桃红四物汤辅助经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折效果观察
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摘要
目的研究桃红四物汤辅助经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折的临床效果。方法选取2015年6月—2017年7月收治的60例老年骨质疏松性胸腰椎压缩骨折患者,按照治疗方式的不同分为研究组与对照组,每组30例。对照组给予经皮椎体后凸成形术,研究组在对照组基础上联合桃红四物汤。比较2组的临床疗效,以及2组治疗前后骨折愈合情况、疼痛视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评分,同时观察并发症及不良反应发生情况。结果治疗后2个月,2组椎体矢状面Cobb角和椎体楔变角均低于治疗前,且研究组低于对照组(P <0. 05)。治疗后2个月,2组椎体前缘高度高于治疗前,且研究组高于对照组(P <0. 05)。治疗后1、3、6个月,2组VAS及ODI评分均低于治疗前,研究组低于对照组(P <0. 05)。研究组总有效率高于对照组,并发症及不良反应总发生率低于对照组(P <0. 01)。结论桃红四物汤辅助经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折可以获得良好的临床效果,能减轻疼痛,改善日常活动能力,且安全性较高。
Objective To study clinical effect of Taohong Siwu Decoction assisted percutaneous kyphoplasty in treatment of elderly patients with osteoporotic thoracolumbar vertebral compression fractures. Methods A total of 60 elderly patients with osteoporotic thoracolumbar vertebral compression fractures admitted during June 2015 and July 2017 were divided into study group( n = 30 for each group) and control group according to different therapeutic methods. Control group was treated with percutaneous kyphoplasty,while study group was added with Taohong Siwu Decoction on the basis of treatment for control group. In two groups,clinical effect,condition of fracture healing,visual analogue scale( VAS) scores and Oswestry dysfunction index( ODI) scores before and after treatment were compared,and conditions of complications and adverse reactions were also observed simultaneously. Results In 2 months after treatment,values of vertebral sagittal Cobb angle and vertebral wedge angle were significantly lower than those before treatment in two groups,and the values in study group were significantly lower than those in control group( P < 0. 05); values of anterior vertebral height were significantly higher than those before treatment in two groups,and the value in study group was significantly higher than that in control group( P < 0. 05). In 1,3 and 6 months after treatment,VAS and ODI scores were significantly lower than those before treatment in two groups,and the scores in study group were significantly lower than those in control group( P < 0. 05). In study group,the total effective rate was significantly higher,while the total incidence rates of complications and adverse reactions were significantly lower than those in control group( P < 0. 01). Conclusion Taohong Siwu Decoction assisted percutaneous kyphoplasty in treatment of elderly patients with osteoporotic thoracolumbar vertebral compression fractures may achieve good clinical effect,relieve pain and improve activities of daily living with good safety.
Objective To study clinical effect of Taohong Siwu Decoction assisted percutaneous kyphoplasty in treatment of elderly patients with osteoporotic thoracolumbar vertebral compression fractures. Methods A total of 60 elderly patients with osteoporotic thoracolumbar vertebral compression fractures admitted during June 2015 and July 2017 were divided into study group( n = 30 for each group) and control group according to different therapeutic methods. Control group was treated with percutaneous kyphoplasty,while study group was added with Taohong Siwu Decoction on the basis of treatment for control group. In two groups,clinical effect,condition of fracture healing,visual analogue scale( VAS) scores and Oswestry dysfunction index( ODI) scores before and after treatment were compared,and conditions of complications and adverse reactions were also observed simultaneously. Results In 2 months after treatment,values of vertebral sagittal Cobb angle and vertebral wedge angle were significantly lower than those before treatment in two groups,and the values in study group were significantly lower than those in control group( P < 0. 05); values of anterior vertebral height were significantly higher than those before treatment in two groups,and the value in study group was significantly higher than that in control group( P < 0. 05). In 1,3 and 6 months after treatment,VAS and ODI scores were significantly lower than those before treatment in two groups,and the scores in study group were significantly lower than those in control group( P < 0. 05). In study group,the total effective rate was significantly higher,while the total incidence rates of complications and adverse reactions were significantly lower than those in control group( P < 0. 01). Conclusion Taohong Siwu Decoction assisted percutaneous kyphoplasty in treatment of elderly patients with osteoporotic thoracolumbar vertebral compression fractures may achieve good clinical effect,relieve pain and improve activities of daily living with good safety.
