摘要
目的探究大补元煎加减辅助治疗老年骨质疏松性胸腰椎骨折椎体成形术(PVP)后临床效果。方法选择2022年2月至2024年2月收治的老年骨质疏松性胸腰椎骨折患者63例,随机数字表法分为治疗组32例、对照组31例。对照组于PVP后常规抗骨质疏松治疗,治疗组在对照组基础上加用大补元煎加减。比较两组术前、术后1 d及术后1、3、6个月时疼痛情况(VAS评分)、Ⅰ型前胶原N端肽(PⅠNP)、β胶联降解产物(β-CTX)、骨密度值、伤椎椎体前缘高度(VH)、局部Cobb角;比较两组术后邻近椎体骨折发生情况。结果两组术后1 d疼痛VAS评分均较术前显著降低,术后1个月低于对照组(P<0.05);两组术后血清PⅠNP水平呈升高趋势,且术后1个月治疗组高于对照组(P<0.05);两组术后血清β-CTX水平呈下降趋势,且术后1、3个月治疗组低于对照组(P<0.05);两组术后1、3、6个月骨密度高于术前(P<0.05);两组术后伤椎VH较术前增加,局部Cobb角较术前减小(P<0.05)。治疗组术后邻近椎体骨折发生率[3.13%(1/32)]低于对照组[12.90%(4/31)](P<0.05)。结论老年骨质疏松性胸腰椎骨折行PVP后,应用大补元煎加减方辅助可更进一步缓解患者疼痛症状,可以促进骨再生,抑制骨吸收,且能够降低邻近椎体骨折的发生率。
Objective To investigate the clinical efficacy of modified Dayuan Yin decoction as an adjuvant therapy in the treatment of elderly patients undergoing percutaneous vertebroplasty(PVP)for osteoporotic thoracolumbar vertebral fractures(OTVF).Methods A total of 63 elderly patients with OTVF admitted from February 2022 to February 2024 were selected and divided into treatment group(n=32)and control group(n=31)by random number table method.The control group was treated with conventional anti-osteoporosis treatment after PVP,and the treatment group was treated with modified Dayuan Yin decoction on the basis of the control group.The visual analogue scale(VAS)pain score,N-terminal propeptide of type Ⅰ procollagen(P Ⅰ NP),β-collagen degradation products(β-CTX),bone mineral density(BMD)value,anterior vertebral height(VH)and local Cobb Angle were compared between the two groups before operation and at 1 d,1 month,3 months and 6 months after operation.The occurrence of adjacent vertebral fracture was compared between the two groups.Results The VAS pain scores in the two groups at 1 day after operation were significantly lower than those before operation,and were lower than those in the control group at 1 month after operation(P<0.05).The serum P ⅠNP level of the two groups showed an increasing trend after operation,which was higher in the treatment group than in the control group at 1 month after operation(P<0.05).The serumβ-CTX level of the two groups showed a downward trend after operation,which was lower in the treatment group than in the control group at 1 and 3 months after operation(P<0.05).The BMD of the two groups at 1,3,and 6 months after operation was higher than that before operation(P<0.05),while the VH of the injured vertebrae was increased and the local Cobb Angle was decreased after operation in the two groups,as compared with those before operation(P<0.05).The incidence of adjacent vertebral fracture in the treatment group[3.13%(1/32)]was lower than that in the control group[12.90%(4/31)]after operation(P<0.05).Conclusion After PVP for elderly patients undergoing OTVF,the application of modified Dayuan Yin decoction as an adjuvant therapy can further relieve the pain symptoms of patients,promote bone regeneration,inhibit bone resorption,and reduce the incidence of adjacent vertebral fractures.
作者
徐荣华
彭志财
游钦键
万小凤
李梦圆
XU Ronghua;PENG Zhicai;YOU Qinjian;WAN Xiaofeng;LI Mengyuan(Department of Orthopedics,Jiangsu Province Hospital of Traditional Chinese Medicine/Yongchuan District Hospital of Traditional Chinese Medicine,Chongqing 402160,China)
出处
《临床误诊误治》
2025年第24期122-128,共7页
Clinical Misdiagnosis & Mistherapy
基金
重庆市科卫联合医学科研项目(2022ZDXM040)。
关键词
大补元煎方
椎体成形术
骨质疏松性椎体压缩性骨折
Ⅰ型前胶原N端肽
β胶联降解产物
伤椎椎体前缘高度
邻近椎体骨折
Dayuan Yin decoction
percutaneous vertebroplasty
osteoporotic vertebral compression fractures
N-terminal propeptide of type Ⅰ procollagen
β-collagen degradation products
anterior vertebral height of the injured vertebra
adjacent vertebral fracture
