接骨壮骨方加减辅助经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折对术后腰椎功能、康复进程及成骨与破骨细胞活性调节效应的影响  

Modulation effect of modified Jiegu Zhuanggu Formula supplemented by percutaneous vertebroplasty on postoperative lumbar spine function,rehabilitation process and osteoblast-osteoclast activity in osteoporotic vertebral compression fracture

作　　者：胡万钧[1] 李新春 甘发荣[1] HU Wanjun;LI Xinchun;GAN Farong(Department of Spine Surgery,Hainan Traditional Chinese Medicine Hospital,Haikou,Hainan 570203)

机构地区：[1]海南省中医院脊柱外科,海南海口570203

出　　处：《河北中医》2024年第8期1283-1287,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：海南省医药卫生科研项目(编号:1326764)。

摘　　要：目的观察接骨壮骨方加减辅助经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折(OVCF)对术后腰椎功能、康复进程及成骨与破骨细胞活性调节效应的影响。方法将70例OVCF患者按照随机数字表法分为2组,对照组35例予经皮穿刺椎体成形术治疗,术后予常规西药治疗,治疗组35例在对照组基础上予接骨壮骨方加减治疗。比较2组治疗前后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、解剖影像学指标(椎体前缘高度、椎体中线高度、伤椎Cobb角)、康复进程(住院时间、术后下床活动时间、骨折愈合时间、恢复正常活动时间)、成骨与破骨细胞活性[骨钙素、骨特异性碱性磷酸酶(BALP)、Ⅰ型前胶原氨基末端肽(PⅠNP)、抗酒石酸酸性磷酸酶(TRACP)、尿羟脯氨酸/尿肌酐(OHP/Cr)、骨密度],统计2组疗效及安全性。结果治疗组总有效率97.14%(34/35),对照组总有效率77.14%(27/35),治疗组临床疗效优于对照组(P<0.05)。2组治疗后疼痛VAS、ODI评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。治疗组住院时间、术后下床活动时间与对照组比较差异无统计学意义(P>0.05);治疗组骨折愈合时间、恢复正常活动时间均短于对照组(P<0.05)。2组治疗后骨钙素、PⅠNP、骨密度均较治疗前升高(P<0.05),BALP、TRACP、OHP/Cr均降低(P<0.05);治疗组治疗后骨钙素、PⅠNP、骨密度均高于对照组(P<0.05),BALP、TRACP、OHP/Cr均低于对照组(P<0.05)。2组治疗后椎体前缘高度、椎体中线高度均较治疗前升高(P<0.05),伤椎Cobb角均减小(P<0.05);治疗组治疗后椎体前缘高度、椎体中线高度均高于对照组(P<0.05),伤椎Cobb角低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论接骨壮骨方加减辅助经皮穿刺椎体成形术治疗OVCF,能减轻患者疼痛,提高腰椎功能,促进骨形成,抑制骨吸收,提高骨密度,恢复伤Objective To investigate the effect of modified Jiegu Zhuanggu Formula supplemented by percutaneous vertebroplasty(PV)on postoperative lumbar spine function,rehabilitation process and osteoblast-osteoclast activity in osteoporotic vertebral compression fracture(OVCF).Methods Seventy patients with OVCF were randomized 1∶1 to PV+routine Western medicine(RWM,the operation group)or modified Jiegu Zhuanggu Formula+PV+RWM(the combined group).The visual analog scale(VAS)for pain,Oswestry disability index(ODI),anatomical imaging(vertebral anterior height,intermediate vertebral height,Cobb's angle of injured vertebral),rehabilitation process(hospitalization time,postoperative ambulation time,fracture healing time,time to return to normal activities),osteoblast-osteoclast activity(osteocalcin,bone-specific alkaline phosphatase[BALP]),procollagen typeⅠN-terminal propeptide[PⅠNP],Tartrate-resistant acid phosphatase[TRACP],the ratio of hydroxyproline/creatinine[OHP/Cr],bone mineral density[BMD]were included as comparators between groups.The efficacy and safety were statistically analyzed between groups.Results The total effective rate in the combined group was significantly higher than that of the operation group(97.14%[34/35]vs 77.14%[27/35],P<0.05).The VAS and ODI scores after treatment were significantly lower in the both group than those before treatment(P<0.05),with the inter-group significant difference(P<0.05).There was no significant difference in hospitalization time and postoperative ambulation time between groups(P>0.05),but the fracture healing time and time to return to normal activity time in the combined group were significantly shorter than those of the operation group(P<0.05).After treatment,significantly higher osteocalcin,PⅠNP,and BMD,and lower BALP,TRACP,and OHP/Cr were detected in the both groups than before treatment(P<0.05),with the inter-group significant difference(P<0.05).The anatomical imaging indexes were significantly lower in the both groups than before treatment(P<0.05),the combined grou

关 键 词：经皮穿刺椎体成形术 骨折 椎体 术后腰椎功能 康复进程 成骨与破骨细胞活性 

分 类 号：R683.2[医药卫生—骨科学]