引文
[1]邓宇,刘奎,陈廖斌.补肾壮骨汤联合经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折[J].中医学报,2017,32(10):1890-1894.
[2]罗建军,王冰.经皮椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折的效果评价[J].颈腰痛杂志,2016,37(3):200-203.
[3]冉仁国,罗政,张岱阳. PVP与椎体后凸成术治疗骨质疏松性胸腰椎压缩性骨折的疗效比较[J].颈腰痛杂志,2017,38(5):428-431.
[4]杨国进,刘玉林,付文举,等.单侧穿刺经皮椎体后凸成形术联合药物治疗老年骨质疏松性椎体压缩骨折的临床疗效[J].实用老年医学,2017,31(12):1157-1160.
[5]伏海平,刘华兴,曾显荣.经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折[J].临床骨科杂志,2017,20(1):33-34.
[6] Kaup M,Wichmann J L,Scholtz J E,et al. Dual-energy CT-based display of bone marrow edema in osteoporotic vertebral compression fractures:impact on diagnostic accuracy of radiologists with varying levels of experience in correlation to MR imaging[J]. Radiology,2016,280(2):150-159.
[7]王叶新,孟纯阳,李庆伟,等.经皮穿刺椎体成形术联合鲑鱼降钙素治疗老年骨质疏松性脊柱压缩骨折的疗效分析[J].保健医学研究与实践,2017,14(4):45-48.
[8]司泽兵,吴继功,马华松,等.经皮球囊扩张椎体后凸成形术治疗老年骨质疏松陈旧性胸腰椎压缩骨折[J].颈腰痛杂志,2016,37(2):105-109.
[9]宋仁谦,周英杰,赵刚,等.高黏度骨水泥经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松压缩骨折的临床疗效观察[J].中国矫形外科杂志,2016,24(8):692-696.
[10]刘波,吕刚,杨宏.补肾活血汤联合经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折的临床观察[J].老年医学与保健,2017,23(3):216-219.
[11]刘焱,朱金华,鲍自立,等.中药联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折疗效观察[J].现代中西医结合杂志,2017,26(25):2829-2831.
[12]郭洪波,郭荣勤,张莹,等.后路短节段椎弓根钉内固定与PKP治疗老年骨质疏松性胸腰椎压缩骨折的疗效比较[J].中国骨与关节损伤杂志,2016,31(11):1183-1185.
[13] Yang E Z,Xu J G,Huang G Z,et al. Percutaneous vertebroplasty vs conservative treatment in aged patients with acute osteoporotic vertebral compression fractures:a prospective randomized controlled clinical study[J]. Spine,2016,41(8):653-660.
[14]张瑞华,曹亚飞,余伟吉,等.经皮椎体后凸成形术联合益督丸治疗胸腰椎压缩性骨折33例[J].中国中医骨伤科杂志,2017,25(11):65-67.
[15]邵明星,王峰,石晶,等.马骨续筋胶囊结合经皮椎体成形术治疗老年骨质疏松性胸腰椎骨折的早期疗效分析[J].临床和实验医学杂志,2016,15(9):894-897.
[16]朱红坤,敖朝霞,周密思.中西医结合治疗老年性胸腰椎压缩性骨折80例[J].山东中医杂志,2016,35(1):41-42.
[17]王鋆泉,周海纯.补肾壮骨汤联合椎体成形术治疗老年骨质疏松性胸腰椎压缩性骨折的临床观察[J].中医药信息,2016,33(2):102-104.
