补肾健骨汤对骨质疏松性腰椎骨折患者骨密度、炎症指标及疼痛程度的影响  

Effects of Bushen Jiangu decoction on bone mineral density,inflammatory indicators and pain degree in patients with osteoporotic lumbar fractures

作　　者：张杰荣 熊时喜[1] 林超 ZHANG Jierong;XIONG Shixi;LIN Chao(First Department of Orthopedics,Sanya Traditional Chinese Medicine Hospital,Sanya 572000,China)

机构地区：[1]三亚市中医院骨一科,海南三亚572000

出　　处：《陕西中医》2023年第12期1717-1721,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：海南省自然科学基金资助高层次人才项目(823RC614);海南省卫生健康行业科研项目(21A200340)。

摘　　要：目的:探究补肾健骨汤对骨质疏松性腰椎骨折患者术后骨密度、炎症指标和疼痛程度的影响。方法:选取肾精不足型骨质疏松性腰椎骨折患者106例,按单双号法随机将患者分为中药组和常规组,各53例。两组患者均行经皮椎体后凸成形术,术后常规组予对症支持治疗,中药组在常规组基础上予补肾健骨汤,两组均治疗12周,随访3个月。比较两组骨折愈合情况、中医症状积分、骨密度、骨代谢指标、疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、炎症指标,记录两组患者治疗期间不良反应。结果:中药组术后下床活动时间、骨折愈合时间明显短于常规组(均P<0.05)。治疗后,两组主症、次症积分下降,且中药组治疗后各项积分低于常规组(均P<0.05)。治疗后,两组血清骨钙素(OST)、骨碱性磷酸酶(BAP)、25羟基维生素D[25(OH)D]水平及骨密度上升,且中药组治疗后上述指标高于常规组(均P<0.05)。治疗后,两组VAS、ODI评分下降,且中药组治疗后评分低于常规组(均P<0.05)。治疗后,两组血清肿瘤坏死因子-α(TNF-α)水平下降,转化生长因子-β1(TGF-β1)、白细胞介素-10(IL-10)水平上升(均P<0.05);且中药组治疗后上述指标与常规组比较差异有统计学意义(均P<0.05)。两组治疗及随访期间均未出现明显不良反应。结论:补肾健骨汤治疗肾精不足型骨质疏松性腰椎骨折患者可促进术后骨折愈合,减轻疼痛和炎症反应,改善骨密度及骨代谢。Objective:To explore the effects of Bushen Jiangu decoction on bone mineral density,inflammation index and pain degree of patients with osteoporotic lumbar fracture after operation.Methods:106 patients with osteoporotic lumbar fractures of kidney essence insufficiency were selected and uniformly numbered after admission and randomly divided into traditional Chinese medicine group and conventional group according to odd-even number method,with 53 cases in each group.Both groups of patients received percutaneous kyphoplasty,and the conventional group was given symptomatic support treatment after surgery,the traditional Chinese medicine group was additionally treated with Bushen Jiangu decoction,and both groups were treated for 12 weeks and followed up for 3 months.The fracture healing conditions,traditional Chinese medicine symptoms scores,bone mineral density,bone metabolism indicators,Visual Analogue Scale(VAS),Oswestry Disability Index(ODI)and inflammatory indicators were compared between the two groups,and the adverse reactions during treatment were recorded in both groups.Results:The postoperative ambulation time and fracture healing time in traditional Chinese medicine group were significantly shorter than those in conventional group(all P<0.05).After treatment,the scores of primary and secondary symptoms were decreased in both groups,and the scores were lower in traditional Chinese medicine group than those in conventional group(all P<0.05).Serum levels of osteocalcin(OST),bone alkaline phosphatase(BAP)and 25 hydrox yvitamin D[25(OH)D]and bone mineral density in both groups were increased after treatment,and the above indicators in traditional Chinese medicine group after treatment were higher than those in conventional group(all P<0.05).After treatment,the scores of VAS and ODI in both groups were declined,and the scores after treatment were lower in traditional Chinese medicine group compared to conventional group(all P<0.05).After treatment,serum level of tumor necrosis factor-α(TNF-α)was reduced while

关 键 词：骨质疏松性腰椎骨折 补肾健骨汤 肾精不足型 骨密度 骨代谢指标 炎症指标 

分 类 号：R683.2[医药卫生—骨科学]