摘要
目的 探讨中药热奄包治疗骨质疏松性椎体压缩性骨折患者经皮椎体成形术(PVP)后残留腰背痛的临床效果.方法 选取2020年4月至2023年1月于江西中医药大学第二附属医院行PVP的骨质疏松性椎体压缩性骨折患者104例作为研究对象,采用随机数字表法分为对照组和观察组,每组52 例,治疗期间剔除转院患者、治疗依从性较差者后最终每组纳入46 例患者完成本研究.对照组术后第3 天予以热水袋外敷配合抗骨质疏松治疗,观察组术后第3 天采用中药热奄包外敷配合抗骨质疏松治疗.比较两组患者治疗优良率、Oswestry 残损指数(ODI)评分、视觉模拟评分法(VAS)评分、压痛点、椎体前缘丢失高度、Cobb角度、骨代谢指标.结果 治疗前两组ODI评分、VAS评分、压痛点、椎体前缘丢失高度、Cobb、Ⅰ型胶原氨基端延长肽(P1NP)、Ⅰ型胶原交联 C-末端肽(β-CTX)及骨碱性磷酸酶(BALP)比较,差异无统计学意义(P＞0.05);观察组治疗优良率 97.83%明显高于对照组的 80.43%(P＜0.05);治疗后两组ODI评分及VAS评分降低,且观察组低于对照组,差异有统计学意义(P＜0.05);治疗后两组压痛点减少,且观察组少于对照组,差异有统计学意义(P＜0.05);治疗后两组椎体前缘丢失高度、Cobb角度降低,且观察组低于对照组,差异有统计学意义(P＜0.05);治疗后两组BALP及P1NP升高且观察组更高(P＜0.05),两组β-CTX降低且观察组更低(P＜0.05).结论 中药热奄包可缓解骨质疏松性椎体压缩性骨折患者PVP后残留腰背痛,明显改善临床症状及骨代谢指标.
Abstract
Objective To explore the clinical effect of Traditional Chinese medicine fever package in the treatment of residual low back pain after percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture.Methods A total of 104 patients with osteoporotic vertebral compression fracture who underwent PVP in the Second Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from April 2020 to January 2023 were selected as the study objects,and were divided into control group and observation group by random number table method,with 52 cases in each group.After excluding patients transferred to hospitals and patients with poor treatment compliance during treatment,46 patients in each group were included to complete the study.The control group was treated with hot water bag external application combined with anti-osteoporosis treatment on the 3rd day after operation,and the observation group was treated with Traditional Chinese medicine fever package external application combined with anti-osteoporosis treatment on the 3rd day after operation.The treatment excellence rate,Oswestry Disability Index(ODI)score,visual analogue scale(VAS)score,tenderness point,anterior vertebral margin loss height,Cobb Angle and bone metabolism indexes were compared between the two groups.Results Before treatment,there were no significant differences in ODI score,VAS score,tenderness point,anterior vertebral margin loss height,Cobb,type I collagen amino terminal prolongating peptide(P1NP),type I collagen cross-linked C-terminal peptide(β-CTX)and bone alkaline phosphatase(BALP)between the two groups(P＞0.05).The excellent and good rate of the observation group was 97.83%,which was significantly higher than that of the control group(80.43%)(P＜0.05).After treatment,the ODI score and VAS score of the two groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P＜0.05).After treatment,the tenderness points of the two groups decreased,and the observation group was less than the control group,the difference was statistically significant(P＜0.05).After treatment,anterior vertebral margin loss height and Cobb Angle decreased,and the observation group was lower than the control group,the difference was statistically significant(P＜0.05).After treatment,BALP and P1NP were increased in both groups and higher in the observation group(P＜0.05),and β-CTX was decreased in both groups and lower in the observation group(P＜0.05).Conclusion Traditional Chinese medicine fever package can relieve the residual back pain after PVP in patients with osteoporotic vertebral compression fracture,and significantly improve the clinical symptoms and bone metabolism indexes.
基金项目
江西省中医药管理局科技计划项目(2022B141)
国家科技期刊平台
NSTL
万方数据