摘要
目的观察针刺联合补肾活血方治疗骨质疏松性胸腰椎压缩性骨折的临床疗效及对患者血清骨代谢指标的影响。方法选择108例骨质疏松性胸腰椎骨折患者,随机分为对照组和联合组,每组54例。两组均进行椎体后凸成形术治疗和常规护理,对照组口服补肾活血方治疗,联合组采用针刺联合口服补肾活血方治疗。比较两组疼痛缓解时间、下床活动时间和骨折愈合时间,观察两组治疗前和随访结束时疼痛数字评估表(numerical rating scale,NRS)评分、中国人骨质疏松症简明生存质量量表(Chinese osteoporosis quality of life short questionnaire,COQOL)评分和Oswestry功能障碍指数(Oswestry disability index,ODI)的变化,观察两组治疗前和随访结束时骨折椎体的椎形态及骨密度检测结果的变化,观察治疗前后两组血清高迁移率族蛋白-1(high mobility group protein-1,HMGB-1)、C-反应蛋白(C-reactive protein,CRP)、P物质(substance P,SP)、皮质醇(cortisol,Cor)、骨形态发生蛋白-7(bone morphogenetic protein-7,BMP-7)、骨钙素N端中分子片段(osteocalcin n-terminal molecular fragment,N-MID)、网膜素-1(omentin-1)、Ⅰ型胶原C端肽(typeⅠcollagen C-terminal peptide,CTX-1)水平的变化,比较两组临床疗效。结果联合组疼痛缓解时间、下床活动时间和骨折愈合时间短于对照组(P<0.05),联合组治疗后HMGB-1、CRP、SP、Corh和CTX-1水平以及随访结束时伤椎楔变角、Cobb角、ODI评分、NRS评分和COQOL评分均低于对照组(P<0.05),联合组治疗后N-MID、Omentin-1和BMP-7水平以及随访结束时骨折椎体椎前缘高度和BMD水平高于对照组(P<0.05)。联合组总有效率高于对照组(P<0.05)。结论在椎体后凸成形术治疗和常规护理基础上,针刺联合补肾活血方治疗骨质疏松性胸腰椎骨折可减少炎症反应和应激反应,降低疼痛介质指标水平,改善骨性标志物及骨代谢水平,促进椎体愈合,提高腰椎功能、临床疗效及生活质量。
Objective To observe the clinical efficacy of acupuncture plus Bu Shen Huo Xue prescription for osteoporotic thoracolumbar vertebral compression fracture and its effect on serum indicators of bone metabolism in the patients.Method One hundred and eight patients with osteoporotic thoracolumbar vertebral fracture were randomized to a control group and a combination group,with 54 cases in each group.Both groups received kyphoplasty and conventional nursing.The control group was given oral Bu Shen Huo Xue prescription and the combination group received acupuncture in addition.Time to pain relief,time to ambulation and time to fracture healing were compared between the two groups.The pain numerical rating scale(NRS)and the Chinese osteoporosis quality of life short questionnaire(COQOL)and the Oswestry disability index(ODI)scores were recorded in the two groups before treatment and at the end of follow-up.The morphology of the fractured vertebrae and bone mineral density(BMD)were observed in the two groups before treatment and at the end of follow-up.Serum high mobility group box protein-1(HMGB-1),C-reactive protein(CRP),substance P(SP),cortisol(Cor),bone morphogenetic protein-7(BMP-7),osteocalcin n-terminal molecular fragment(N-MID),omentin-1,and type I collagen C-terminal peptide(CTX-1)levels were measured in the two groups before and after treatment.The clinical therapeutic effects were compared between the two groups.Result Time to pain relief,time to ambulation and time to fracture healing were shorter in the combination group than those in the control group(P<0.05).HMGB-1,CRP,SP,Cor and CTX-1 levels after treatment and injured vertebral wedge angle,Cobb angle,and ODI,NRS and COQOL scores at the end of follow-up were lower in the combination group than those in the control group(P<0.05).N-MID,Omentin-1and BMD levels after treatment and fracture vertebral anterior edge height and BMD levels at the end of follow-up were higher in the combination group than those in the control group(P<0.05).The total efficacy rate was higher in the combination group than that in the control group(P<0.05).Conclusion On the basis of kyphoplasty and conventional nursing,acupuncture plus Bu Shen Huo Xue prescription can reduce inflammatory and stress reactions,decrease pain mediator indicator levels,improve bone markers and bone metabolism levels,promote injured vertebra healing and ameliorate lumbar spine function,improve the clinical efficacy and the quality of life in treating osteoporotic thoracolumbar vertebral fracture.
作者
乔卫平
于建伟
史鹏博
孙明帅
QIAO Weiping;YU Jianwei;SHI Pengbo;SUN Mingshuai(First Hospital Affiliated to Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)
出处
《上海针灸杂志》
CSCD
2024年第6期657-662,共6页
Shanghai Journal of Acupuncture and Moxibustion
基金
河南省自然科学基金项目(182300410186)。
关键词
针刺疗法
针药并用
补肾活血
骨质疏松
骨折
压缩性
骨代谢
Acupuncture therapy
Acupuncture medication combined
Bu Shen Huo Xue
Osteoporosis
Fractures,Compression
Bone metabolism
