地萸生髓汤联合唑来膦酸对PKP手术患者骨代谢及腰椎功能恢复的影响  

Effect of Diyu Shengsui Decoction Combined with Zoledronic Acid on Bone Metabolism and Lumbar Functional Recovery in Patients with PKP Surgery

作　　者：余程威 刘海峰[1] 吴惠明[1] YU Chengwei;LIU Haifeng;WU Huiming(Department of Orthopedics and Traumatology,Wenzhou TCM Hospital of Zhejiang Chinese Medical University,Wenzhou Zhejiang 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院骨伤科,浙江温州325000

出　　处：《新中医》2024年第12期66-70,共5页New Chinese Medicine

基　　金：温州市科技局课题(Y20220239)。

摘　　要：目的:观察地萸生髓汤联合唑来膦酸对经皮椎体后凸成形术(PKP)患者骨代谢及腰椎功能恢复的影响。方法:将80例行PKP的骨质疏松性椎体压缩性骨折(OVCF)患者随机分成对照组和试验组各40例。对照组术后应用唑来膦酸治疗,试验组在对照组基础上加用地萸生髓汤治疗。比较2组治疗前、治疗3个月后伤椎Cobb角、骨密度、骨代谢指标[Ca^(2+)、β-胶原特殊序列(β-CTX)、骨碱性磷酸酶(BALP)]、骨愈合指标[胰岛素样生长因子-1(IGF-1)、血管内皮生长因子(VEGF)]、Oswestry功能障碍指数(ODI);比较2组疗程结束后1年内骨折再发率。结果:治疗后,2组伤椎Cobb角均较治疗前减小(P<0.05),骨密度均较治疗前增大(P<0.05);且试验组伤椎Cobb角小于对照组(P<0.05),骨密度高于对照组(P<0.05)。治疗后,2组Ca^(2+)、BALP水平均较治疗前增高(P<0.05),β-CTX水平均较治疗前降低(P<0.05);且试验组Ca^(2+)、BALP水平高于对照组(P<0.05),β-CTX水平低于对照组(P<0.05)。治疗后,2组IGF-1、VEGF均较治疗前增高(P<0.05),且试验组2项指标均高于对照组(P<0.05)。治疗后,2组ODI评分均较治疗前降低(P<0.05),且试验组ODI评分低于对照组(P<0.05)。治疗后1年内,试验组椎体骨折再发率为2.50%,对照组为7.50%,2组比较,差异无统计学意义(P>0.05)。结论:OVCF患者PKP术后应用地萸生髓汤联合唑来膦酸治疗,可缩小伤椎Cobb角,提高骨密度,有效改善骨代谢、骨愈合指标及腰椎功能。Objective:To observe the effect of Diyu Shengsui Decoction combined with Zoledronic Acid on bone metabolism and lumbar functional recovery in patients with percutaneous kyphoplasty(PKP).Methods:A total of 80 cases of patients who had osteoporotic vertebral compression fractures(OVCF)and underwent PKP were randomly divided into the control group and the trial group,with 40 cases in each group.The control group was treated with Zoledronic Acid,and the trial group was additionally treated with Diyu Shengsui Decoction based on the treatment of the control group.The Cobb angle of the injured vertebra,bone density,and bone metabolism indicators[Ca^(2+),β-CrossLaps(β-CTX)and bone alkaline phosphatase(BALP)],bone healing indicators[insulin-like growth factor-1(IGF-1)and vascular endothelial growth factor(VEGF)],and Oswestry Dysfunction Index(ODI)were compared between the two groups before treatment and after three months of treatment.The recurrence rates of fractures within one year after the end of treatment were compared between the two groups.Results:After treatment,the Cobb angle of the injured vertebra in the two groups was decreased when compared with that before treatment(P<0.05),and bone density was increased when compared with that before treatment(P<0.05);the Cobb angle of the injured vertebra in the trial group was smaller than that in the control group(P<0.05),and bone density in the trial group was larger than that in the control group(P<0.05).After treatment,the levels of Ca^(2+)and BALP in the two groups were increased when compared with those before treatment(P<0.05),and the levels ofβ-CTX were decreased when compared with those before treatment(P<0.05);the levels of Ca^(2+)and BALP in the trial group were higher than those in the control group(P<0.05),and the level ofβ-CTX in the trial group was lower than that in the control group(P<0.05).After treatment,IGF-1 and VEGF in the two groups were increased when compared with those before treatment(P<0.05),and the two indicators in the trial group were hi

关 键 词：骨质疏松性椎体压缩性骨折 经皮椎体后凸成形术 地萸生髓汤 唑来膦酸 骨代谢 骨愈合 腰椎功能 

分 类 号：R683.2[医药卫生—骨科学]