| 中药膏方联合八段锦治疗PVP术后骨质疏松性椎体压缩骨折患者的疗效观察 |
| 投稿时间：2021-08-10 修订日期：2022-01-17 点此下载全文 |
| 引用本文：潘羽强,马明华,张若曦,章祎俊,徐玲玲,年华.中药膏方联合八段锦治疗PVP术后骨质疏松性椎体压缩骨折患者的疗效观察[J].药学实践杂志,2023,41(7):437~442 |
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| 基金项目:上海市中药专家传承工作室建设项目(2020ZYGZS-002)；上海市卫生健康委员会中医药科研项目(2020YP001) |
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| 中文摘要:目的 观察中药膏方联合八段锦治疗经皮椎体成形术（PVP）术后骨质疏松性椎体压缩骨折（OVCF）患者的疗效。 方法 前瞻性选取120例2016年1月至2017年9月于我院行PVP治疗的OVCF患者为研究对象，按随机数字表法将其分为观察组（60例），对照组（60例）。对照组予以碳酸钙D3咀嚼片口服，同时进行常规指导；观察组在对照组疗法的基础上予以中药膏方口服，同时进行八段锦锻炼。两组均治疗6个月，并随访3年。观察两组治疗6个月后的疗效及治疗1、3、6个月的腰背疼痛情况，比较两组治疗前、治疗6个月后的骨密度（BMD）、椎体后凸角度（Cobb角）、椎体前壁高度（AVBH）变化情况及骨代谢指标水平，记录两组随访时间及随访期间PVP术后推体再骨折发生率。 结果 治疗6个月后，观察组临床治愈率为73.33%，高于对照组的53.33%（P<0.05）。与治疗前比较，治疗3、6个月后两组视觉模拟评分法（VAS）评分逐渐降低，且观察组低于对照组（P<0.05）。与治疗前比较，治疗6个月后两组腰椎、股骨颈BMD及AVBH均升高，且观察组高于对照组（P<0.05）；两组Cobb角及血清I型原胶原降解产物（β-Cross I）、N端中段骨钙素（N-MID Ost）、甲状旁腺素（PTH）水平均降低，且观察组低于对照组（P<0.05）。两组随访时间、随访1年内、1~3年内PVP术后推体再骨折发生率比较，均无统计学意义（P>0.05）；随访3年内，观察组PVP术后推体再骨折发生率为3.33%，低于对照组的20.00%（P<0.05）。 结论 中药膏方联合八段锦治疗PVP术后OVCF可降低其血清β-Cross I、N-MID Ost、PTH水平，调节机体骨代谢，有助于提高腰椎、股骨颈BMD及AVBH，降低Cobb角，促进腰部功能的恢复，进而缓解患者腰背疼痛，显著降低PVP术后推体再骨折发生率。 |
| 中文关键词:骨质疏松性椎体压缩骨折 经皮椎体成形术 中药膏方 八段锦 骨代谢 疼痛 |
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| Curative effects of traditional Chinese medicine paste combined with Baduanjin in treatment of osteoporotic vertebral compression fracture after PVP |
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| Abstract:Objective To study the curative effects of traditional Chinese medicine paste combined with Baduanjin in treatment of osteoporotic vertebral compression fracture (OVCF) after percutaneous vertebroplasty (PVP). Methods 120 OVCF patients treated with PVP in our hospital from January 2016 to September 2017 were divided into the observation group (60 cases) and the control group (60 cases) according to the random number table method. The control group was given calcium carbonate D3 chewable tablets orally with routine guidance. In addition to the same treatment as the control group, the observation group received the traditional Chinese medicine paste orally with Baduanjin exercise. Both groups were treated for 6 months and followed-up for 3 years. The curative effects in the two groups after 6 months treatment and the low back pain after 1, 3 and 6 months of treatment were recorded. The changes of bone mineral density (BMD), kyphosis angle (Cobb angle), anterior wall height of vertebral body (AVBH) and level of bone metabolism indexes in the two groups were compared before and after treatment for 6 months. The follow-up times and the incidences of push-back fracture after PVP during follow-up were recorded. Results After 6 months of treatment, the clinical cure rate of the observation group was 73.33%, which was higher than 53.33% of the control group(P<0.05). Compared with pretreatment, the scores of visual analogue scale (VAS) in the two groups gradually decreased after 3 and 6 months of treatment, and the observation group had a lower scores than the control group (P<0.05). After 6 months treatment, BMD and AVBH of lumbar vertebrae and femoral neck in both groups increased, and the observation group was higher than that in the control group. The Cobb angle and serum levels of Type I procollagen degradation products (β-Cross I), the n-terminal middle osteocalcin (N-MID Ost) and parathyroid hormone (PTH) decreased in both groups, and the observation group was lower than those in the control group (P<0.05). There was no significant difference in fracture incidence after PVP in the year 1, year 1 to 3 follow up between the two groups (P>0.05). During the 3 years follow-up, the incidence of push-body fracture after PVP in the observation group was 3.33%, which was lower than that in the control group 20.00%( P<0.05). Conclusion Traditional Chinese medicine paste combined with Baduanjin reduced the serum levels of β-Cross I, N-MID Ost and PTH, regulated bone metabolism, improved BMD and AVBH of lumbar vertebrae and femoral neck, reduced Cobb angle, promoted the recovery of lumbar function, alleviated patients' back pain, lowered the incidence of push-body fracture after PVP. The curative effects were remarkable. |
| keywords:osteoporotic vertebral compression fracture percutaneous vertebroplasty Traditional Chinese Medicine paste Baduanjin bone metabolism ache |
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