamin D3 Tablets on the next day after PKP/PVP surgery, the control group was given Zoledronic Acid Injection intravenously 3 d after surgery, and the study group was given Bushen Huoxue Decoction Flavored treatment on the basis of the treatment of the control group. The pain, dysfunction, traditional Chinese medicine symptom score, bone mineral density, height of fractured vertebra, Cobb angle of scoliosis, serum indexes before and after treatment and clinical efficacy were compared between the two groups. Result: After treatment, the visual analogue scales(VAS), Oswestry disability index(ODI), traditional Chinese medicine syndrome scores, bone alkaline phosphatase(BALP) and parathyroid hormone(PTH) levels were lower than those before treatment, the levels of bone Gla protein(BGP)and type Ⅰ procollagen amino terminal propeptide(PⅠNP) were higher than those before treatment, the VAS, ODI, traditional Chinese medicine syndrome scores, BALP and PTH levels in the study group were lower than those in the control group, and the BGP and PⅠNP levels were higher than those in the control group(P<0.05). After treatment, the bone mineral density of the two groups was higher than that before treatment, and the Cobb angle of scoliosis was smaller than that before treatment, and the bone mineral density of the study group was higher than that of the control group, and the Cobb angle of scoliosis

关 键 词：补肾活血汤 唑来膦酸 压缩性骨折 经皮球囊扩张椎体后凸成形术 经皮椎体成形术 骨质疏松 

分 类 号：R687.3[医药卫生—骨科学]