活血补肾汤对腰椎骨折椎体成形术患者血清骨保护素、骨代谢指标及椎体功能的影响

文章信息/Info

• Title:活血补肾汤对腰椎骨折椎体成形术患者血清骨保护素、骨代谢指标及椎体功能的影响

• 卷期:2024年22卷16期

• 作者:黄魁，郑先发，王捷夫

• 南城县中医院骨科 江西 抚州 344700

• Author(s):Huang Kui, Zheng Xianfa, Wang Jiefu

• Nancheng County Hospital of Traditional Chinese Medicine Orthopedics Fuzhou, Jiangxi 344700

• 关键词 椎体成形术；骨质疏松性胸腰椎压缩骨折；活血补肾汤；血清骨保护素；骨代谢

• Keywords: Vertebroplasty; Osteoporotic thoracolumbar compression fracture; Huoxue Bushen Tang; Serum osteoprotegerin; Bone metabolism

• 摘要:目的：探讨活血补肾汤在腰椎骨折椎体成形术患者中的应用价值。方法：选择2019年5月至2022年5月我院收治的腰椎骨折椎体成形术患者68例，按随机数字表法分为两组，各34例。术后对照组采用常规治疗，观察组加活血补肾汤治疗，两组均治疗4周，且术后均随访12周。对比分析两组血清骨保护素、骨代谢指标、椎体功能、疼痛程度。结果：术后12周，观察组血清OPG、骨钙素、Ⅰ型前胶原羧基端肽、骨碱性磷酸酶，高于对照组，Oswestry功能障碍指数问卷表评分、视觉模拟评分法评分，低于对照组，差异有统计学意义（P＜0.05）。结论：活血补肾汤能够有效改善腰椎骨折椎体成形术患者术后骨代谢，上调血清OPG水平，缓解术后疼痛，促进椎体功能恢复。                                                                                                                                                                                

• AbstractTo investigate the application value of Huoxue Bushen Decoction in patients with lumbar vertebral fracture undergoing vertebroplasty. Methods: 68 patients with lumbar vertebral fracture undergoing vertebroplasty in our hospital from May 2019 to May 2022 were selected and randomly divided into two groups, 34 patients in each group. The control group was treated with routine therapy after operation, and the observation group was treated with Huoxue Bushen Decoction. Both groups were treated for 4 weeks, and were followed up for 12 weeks after operation. The serum osteoprotegerin, bone metabolism index, vertebral function and pain degree were compared between the two groups. Results: At 12 weeks after operation, the serum OPG, osteocalcin, C-terminal peptide of type I procollagen, and bone alkaline phosphatase in the observation group were higher than those in the control group. The scores of Oswestry Disability Index Questionnaire and visual simulation scoring method were lower than those in the control group, with statistical significance（P＜0.05）. Conclusion: Huoxue Bushen Decoction can effectively improve the bone metabolism of patients with lumbar fracture undergoing vertebroplasty, increase the level of serum OPG, relieve postoperative pain, and promote the recovery of vertebral function.

  骨质疏松性胸腰椎压缩骨折（OTCF）为骨科常见疾病，其多发于老年群体，以腰背疼痛、活动受限为主要表现，严重影响老年患者日常生活[1]。针对此，临床多采用椎体成形术治疗，主要通过椎弓根向椎体内注入骨水泥，促进椎体高度恢复，从而改善患者症状[2]。但手术具有一定创伤性，术后患者仍需承受疼痛，而术后常规指导患者进行康复训练，虽能够促进腰椎功能恢复，但难以改善患者体内骨代谢失衡，且患者因疼痛、肢体制动等原因，康复训练依从性差，难以达到预期康复效果。中医学认为骨质疏松是造成OTCF的根本原因，而骨质疏松的发生多与肝肾不足造成筋骨失养有关[3]。