金匮肾气丸辅助经皮椎体后凸成形术对骨质疏松性椎体压缩骨折的疗效观察

Therapeutic Effect Observation of Jinkui Shenqi Pill Assisted with Percutaneous Kyphoplasty on Osteoporotic Vertebral Compression Fracture

关键词:  骨质疏松性椎体压缩骨折  经皮椎体后凸成形术  金匮肾气丸  临床疗效

Key words:  osteoporotic vertebral compression fracture  percutaneous kyphoplasty  jingui shenqi pill  clinical effect

摘要:

目的 观察金匮肾气丸辅助经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）对骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fracture，OVCF）的临床疗效。方法 选取2015年2月-2018年2月收治的124例OVCF患者，按随机数字表法分为观察组和对照组，各62例。对照组给予PKP手术及术后常规治疗3个月，观察组在此基础上加用金匮肾气丸，疗程4周。观察并对比分析2组间术前、术后3个月及术后1年EVOS、ODI评分、骨密度、椎体高度、VAS及QOL-100评分的差异，检测骨代谢指标PINP、β-CTX、BGP、BALP术前及术后3个月的变化情况，同时记录不良反应及再骨折发生情况。结果 观察组术后3个月、1年EVOS评分高于对照组（P<0.05），ODI评分低于对照组（P<0.05）；责任椎椎高比大于对照组（P<0.05），Cobb角低于对照组（P<0.05）。术后1年，观察组骨密度值较术前、术后3个月明显升高，且高于对照组（P<0.05）。观察组术后BGP水平高于对照组（P<0.05），PINP、BALP、β-CTX水平低于对照组（P<0.05）。观察组术后3个月、1年QOL-100评分高于对照组（P<0.05），VAS评分低于对照组（P<0.05）。观察组椎体再骨折发生率3.23%明显低于对照组16.13%（χ²=4.521，P<0.05）。结论 金匮肾气丸辅助PKP治疗OVCF患者，临床效果显著，且骨折再发生率低，值得临床应用。

Abstract:

OBJECTIVE To observe the clinical effect of Jingui Shenqi pill assisted with percutaneous kyphoplasty(PKP) on osteoporotic vertebral compression fracture(OVCF). METHODS The 124 patients with OVCF from February 2015 to February 2018 were enrolled and divided into observation group and control group according to the random number table, with 62 cases in each group. The control group was treated with PKP operation and routine treatment for 3 months after operation, and on this basis, the observation group was treated with Jingui shenqi pill for 4 weeks. A one-year follow-up was conducted to observe and compare the differences of EVOS, ODI score, bone density, vertebral height, VAS and QOL-100 scores between the two groups before operation, 3 months after operation and one year after operation. The changes of bone metabolic indexes of PINP, β-CTX, BGP and BALP before and 3 months after operation were detected, and the occurrence of adverse events and re-fracture was recorded. RESULTS The EVOS scores in the observation group were higher than those in the control group at 3 months and one year after operation(P<0.05), and the ODI scores were lower(P<0.05); the height ratio of the responsible vertebrae was greater(P<0.05), and the Cobb angle was lower(P<0.05). One year after operation, the bone mineral density in the observation group was significantly higher than that before operation and 3 months after operation, and was higher than that in the control group(P<0.05). The levels of BGP in the observation group were higher than those in the control group(P<0.05), and the levels of PINP, BALP and β-CTX were lower(P<0.05). The QOL-100 scores in the observation group were higher than those in the control group at 3 months and 1 year after operation(P<0.05), and the VAS scores were lower(P<0.05). The incidence of vertebral re-fracture in the observation group was 3.23% lower than that in the control group 16.13%(χ²=4.521, P<0.05). CONCLUSION Jingui Shenqi pill assisted with PKP in the treatment of OVCF patients, the clinical effect is significant, and the recurrence rate of fracture is low, which is worthy of clinical application.