射频针刀联合仙灵骨葆胶囊治疗老年骨质疏松椎体压缩骨折PVP术后疼痛的临床疗效观察

Clinical observation of radiofrequency acupotomy combined with Xianling Gubao capsule for the treatment of senile osteoporotic vertebral compression fracture PVP postoperative pain

关键词:  射频针刀  仙灵骨葆  骨质疏松  椎体压缩性骨折  经皮椎体成形术

Key words:  radiofrequency needle knife  Xianling Gubao capsule  osteoporosis  vertebral compression fractures  percutaneous vertebroplasty

摘要:

[目的]观察射频针刀联合仙灵骨葆胶囊口服治疗老年骨质疏松椎体压缩骨折经皮椎体成形（PVP）术后疼痛的临床疗效。[方法]将60例骨质疏松性椎体压缩骨折（OVCF）患者均采取PVP手术治疗，并随机分为治疗组和对照组各30例，对照组术后行腰背部痛点射频针刀治疗配合口服阿仑膦酸钠片、罗盖全以及钙尔奇D片，治疗组在对照组基础上服用仙灵骨葆胶囊。对比两组治疗前、治疗3个月、6个月后视觉模拟（VAS）评分、腰椎活动功能Oswestry残损指数评分（ODI）、腰椎及股骨颈骨密度变化评分、椎体骨折后Cobb角恢复率评分。临床疗效采用OVCF的治疗指南进行评价。使用SPSS18.0进行统计分析。[结果]治疗后两组患者VAS评分、腰椎活动功能ODI评分及两组椎体后凸Cobb角较治疗前明显降低，腰椎及股骨颈骨密度变化评分较治疗前明显提高，同组治疗前后差异有统计学意义（P<0.05）；治疗后3个月、6个月，治疗组VAS评分、ODI评分及椎体后凸Cobb角均低于对照组，治疗组腰椎及股骨颈骨密度变化评分高于对照组，两组间比较差异具有统计学意义（P<0.05）。治疗后，对照组椎体后凸Cobb角恢复率明显低于治疗组，两组间比较差异具有统计学意义（P<0.05）；治疗后，治疗组和对照组有效率分别为96.67%、80.00%，两组疗效相当，两组间比较差异无统计学意义（P>0.05）。[结论]射频针刀联合仙灵骨葆胶囊治疗OVCF能有效、快速缓解PVP术后患者腰背部疼痛，改善腰椎功能，促进骨密度增加，降低骨质疏松性骨折的再次发生率，值得临床推广运用。

Abstract:

[Objective] To observe the clinical efficacy of radiofrequency needle knife combined with Xianling Gubao capsules in the treatment of pain after PVP in elderly patients with osteoporotic vertebral compression fractures.[Methods] The 60 cases of OVCF patients were treated with PVP and were randomly divided into treatment group and control group of 30 cases. The control group was treated with radiofrequency needle knife combined with oral alendronate sodium tablets, Luo Gaiquan and Calcium D chip. The treatment group took Xianling Gubao capsules on the basis of the control group.VAS score, ODI score of lumbar spine function, bone mineral density score of lumbar and femoral neck, score of Cobb angle recovery after vertebral fractures were compared between two groups before treatment, 3 months and 6 months after treatment. Clinical efficacy was evaluated using the OVCF treatment guidelines. Statistical analysis was performed using SPSS 18.0.[Results] After treatment, VAS score, ODI score of lumbar activity and Cobb angle of kyphosis in both groups were significantly lower than those before treatment. The BMD scores of lumbar and femoral neck were significantly higher than those before treatment, and there was significant difference between the same group before and after treatment (P<0.05). After3 months and 6 months treatment, VAS score, ODI score of lumbar activity and Cobb angle of kyphosis in treatment group were lower than those in control group. The BMD scores of lumbar and femoral neck in treatment group were higher than those in control group, with significant difference between the two groups (P<0.05).After treatment, the Cobb angle recovery rate of the control group was significantly lower than that of the treatment group, the difference between the two groups was statistically significant (P<0.05); After treatment, the effective rate was 96.67% in the treatment group and 80.00% in the control group, the difference between the two groups was not statistically significant (P>0.05).[Conclusion] The combination of radiofrequency needle knife and Xianling Gubao capsules can effectively and quickly relieve lumbar and back pain after PVP, improve lumbar function, increase bone density and reduce the recurrence rate of osteoporotic fractures. It is worthy of clinical promotion and application.