分期辨证论治联合经皮椎体成形术治疗椎体压缩性骨折临床研究  

Clinical Study on Staged Syndrome Differentiation and Treatment Combined with Percutaneous Vertebroplasty for Vertebral Compression Fractures

作　　者：陈道振[1] 陈坤峰[1] 徐继胜[1] CHEN Daozhen;CHEN Kunfeng;XU Jisheng(The First People′s Hospital of Shangqiu City,Shangqiu,Henan,China,476100)

机构地区：[1]商丘市第一人民医院,河南商丘476100

出　　处：《河南中医》2025年第4期595-600,共6页Henan Traditional Chinese Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ2021990)。

摘　　要：目的:观察分期辨证论治联合经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗椎体压缩性骨折(vertebral compression fracture,VCF)的临床疗效及其对患者椎体高度、角度及功能的影响。方法:选取商丘市第一人民医院收治的108例VCF患者为研究对象,采用随机信封法分为手术组和联合组,每组各54例。手术组给予PVP及常规治疗,联合组在手术组治疗的基础上给予分期辨证论治。比较两组患者围手术期一般指标恢复情况、并发症发生率及手术前后椎体前缘高度比(anterior vertebral height ratio,AVHR)、Cobb角、视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)变化情况。结果:联合组卧床时间及住院时间短于手术组,差异具有统计学意义(P<0.05)。两组患者手术后AVHR水平较高于本组手术前、Cobb角小于本组手术前,且手术后组间比较,差异具有统计学意义(P<0.05)。两组患者手术后VAS评分、ODI评分低于手术前,且联合组低于手术组,差异具有统计学意义(P<0.05)。联合组并发症发生率为5.56%,低于手术组的18.52%,差异具有统计学意义(P<0.05)。结论:分期辨证论治联合PVP治疗VCF,可缩短患者卧床及住院时间,促进椎体高度和脊柱力线恢复,缓解疼痛及功能障碍程度,降低并发症发生率。Objective:To observe the clinical efficacy of staged syndrome differentiation and treatment combined with percutaneous vertebroplasty(PVP) for vertebral compression fracture(VCF) and its effects on vertebral height,Vertebral body height,angle and function and functional recovery.Methods:A total of 108 VCF patients admitted to The First People′s Hospital of Shangqiu City were enrolled and randomly divided into the surgery group and the combined group using the random envelope method,with 54 cases in each group.The surgery group received PVP and routine treatment,while the combined group received additional staged syndrome differentiation and treatment based on the surgery group′s regimen.Perioperative recovery indicators,complication rates,and changes in anterior vertebral height ratio(AVHR),Cobb angle,visual analogue scale(VAS) scores,and Oswestry disability index(ODI) before and after surgery were compared between the two groups.Results:The combined group showed significantly shorter bed rest and hospitalization durations compared to the surgery group(P<0.05).Postoperative AVHR levels were higher,while Cobb angles were smaller in both groups compared to preoperative indicators,with statistically significant differences(P<0.05).The VAS and ODI scores of both groups were lower than those before surgery,and the combined group′s above scores were lower than those of the surgery group,with statistically significant differences(P<0.05).The complication rate of the combined group was 5.56%,which was lower than that of the surgical group:18.52%,with a statistically significant difference(P<0.05).Conclusion:Staged syndrome differentiation and treatment combined with in the treatment of VCF can shorten the bed rest and hospital stay of patients,promote the recovery of vertebral height and spinal alignment,alleviate the degree of pain and functional impairment,and reduce the incidence of complications.

关 键 词：椎体压缩性骨折 经皮椎体成形术 分期辨证论治 

分 类 号：R274.13[医药卫生—中医骨伤科学]