世界复合医学2024，Vol.10Issue(1) ：21-25,29.DOI:10.11966/j.issn.2095-994X.2024.10.01.06

经皮椎体后凸成形术治疗绝经后女性腰椎骨质疏松性椎体压缩骨折术后中西医结合治疗效果的回顾性分析

A Retrospective Analysis of the Effectiveness of PKP in Treating Postoperative OVCF in Post-menopausal Women with Combination of Traditional Chinese and Western Medicines

胡兆斌 王铠 刘凯 韩嵩 于潮将 邰志洪
世界复合医学2024，Vol.10Issue(1) ：21-25,29.DOI:10.11966/j.issn.2095-994X.2024.10.01.06
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经皮椎体后凸成形术治疗绝经后女性腰椎骨质疏松性椎体压缩骨折术后中西医结合治疗效果的回顾性分析

A Retrospective Analysis of the Effectiveness of PKP in Treating Postoperative OVCF in Post-menopausal Women with Combination of Traditional Chinese and Western Medicines

胡兆斌 1王铠 1刘凯 1韩嵩 1于潮将 1邰志洪1
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作者信息

  • 1. 泰州市中医院骨科,江苏泰州 225300
  • 折叠

摘要

目的 比较不同药物治疗方案在腰椎骨质疏松性椎体压缩骨折(Osteoporotic Vertebral Compression Fracture,OVCF)绝经后女性经皮椎体后凸成形术(Percutaneous Kypho Plasty,PKP)治疗后的疗效.方法 回顾性分析2020年1月—2022年12月泰州市中医院收治的60例诊断为OVCF的绝经后女性患者的临床资料,对所有患者施行PKP,根据服用药物的不同分为两组,每组30例.观察组采用碳酸钙D3、阿仑膦酸钠及杜仲壮腰汤口服治疗,对照组采用碳酸钙D3、阿仑膦酸钠口服治疗.比较两组患者术前及术后1 d、7 d、1个月、3个月中医证候积分、疼痛评分、腰椎功能障碍评分(Oswestry Disability Index,ODI)的改善效果,治疗后 1 个月和 3 个月骨密度(Bone Mineral Density,BMD)差异和临床疗效.结果 治疗前,两组患者中医证候积分、疼痛评分、ODI、BMD等指标比较,差异无统计学意义(P均>0.05);治疗后,两组患者术后1 d、7 d中医证候积分比较,差异无统计学意义(P均>0.05);两组患者术后1个月、3个月中医证候积分、ODI均降低,且观察组低于对照组,差异有统计学意义(P均<0.05).两组患者术后1 d疼痛视觉模拟评分(Visual Analogue Scale,VAS)比较,差异无统计学意义(P>0.05);术后1个月、3个月,观察组VAS评分低于对照组,差异有统计学意义(P均<0.05).术后第1天两组患者BMD比较,差异无统计学意义(P>0.05);术后3个月两组患者BMD均高于术后第 1天,且观察组BMD(-2.42±0.63)高于对照组(-2.66±0.65),差异有统计学意义(t=2.152,P<0.05).观察组临床有效率显著高于对照组,差异有统计学意义(P<0.05).结论 PKP术后在常规抗骨质疏松治疗的基础上加用杜仲壮腰汤可以缩短绝经后女性腰椎OVCF患者疼痛时间和减轻疼痛程度,改善腰椎功能,提高BMD水平及临床疗效.

Abstract

Objective To compare the differences in the efficacy of different medication regimens in the clinical treatment of lumbar osteoporotic vertebral compression fracture(OVCF)in menopausal women after percutaneous kyphoplasty(PKP).Methods The clinical data of 60 postmenopausal female patients diagnosed with OVCF admitted to Taizhou Hospital of Traditional Chinese Medicine from January 2020 to December 2022 were retrospectively selected.PKP surgery was performed on all patients and they were divided into two groups with 30 cases in each group according to the different drugs taken.The observation group received oral treatment with calcium carbonate D3,alendronate sodium and Guzhong Zhuangwei Decoction,while the control group received oral treatment with calcium carbonate D3 and alendronate sodium.The improvement effects of TCM syndrome score,pain score and Oswestry Disability Index(ODI)were compared between the two groups before surgery,1 day and 7 days,1 month and 3 months after surgery.Differences of bone mineral density(BMD)at 1 day and 3 months after treatment and clinical efficacy.Results Before treatment,there was no sig-nificant difference in TCM syndrome score,pain score,lumbar dysfunction score and bone mineral density be-tween the two groups(P>0.05).After treatment,there was no significant difference in TCM syndrome scores 1 day and 7 days after surgery between the two groups(P>0.05).TCM syndrome scores and ODI index of two groups were decreased 1 month and 3 month after operation,and observation group were lower than control group,the differences were statistically significant(all P<0.05).There was no significant difference in Visual Analogue Scale/Score(VAS)1 day after surgery between the two groups(P>0.05).At 1 month and 3 months af-ter operation,VAS score of observation group was lower than control group,and the differences were statisti-cally significant(all P<0.05).There was no significant difference in BMD detection values between the two groups on the first day after surgery(P>0.05).BMD values in both groups were higher 3 months after surgery than on the first day after surgery,and BMD values in the observation group(-2.42±0.63)were higher than those in the control group(-2.66±0.65),the differences were statistically significant(t=2.152,P<0.05).The clinical effective rate of the observation group was significantly higher than that of the control group,and the dif-ference was statistically significant(P<0.05).Conclusion The addition of Duzhong Zhuangyao decoction to con-ventional anti-osteoporosis treatment after PKP can shorten the pain time and reduce the pain level of post-menopausal women with lumbar OVCF,improve the function of lumbar vertebrae,increase the level of bone mineral density of the patients,and improve the clinical efficacy of the treatment,which is worthy of further re-search and popularization.

关键词

骨质疏松/椎体压缩骨折/杜仲壮腰汤/腰椎功能/骨密度

Key words

Osteoporosis/Vertebral compression fracture/Duzhong Zhuangyao decoction/Lumbar spine function/Bone density

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出版年

2024
世界复合医学

世界复合医学

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