大将逐瘀汤联合椎体成形术治疗腰椎压缩性骨折气滞血瘀证患者的临床观察OA
Clinical Efficacy of Dajiang Zhuyu Decoction Combined with Vertebroplasty for Lumbar Compression Fractures with Qi Stagnation and Blood Stasis Syndrome
目的 观察大将逐瘀汤联合椎体成形术对腰椎压缩性骨折患者骨保护素(osteoprotegerin,OPG)、核因子κB受体活化因子配体(receptor activator of nuclear factor-κB ligand,RANKL)、I型前胶原氨基端前肽(n-terminal propeptide of type i procollagen,PINP)水平的影响.方法 选取2022年1月—2022年12月于黄冈职业技术学院附属英山人民医院骨二科就诊的115 例腰椎压缩性骨折患者作为研究对象,按随机数字表法分为对照组和观察组,其中对照组58 例、观察组57 例.对照组给予椎体成形术治疗,观察组给予大将逐瘀汤联合椎体成形术治疗,两组患者均治疗2周.观察比较两组患者临床疗效及并发症发生情况,治疗前后中医证候积分、疼痛程度、骨折椎体恢复情况(Cobb角、椎体压缩率)、腰椎功能Oswestry功能障碍指数评分(oswestry disability index score,ODI)及OPG、RANKL、PINP水平.结果 治疗后,观察组临床有效率96.49%(55/57)高于对照组的84.48%(49/58),差异有统计学意义(P<0.05).治疗后,两组患者腰部骨折、腰部刺痛或肿痛、痛处拒按拒动、痛处固定、腰部活动受限、疲乏无力、面色少华中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组上述中医证候积分较对照组降低,差异有统计学意义(P<0.05).治疗后,两组疼痛程度评分、ODI评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组疼痛程度评分、ODI评分较对照组降低,差异有统计学意义(P<0.05).治疗后,两组Cobb角及椎体压缩率均较治疗前降低,差异有统计学意义(P<0.05);且观察组Cobb角及椎体压缩率较对照组降低,差异有统计学意义(P<0.05).治疗后,两组患者OPG、PINP水平均较治疗前升高,RANKL水平较治疗前降低,差异有统计学意义(P<0.05);且观察组OPG、PINP水平较对照组升高,RANKL水平较对照组下降,差异有统计学意义(P<0.05).观察组总并发症发生率1.75%(1/57)低于对照组的13.79%(8/58),两组患者并发症发生情况比较,差异有统计学意义(P<0.05).结论 大将逐瘀汤联合椎体成形术可改善腰椎压缩性骨折患者腰椎功能,减轻其疼痛程度.
Objective To observe the effects of the Dajiang Zhuyu Decoction combined with vertebroplasty on osteoprotegerin(OPG),receptor activator of nuclear factor-κB ligand(RANKL),and N-terminal propeptide of type I procollagen(PINP)levels in patients with lumbar compression fractures.Methods A total of 115 patients with lumbar compression fractures admitted to the Second Department of Orthopedics,The People's Hospital of Ying Shan affiliated to Huanggang Polytechnic University from January 2022 to December 2022 were selected as the research subjects.They were divided into a control group(58 cases)and an observation group(57 cases)according to the random number table method.Both groups received vertebroplasty,while the observation group additionally received Dajiang Zhuyu Decoction.After 2 weeks of treatment,the clinical efficacy and complication rate were compared between the two groups.The following parameters were assessed before and after treatment:the traditional Chinese medicine(TCM)syndrome scores,pain degree,recovery status of the fractured vertebrae(Cobb angle and vertebral compression rate),lumbar function[Oswestry disability index(ODI)scores],as well as OPG,RANKL,and PINP levels.Results After treatment,the clinical efficacy was 96.49%(55/57)in the observation group,statistically significant in comparison to 84.48%(49/58)in the control group(P<0.05).The TCM syndrome scores of lumbar fractures,lumbar stabbing pain or swelling pain,refusal to pressure or moving in pain location,fixed pain location,restricted lumbar movement,fatigue and weakness,alongside pale complexion were decreased in both groups(P<0.05),and were significantly lower in the observation group(P<0.05).Similarly,pain degree and ODI scores were decreased in both groups(P<0.05),and were significantly lower in the observation group(P<0.05).Cobb angle and vertebral compression rate were decreased in both groups(P<0.05),and were significantly lower in the observation group(P<0.05).OPG and PINP were increased,while RANKL level was decreased in both groups(P<0.05),and were significantly lower in the observation group(P<0.05).Furthermore,the total complication rate was 1.75%(1/57)in the observation group,significantly lower than 13.79%(8/58)in the control group(P<0.05).Conclusion For lumbar compression fractures,Dajiang Zhuyu Decoction combined with vertebroplasty improves lumbar function and alleviates pain degree.
饶文俊;吴尧;叶帧干;王东升;王峰;闻海军
黄冈职业技术大学附属英山人民医院,湖北 黄冈 438700黄冈职业技术大学附属英山人民医院,湖北 黄冈 438700黄冈职业技术大学附属英山人民医院,湖北 黄冈 438700黄冈职业技术大学附属英山人民医院,湖北 黄冈 438700黄冈职业技术大学附属英山人民医院,湖北 黄冈 438700黄冈职业技术大学附属英山人民医院,湖北 黄冈 438700
医药卫生
大将逐瘀汤椎体成形术腰椎压缩性骨折腰椎功能疼痛程度
Dajiang Zhuyu Decoctionvertebroplastylumbar compression fracturelumbar functionpain degree
《世界中西医结合杂志》 2026 (7)
1399-1404,6
国家中医药管理局第二批中医药科技项目(GZY-KJS-2021-018)
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