续骨活血汤对老年椎体脆性骨折椎体成形术后再发骨折的影响研究

目的：观察续骨活血汤对老年椎体脆性骨折（OVCF） 患者椎体成形术（PVP） 后再发骨折的影响。方法：回顾性分析96例行PVP的老年OVCF患者的临床资料，根据治疗方案不同分为续骨活血汤组45例和常规治疗组51例。比较2组术后半年内再发骨折情况，治疗3、6个月后的骨愈合有效率以及治疗前与治疗3、6 个月后的骨密度、髋关节功能（Harris 评分）、骨代谢指标[空腹血骨钙素（BGP）、骨碱性磷酸酶（BALP）］、中医证候积分、Oswestry功能障碍指数（ODI） 评分。结果：续骨活血汤组术后半年内再发骨折率4.44%，低于常规治疗组19.61%（P＜0.05）。治疗6个月后，续骨活血汤组骨愈合有效率100%，高于常规治疗组86.27% （P＜0.05）。治疗6 个月后，2 组骨密度均增大（P＜0.05），且续骨活血汤组大于常规治疗组（P＜0.05）。治疗3个月、6个月后，2组Harris评分均逐渐升高（P＜0.05），且治疗6个月续骨活血汤组高于常规治疗组（P＜0.05）。治疗3个月、6个月后，续骨活血汤组BGP、BALP水平均逐渐升高（P＜0.05），治疗6个月后，常规治疗组BGP、BALP水平均升高（P＜0.05），且同一时间点续骨活血汤组BGP、BALP水平高于常规治疗组（P＜0.05）。治疗3个月、6个月后，续骨活血汤组中医证候积分均降低（P＜0.05），且同一时间点均低于常规治疗组（P＜0.05）。治疗3个月、6个月后，2组ODI评分均降低（P＜0.05），且同一时间点续骨活血汤组低于常规治疗组（P＜0.05）。结论：续骨活血汤能有效降低老年OVCF患者PVP后再发骨折的发生率，不仅能改善患者髋关节功能，增加骨密度，还能调节骨代谢，促进骨愈合，提高生活质量。

Study on Effect of Xugu Huoxue Decoction on Refracture of Senile Patients withOsteoporotic Vertebral Compression Fractures After Percutaneous Vertebroplasty

Abstract：Objective：To observe the effect of Xugu Huoxue Decoction on refracture of senile patientswith osteoporotic vertebral compression fractures (OVCF) after percutaneous vertebroplasty (PVP).Methods： The clinical data of 96 senile patients with OVCF receiving PVP were retrospectively analyzed，and divided into the Xugu Huoxue Decoction group and the routine treatment group according to differenttreatment plans ， with 45 and 51 cases in each group respectively. The refracture status within half a yearafter surgery，effective rate of symphysis after 3 and 6 months of treatment，and bone density，hip jointfunction (Harris scores)，levels of bone metabolism indexes [osteocalcin (BGP)，bone alkaline phosphatase(BALP)]， traditional Chinese medicine (TCM) syndrome scores and scores of Oswestry Disability Index(ODI) before treatment and after 3 and 6 months of treatment were respectively compared between the twogroups. Results：The incidence of refracture within half a year after surgery was 4.44% in the Xugu HuoxueDecoction group， lower than that of 19.61% in the routine treatment group (P＜0.05). After 6 months oftreatment， the effective rate of symphysis was 100% in the Xugu Huoxue Decoction group， higher thanthat of 86.27% in the routine treatment group (P＜0.05). After 6 months of treatment，the bone density inthe Xugu Huoxue Decoction group was greater than that in the routine treatment group (P＜0.05). After3 and 6 months of treatment，the Harris scores in the two groups were gradually increased (P＜0.05)，andthe Harris score in the Xugu Huoxue Decoction group after six months of treatment was higher than that inthe routine treatment group (P＜0.05). After 3 and 6 months of treatment，the levels of BGP and BALP inthe two groups were gradually increased (P＜0.05). After 6 months of treatment， the levels of BGP andBALP in the routine treatment group were increased (P＜0.05)， and the above two levels in the XuguHuoxue Decoction group at the same time point were higher than those in the routine treatment group (P＜0.05). After 3 and 6 months of treatment，the TCM syndrome score in the Xugu Huoxue Decoction groupwas respectively decreased (P＜0.05)，and the above score at the same time point was lower than that inthe routine treatment group (P＜0.05). After 3 and 6 months of treatment，the ODI scores in the two groupswere decreased (P＜0.05)，and the ODI score in the Xugu Huoxue Decoction group at the same time pointwas lower than that in the routine treatment group (P＜0.05). Conclusion： Xugu Huoxue Decoction caneffectively decrease the incidence of refracture of senile patients with OVCF after PVP，which not only canimprove the hip joint function and increase the bone density， but also regulate the bone metabolism，promote the symphysis and enhance the quality of life.