| 摘要: |
| 目的 观察并分析宽筋散热熨治疗骨质疏松性椎体压缩性骨折(OVCF)经皮椎体成形术(PVP)后残留腰背痛的临床疗效。方法:纳入2021年3月—2023年8月在我院就诊的PVP术后仍然残留有腰背痛的OVCF患者80例，按照随机数字表法分为治疗组和对照组，每组均40例。对照组口服碳酸钙D3片与阿法骨化醇片，治疗组在对照组基础上加用宽筋散热熨治疗，两组疗程均为4周。观察两组治疗前后视觉模拟疼痛(VAS)评分、腰椎日本骨科协会评估(JOA)评分、血液流变学指标(全血低切黏度、血浆黏度、红细胞聚集指数)、骨密度(左侧股骨颈、左侧桡骨远端)、骨代谢指标[骨钙素(BGP)、Ⅰ型胶原氨基端延长肽(PINP)、β-胶原特殊序列(β-CTX)、抗酒石酸酸性磷酸酶-5b(TRAP-5b)]水平变化，同时进行临床疗效和安全性评价。结果:治疗后，两组较治疗前的VAS评分、全血低切黏度、血浆黏度、红细胞聚集指数、β-CTX及TRAP-5b水平均明显降低(P<0.05)；而腰椎JOA评分、骨密度(BMD)、BGP及PINP水平均明显升高(P<0.05)。治疗后，治疗组VAS评分、腰椎JOA评分、血液流变学指标、BMD及骨代谢指标水平均优于对照组(P<0.05)。治疗组、观察组总优良率分别为85.00%、52.50%，治疗组疗效优于对照组(P<0.05)。两组均未发生胃肠道反应、过敏、头晕及皮肤烫伤等不良反应。结论: 宽筋散热熨治疗OVCF患者PVP术后残留腰背痛的临床疗效良好，可显著改善临床症状、血液流变学指标、BMD及骨代谢相关指标水平。 |
| 关键词: 宽筋散 热熨 骨质疏松性椎体压缩性骨折 经皮椎体成形术 残留腰背痛 |
| DOI：10.3969/j.issn.1007-6948.2024.02.012 |
| 投稿时间：2023-10-01 |
| 基金项目: |
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| Efficacy observation on KuanJin Powder hot ironing in the treatment of residual low back pain in patients with osteoporotic vertebral compression fracture after PVP |
| LIU Hua,CHEN Xiao-fang,XU Ye |
| Department of Orthopedics and Traumatology, Haian Hospital of Traditional Chinese Medicine in Jiangsu Province, Haian 226600, China |
| Abstract: |
| Objective To observe and analysis the clinical efficacy of hot ironing therapy with KuanJin Powder in the treatment of residual low back pain in patients with osteoporotic vertebral compression fracture (OVCF) after pereutaneous vertebroplasty (PVP). Methods A total of 80 patients with residual back pain after PVP who were treated in our hospital from March 2021 to August 2023 were enrolled in this study. They were divided into treatment group and control group according to the random number table method, with 40 cases in each group. Patients in the control group received calcium carbonate D3 and alfacalcidol. Additionally, the patients in the treatment group received hot ironing therapy with KuanJin Powder based on that treatment. The treatment courses of the two groups were 4 weeks. The Visual Analogue Scale (VAS) score, lumbar vertebra Japanese Orthopaedic Association (JOA) score, hemorheological indexes low shear blood viscosity, plasma viscosity and erythrocyte aggregation index, bone mass density (the left femoral neck and left distal radius) and bone metabolism indexes[BGP, type I procollagen N-terminal propeptide (PINP), β-Carboxyl terminal peptide (β-CTX) and tartra-resistant acid phosphatase 5b (TRAP-5b)] were recorded and analyzed before and after treatment. The clinical effect and treatment safety were assessed simultaneously. Results Compared with that before treatment, the VAS score and level of low shear blood viscosity, plasma viscosity, erythrocyte aggregation index, β-CTX and TRAP-5b of the two groups after treatment were significantly reduced (P<0.05), while the lumbar vertebra JOA score and level of bone mass density, BGP and PINP were significantly increased (P<0.05). The VAS score, lumbar vertebra JOA score and level of hemorheological indexes, bone mass density and bone metabolism indexes in the treatment group were better than those in the control group after treatment (P<0.05). The total survival rate of the treatment group was 85.0%,which was significantly higher than that of the control group (52.50%) (P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (P＞0.05). Conclusion Hot ironing therapy with KuanJin Powder is effective in treating residual low back pain in patients with OVCF after PVP, which can improve clinical symptom and hemorheological indexes and level of BMD and bone metabolism indexes significantly. |
| Key words: KuanJin Powder hot ironing osteoporotic vertebral compression fracture pereutaneous vertebroplasty residual low back pain curative effect |
