浮针联合补肾活血汤治疗肾虚血瘀型骨质疏松性椎体压缩骨折椎体成形术后残余疼痛的研究  

Floating needle combined with decoction for tonifying kidney and activating blood on residual pain after vertebroplasty for osteoporotic vertebral compression fracture with syndrome of kidney deficiency and blood stasis

作　　者：王淑江 叶豪 秦黎勇 龙胜利 WANG Shujiang;YE Hao;QIN Liyong;LONG Shengli(Guizhou University of Traditional Chinese Medicine,Guiyang 550002,Guizhou,China;Qianxinan Autonomous Prefecture Hospital of Traditional Chinese Medicine,Xingyi 562400,Guizhou,China;Guiyang Fourth People’s Hospital,Guiyang 550007,Guizhou,China)

机构地区：[1]贵州中医药大学,贵州贵阳550002 [2]黔西南州中医院,贵州兴义562400 [3]贵阳市第四人民医院,贵州贵阳550007

出　　处：《现代中西医结合杂志》2024年第20期2811-2816,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：贵州省中医药管理局中医药、民族医药科学技术研究课题(QZYY-2023-149)。

摘　　要：目的探讨浮针联合补肾活血汤治疗肾虚血瘀型骨质疏松性椎体压缩骨折(OVCF)椎体成形术后残余疼痛的疗效及机制。方法采用随机数字表法,将2022年8月—2023年6月在贵阳市第四人民医院治疗的60例肾虚血瘀型OVCF椎体成行术后残余疼痛患者分为浮针联合补肾活血汤组、普通刺法联合补肾活血汤组和对症止痛组,每组20例。3组常规抗骨质疏松治疗6个月,浮针联合补肾活血汤组予浮针治疗2周和口服补肾活血汤6个月,普通刺法联合补肾活血汤组予普通针刺2周和口服补肾活血汤6个月,对症止痛组予对症止痛治疗。比较3组治疗前1 d及治疗1周、2周、1个月、3个月、6个月后的疼痛VAS评分、Oswestry功能障碍指数(ODI)评分、压痛点数目,治疗前1 d及治疗1周、2周后的炎症指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]和治疗前1 d及治疗3个月、6个月后的骨密度,统计3组治疗6个月后的总体疗效。结果与治疗前1 d比较,3组治疗后各时间点VAS评分、ODI评分、压痛点数目及血清TNF-α、IL-6水平均明显降低(P均<0.05),3组治疗6个月后的骨密度度均明显提高(P均<0.05);与普通刺法联合补肾活血汤组及对症止痛组比较,浮针联合补肾活血汤组治疗后各时间点的VAS评分、ODI评分、压痛点数目及血清TNF-α、IL-6水平均更低(P均<0.05),治疗6个月后的骨密度更高(P均<0.05)。浮针联合补肾活血汤组治疗总有效率为95%(19/20),高于普通刺法联合补肾活血汤组的85%(17/20)及对症止痛组的65%(13/20),差异均有统计学意义(P均<0.05)。结论浮针联合补肾活血汤口服能够有效减轻肾虚血瘀型OVCF椎体成形术后残余疼痛症状,减轻炎症反应,提高骨密度,改善腰椎功能活动。Objective It is to explore the efficacy and mechanism of floating needle combined with decoction for tonifying kidney and activating blood(DTKAB)on residual pain after vertebroplasty for osteoporotic vertebral compression fracture(OVCF)with syndrome of kidney deficiency and blood stasis.Methods Sixty patients with residual pain after vertebroplasty for OVCF with syndrome of kidney deficiency and blood stasis treated in Guiyang Fourth People’s Hospital from August 2022 to June 2023 were divided into the group of floating needle+DTKAB,group of normal acupuncture+DTKAB and group of symptomatic analgesia according to a randomized numerical table method,with 20 cases in each group.The three groups were treated with conventional anti-osteoporosis therapy for 6 months,the group of floating needle+DTKAB was treated with floating needle for 2 weeks and with DTKAB by oral administration for 6 months,the group of normal acupuncture+DTKAB was treated with normal acupuncture for 2 weeks and with DTKAB by oral administration for 6 months,the group of symptomatic analgesia was treated with symptomatic analgesic medicine.The pain VAS scores,Oswestry dysfunction index(ODI)scores,number of pressure points one day before treatment and after one week,2 weeks,one month,3 months and 6 months of treatment,and inflammation indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]one day before treatment and after one week,2 weeks of treatment,and bone mineral density one day before treatment and after 3 and 6 months of treatment were compared among the three groups,and the overall efficacy of the three groups after 6 months of treatment was assessed.Results Compared with those one day before treatment,the VAS scores,ODI scores,number of pressure points and serum levels of TNF-αand IL-6 were significantly reduced at all time points after treatment in the three groups(all P<0.05),while the bone densities after 6 months of treatment were significantly increased in the three groups(all P<0.05).Compared with the group of normal acupun

关 键 词：骨质疏松性椎体压缩骨折 术后残余疼痛 浮针 补肾活血汤 

分 类 号：R683.2[医药卫生—骨科学]