【摘要】 目的评价强腰活血汤加减联合经皮椎弓根钉棒内固定治疗胸腰椎骨折的有效性和安全性,为丰富中西医结合方法治疗胸腰椎骨折提供参考。方法选择海南省中医院2017年1月—2018年5月治疗的60例胸腰椎骨折患者为研究对象,随机分为对照组和观察组,2组患者均给予经皮椎弓根钉棒内固定治疗,观察组患者同时给予强腰活血汤,连续服用6个疗程。治疗前及治疗后60 d分别采用疼痛视觉模拟评分(VAS)、影像学资料、Oswestry功能障碍指数(ODI)、血清骨保护素(OPG)和核因子κB受体活化因子配体(RANKL)评价2组患者,记录可能的药物不良反应。结果与治疗前相比,对照组和观察组的VAS评分、矢状面后凸Cobb角、ODI得分和血清RANKL质量浓度均降低(P <0.05),椎前缘高度百分比和血清OPG质量浓度升高(P <0.05);治疗后,观察组的VAS评分、矢状面后凸Cobb角、ODI得分和血清RANKL质量浓度低于对照组(P <0.05),椎前缘高度百分比和血清OPG质量浓度高于对照组(P <0.05),2组患者均未出现严重不良反应。结论强腰活血汤加减联合经皮椎弓根钉棒内固定对胸腰椎骨折具有良好的治疗效果,调节患者体内OPG和RANKL质量浓度可能是其治疗途径之一,强腰活血汤不良反应较少,安全性可以接受。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of Qiangyao Huoxue Decoction combined with internal percutaneous pedicle screw and rod fixation in the treatment of thoracolumbar fracture, provide reference for enriching the treatment of thoracolumbar fracture with integration of traditional and Western medicine. Methods 60 patients with thoracolumbar fractures treated in Hainan Provincial Hospital of Traditional Chinese Medicine were selected from Jan 2017 to May 2018 as the research subjects. The patients in both the control group and the observation group were treated with internal percutaneous pedicle screw and rod fixation. The patients in the observation group were also treated with Qiangyao Huoxue Decoction on the basis of the above treatment, with 6 courses continuously. Visual analogue scale(VAS), imaging data, Oswestry disability index(ODI), osteoprotegerin(OPG) and receptor activator of nuclear factor kappa-Βligand(RANKL)were used to evaluate the two groups before and 60 days after treatment. Possible adverse drug reactions were recorded. Results Compared with the prior treatment, the VAS score, Cobb angle, ODI score of sagittal kyphosis and RANKL level in the control group and the observation group decreased(P < 0.05), the percentage of vertebral front height and OPG level increased(P < 0.05); after treatment, the VAS score, Cobb angle,ODI score of sagittal kyphosis and RANKL mass concentration in the observation group were lower than those in the control group(P < 0.05), the percentage of vertebral front height and OPG mass concentration was higher than that in the control group(P < 0.05). No serious adverse reactions occurred in the two groups.Conclusion Qiangyao Huoxue Decoction combined with internal percutaneous pedicle screw and rod fixation has a good therapeutic effect on thoracolumbar fracture, regulation of OPG and RANKL levels and might be one of the therapeutic routes with less adverse drug reactions and more acceptable safety.更多还原