摘要
目的:观察补肾活血利水方联合超声引导经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的临床疗效及对患者血清炎症因子与骨代谢的影响。方法:采用随机数字表法将105例OVCF患者分为常规组、超声引导组与中药联合组3组,每组35例。常规组采用常规X线透视下PKP治疗,超声引导组采用超声引导PKP治疗,中药联合组采用补肾活血利水方联合超声引导PKP治疗。比较3组围手术期相关指标及术后6个月内再骨折率。比较3组术前、术后56 d及术后6个月功能障碍、疼痛程度、骨密度、血清炎症因子及骨代谢指标。结果:超声引导组与中药联合组手术时间短于常规组(P<0.05),术中透视次数少于常规组(P<0.05)。术后56 d、术后6个月,3组Oswestry功能障碍指数(ODI)评分、视觉模拟评分法(VAS)评分均低于术前(P<0.05),且中药联合组术后6个月ODI评分、VAS评分均较常规组与超声引导组降低,骨密度升高(P<0.05)。术后56 d、术后6个月,3组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平均低于术前(P<0.05),且中药联合组术后6个月血清TNF-α、IL-6、I型原胶原N-端前肽(PINP)、血清I型胶原交联C-末端肽(S-CTX)水平均低于常规组与超声引导组(P<0.05)。术后6个月,3组再骨折率比较,差异无统计学意义(P>0.05)。结论:补肾活血利水方联合超声引导PKP治疗可减轻患者功能障碍及疼痛程度,增加骨密度,降低血清TNF-α、IL-6、PINP及S-CTX水平。
Objective:To observe the clinical effect of Bushen Huoxue Lishui prescription combined with percutaneous kyphoplasty(PKP)under ultrasonic guidance for osteoporotic vertebral compression fracture(OVCF)and its effects on serum inflammation factors and bone metabolism of patients.Methods:A total of 105 cases of OVCF patients were divided into the routine group,the ultrasonic guidance group,and the combined Chinese medicine group according to the random number table method,with 35 cases in each group.The routine group was treated with routine PKP under routine X-ray fluoroscopy;the ultrasonic guidance group was treated with PKP under ultrasonic guidance,and the combined Chinese medicine group was treated with Bushen Huoxue Lishui prescription combined with PKP under ultrasonic guidance.The perioperative related indexes and the re-fracture rates within 6 months after operation were compared among the three groups.The indexes of dysfunction,pain degree,bone mineral density,serum inflammation factors and bone metabolism in the three group were compared before operation,56 days and 6 months after operation.Results:The operation time in the ultrasonic guidance group and the combined Chinese medicine group was shorter than that in the routine group,and the times of fluoroscopy during the operation was less(P<0.05).At 56 days and 6 months after operation,the scores of Oswestry Dysfunction Index(ODI)and Visual Analogue Scale(VAS)in the three groups were lower than those before operation(P<0.05),and the scores of ODI and VAS in the combined Chinese medicine group were lower than those in the routine group and ultrasonic guidance group(P<0.05),and the bone mineral density was increased(P<0.05).At 56 days and 6 months after operation,levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the three groups were lower than those before operation(P<0.05),and the levels of TNF-α,IL-6,procollagen type I intact N-terminal propeptide(PINP)and serum-carboxy-terminal collagen crosslinks(S-CTX)in serum 6 months after operation in the combined Chinese medicine group were lower than those in the routine group and ultrasonic guidance group(P<0.05).There was no significant difference being found in the comparison of re-fracture rates during the six months after operation among the three groups(P<0.05).Conclusion:Bushen Huoxue Lishui prescription combined with ultrasonic guidance PKP can relieve the degree of dysfunction and pain,enhance bone mineral density,and reduce levels of TNF-αand IL-6 in serum as well as PINP and S-CTX.
出处
《新中医》
CAS
2022年第15期97-102,共6页
New Chinese Medicine
关键词
骨质疏松性椎体压缩骨折
补肾活血利水方
超声引导经皮椎体后凸成形术
白细胞介素-6
Ⅰ型原胶原N-端前肽
Osteoporotic vertebral compression fracture
Bushen Huoxue Lishui prescription
Percutaneous kyphoplasty under ultrasonic guidance
Interleukin-6
Procollagen type I intact N-terminal propeptide