[18]程永远.益肾补骨汤联合椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折临床观察[J].陕西中医,2017,38(1):76-78.
[19]崔光辉.中药联合经皮椎体成形术治疗老年骨质疏松并急性胸腰椎压缩性骨折临床研究[J].陕西中医,2017,38(12):1732-1733.
[2]罗建军,王冰.经皮椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折的效果评价[J].颈腰痛杂志,2016,37(3):200-203.
[3]冉仁国,罗政,张岱阳. PVP与椎体后凸成术治疗骨质疏松性胸腰椎压缩性骨折的疗效比较[J].颈腰痛杂志,2017,38(5):428-431.
[4]杨国进,刘玉林,付文举,等.单侧穿刺经皮椎体后凸成形术联合药物治疗老年骨质疏松性椎体压缩骨折的临床疗效[J].实用老年医学,2017,31(12):1157-1160.
[5]伏海平,刘华兴,曾显荣.经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折[J].临床骨科杂志,2017,20(1):33-34.
[6] Kaup M,Wichmann J L,Scholtz J E,et al. Dual-energy CT-based display of bone marrow edema in osteoporotic vertebral compression fractures:impact on diagnostic accuracy of radiologists with varying levels of experience in correlation to MR imaging[J]. Radiology,2016,280(2):150-159.
[7]王叶新,孟纯阳,李庆伟,等.经皮穿刺椎体成形术联合鲑鱼降钙素治疗老年骨质疏松性脊柱压缩骨折的疗效分析[J].保健医学研究与实践,2017,14(4):45-48.
[8]司泽兵,吴继功,马华松,等.经皮球囊扩张椎体后凸成形术治疗老年骨质疏松陈旧性胸腰椎压缩骨折[J].颈腰痛杂志,2016,37(2):105-109.
[9]宋仁谦,周英杰,赵刚,等.高黏度骨水泥经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松压缩骨折的临床疗效观察[J].中国矫形外科杂志,2016,24(8):692-696.
[10]刘波,吕刚,杨宏.补肾活血汤联合经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折的临床观察[J].老年医学与保健,2017,23(3):216-219.
[11]刘焱,朱金华,鲍自立,等.中药联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折疗效观察[J].现代中西医结合杂志,2017,26(25):2829-2831.
[12]郭洪波,郭荣勤,张莹,等.后路短节段椎弓根钉内固定与PKP治疗老年骨质疏松性胸腰椎压缩骨折的疗效比较[J].中国骨与关节损伤杂志,2016,31(11):1183-1185.
[13] Yang E Z,Xu J G,Huang G Z,et al. Percutaneous vertebroplasty vs conservative treatment in aged patients with acute osteoporotic vertebral compression fractures:a prospective randomized controlled clinical study[J]. Spine,2016,41(8):653-660.
[14]张瑞华,曹亚飞,余伟吉,等.经皮椎体后凸成形术联合益督丸治疗胸腰椎压缩性骨折33例[J].中国中医骨伤科杂志,2017,25(11):65-67.
[15]邵明星,王峰,石晶,等.马骨续筋胶囊结合经皮椎体成形术治疗老年骨质疏松性胸腰椎骨折的早期疗效分析[J].临床和实验医学杂志,2016,15(9):894-897.
[16]朱红坤,敖朝霞,周密思.中西医结合治疗老年性胸腰椎压缩性骨折80例[J].山东中医杂志,2016,35(1):41-42.
[17]王鋆泉,周海纯.补肾壮骨汤联合椎体成形术治疗老年骨质疏松性胸腰椎压缩性骨折的临床观察[J].中医药信息,2016,33(2):102-104.
[18]程永远.益肾补骨汤联合椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折临床观察[J].陕西中医,2017,38(1):76-78.
[19]崔光辉.中药联合经皮椎体成形术治疗老年骨质疏松并急性胸腰椎压缩性骨折临床研究[J].陕西中医,2017,38(12):1732-1733.