仲黄颗粒配合手术治疗骨量减少的腰椎间盘突出症临床疗效及对BMD、血清OPG水平的影响

目的观察仲黄颗粒配合腰椎后路椎间融合术(posterior lumbar interbody fusion,PLIF)治疗合并骨量减少的肝肾亏虚型腰椎间盘突出症的临床疗效,进一步探讨该方法的临床作用机理。方法选取自2014年5月至2017年6月,日照市中医医院共收治的合并骨量减少的肝肾亏虚型腰椎间盘突出症患者96例,其中治疗组48例采用PLIF术后配合仲黄颗粒口服治疗;对照组48例采用PLIF术治疗。分别记录治疗前和治疗后6个月、12个月Oswestry功能障碍指数(oswestry disability index,ODI)评分、骨密度T值及血清骨保护素(osteoprotegerin,OPG)水平三方面的变化及末次随访时不融合、融合器沉降及螺钉松动不良事件。结果治疗组和对照组分别有42例、40例患者获得随访,两组患者对临床疗效均较为满意,但治疗组满意度高于对照组,两组间差异有统计学意义(P0.05)。结论仲黄颗粒可能通过升高血清OPG提高患者骨密度及术后长期临床疗效,从而减少术后植骨不融合、融合器沉降和螺钉松动不良事件的发生。

Clinical study of Zhong Huang granule combined with operation in the treatment of Lumbar Disc Herniation complicated with osteopenia and its influence on BMD and serum OPG level

Objective To observe the clinical efficacy of Zhong Huang granule combined with posterior lumbar interbody fusion (PLIF) in the treatment of Lumbar Disc Herniation of Liver-Kidney Asthenia type complicated with osteopenia, and to further explore the clinical mechanism of this method. Methods From May 2014 to June 2017, 96 cases with Lumbar Disc Herniation of Liver-Kidney Asthenia type complicated with osteopenia were selected, 48 cases in the treatment group were treated by PLIF combined with orally taking Zhong Huang granules. In the control group, 48 cases were treated by PLIF. ODI (Oswestry disability index) scores, bone density T-score and serum OPG (osteoprotegerin) levels were observed and recorded before and after treatment at 6 and 12 months, as well as the adverse events of non-fusion, fusion device settlement and screw loosening at the last follow-up. Results 42 patients in the treatment group were followed up, and 40 patients in the control group were followed up. Satisfactory clinical efficacy was achieved in both groups, but the treatment group was superior to the control group, with statistically significant difference. Conclusion Zhong Huang granule can increase the serum OPG level, improve bone density and long-term postoperative clinical efficacy, and reduce the incidence of postoperative screw loosening, fusion device settlement and non-fusion adverse events.