接骨丹联合经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折疗效研究  

Curative effect study on Jiegudan combined with percutaneous vertebral body kyphoplasty in treatment of osteoporotic vertebral compression fractures in the elderly

作　　者：王彦鹏 全健 郝龙飞 崔强 雷斌 王婷 沈守卫 徐鹏 WANG Yanpeng;QUAN Jian;HAO Longfei;CUI Qiang;LEI Bin;WANG Ting;SHEN Shouwei;XU Peng(Department of Orthopaedic InjuriesⅡ,Shaanxi Provincial Hospital of Chinese Medicine,Xi’an 710003,China;不详)

机构地区：[1]陕西省中医医院骨伤二科,陕西西安710003 [2]铜川市宜君县中医医院,陕西铜川727200 [3]陕西中医药大学,陕西咸阳712046

出　　处：《陕西中医》2023年第7期901-904,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：陕西省自然科学基础研究计划项目(2021JZ-59);陕西省重点研发计划项目(2021SF-420)。

摘　　要：目的:探讨接骨丹对老年骨质疏松性椎体压缩骨折(OVCF)经皮椎体后凸成形术(PKP)术后疗效。方法:筛选老年OVCF患者64例,所有患者均接受PKP术治疗,并按随机数字表法分两组,各32例。对照组术后接受钙尔奇D治疗,观察组术后接受接骨丹治疗。治疗2个月后,比较两组疗效,记录治疗前、治疗2个月后视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分及骨代谢指标[骨钙素(BGP)、Ⅰ型前胶原氨基末端肽(PINP)、Ⅰ型胶原降解产物(ICTP)]变化,并记录和分析两组治疗期间所产生的不良反应。结果:观察组总有效率为96.88%,高于对照组的78.13%,差异有统计学意义(P<0.05)。治疗2个月,两组VAS、ODI评分均降低,观察组的VAS评分为(2.12±0.21)分、ODI评分为(30.45±4.11)分,均低于对照组VAS(3.09±0.24)分、ODI(42.19±3.98)分,差异有统计学意义(P<0.05)。治疗后,两组BGP、PINP均升高,观察组的BGP(10.21±1.33)ng/ml、PINP(48.21±4.01)ng/ml,均高于对照组的BGP(8.91±1.3)ng/ml、PINP(42.18±4.05)ng/ml。治疗后,观察组的ICTP(4.87±0.65)ng/ml低于对照组的(5.98±0.61)ng/ml,差异有统计学意义(P<0.05)。观察组不良反应总发生率6.25%低于对照组12.50%,差异无统计学意义(P>0.05)。结论:接骨丹可明显缓解老年OVCF术后腰背痛程度,优化骨代谢指标,有效促进骨重建,抑制骨吸收,加速椎体生理功能修复,安全性较好。Objective:To investigate clinical efficacy of Jiegudan in the treatment of osteoporotic vertebral compression fractures(OVCF)in the elderly after percutaneous kyphoplasty(PKP).Methods:64 elderly patients with OVCF were screened and treated with PKP.They were divided into two groups with 32 cases each according to random number table method.The control group received post-operative treatment with Calcium D,while the observation group received post-operative treatment with Jiegudan.After two months of treatment,efficacy of the two groups were compared and changes in visual analogue scoring(VAS)scores,oswestry dysfunction index(ODI)scores and bone metabolism indicators[osteocalcin(BGP),pre-collagen typeⅠamino-terminal peptide(PINP),typeⅠcollagen degradation products(ICTP)]before and at 2 months of treatment.The adverse reactions of the two groups were recorded and analyzed.Results:The total effective rate of the observation group was 96.88%higher than that of the control group 78.13%,difference statistically significant(P<0.05).After two months of treatment,the VAS and ODI scores of both groups decreased,the VAS scores of the observation group were(2.12±0.21)and ODI(30.45±4.11),significantly lower than those of the control group(3.09±0.24)and(42.19±3.98),difference statistically significant(all P<0.05).After treatment,the BGP and PINP of both groups increased,BGP of the observation group being(10.21±1.33)ng/ml and PINP(48.21±4.01)ng/ml,which were significantly higher than those of in the control group(8.91±1.3)ng/ml and(42.18±4.05)ng/ml.After treatment,ICTP in the two groups were lower than before treatment,ICTP of the observation group was(4.87±0.65)ng/ml lower than that of the control group(5.98±0.61)ng/ml,difference statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 6.25%lower than that of the control group 12.50%,difference not statistically significant(P>0.05).Conclusion:Jiegudan can significantly relieve the degree of lumbar and back pain after OVCF

关 键 词：骨质疏松性椎体压缩骨折 经皮椎体后凸成形术 椎体功能 腰背痛 不良反应 

分 类 号：R683.2[医药卫生—骨科学]