【摘要】 目的 探讨艽活四物汤联合经皮椎体成形术治疗老年骨质疏松胸腰椎压缩性骨折的疗效及对患者骨代谢指标和动脉氧合能力的影响。方法 选取2018年3月～2019年3月收治的86例老年骨质疏松胸腰椎压缩性骨折患者，将其随机分为对照组和观察组，各43例。所有患者均采用经皮穿刺椎体成形术治疗，对照组术后给予常规抗骨质疏松三联疗法治疗，观察组在此基础上增加艽活四物汤治疗。观察比较两组患者的临床疗效，治疗前后骨代谢、椎体功能恢复情况。结果 相较治疗前，两组患者治疗后的骨密度(BMD)、椎体前壁高度(AVBH)、椎体后凸角度(Cobb)、疼痛视觉模拟评分(VAS)指标均改善，且观察组治疗后BMD、AVBH水平高于对照组，Cobb、VAS评分低于对照组(P<0.05或0.001)。相较治疗前，两组患者治疗后的世界卫生组织生存质量测定量表(WHO-QOL-100)、Barthel指数(BI)及Oswestry功能障碍指数(ODI)指标均改善，且观察组治疗后WHO-QOL-100和BI均高于对照组，ODI指数低于对照组(P<0.01或0.001)。相较治疗前，两组患者治疗后的骨保护素(OPG)、骨钙素(BGP)、碱性磷酸酶(ALP)及Ⅰ型胶原交联羧基末端肽(CTX-Ⅰ)均改善，且观察组治疗后OPG、ALP及BGP水平高于对照组，CTX-Ⅰ水平低于对照组(P<0.05或0.001)。结论 艽活四物汤联合经皮椎体成形术通过改善患者的骨代谢指标，能够快速缓解患者的疼痛，促进椎体功能的恢复，提升患者的活动能力和生存质量，对于老年骨质疏松胸腰椎压缩性骨折具有令人满意的治疗效果。更多还原

【Abstract】 Objective To investigate the clinical effects of Jiuhuosiwu decoction combined with percutaneous vertebroplasty in the treatment of senile osteoarthritis thoracolumbar compression fractures and its influence on bone metabolism and arterial oxygenation. Methods 86 elderly patients with osteoarthritis thoracolumbar compression fractures treated from March 2018 to March 2019 were selected and randomly divided into control group and observation group, with 43 cases in each group. All patients were treated with percutaneous puncture vertebroplasty. The control group were treated with conventional anti-osteoporosis triple therapy, and based on which, the observation group were treated with Jiuhuosiwu decoction. And then, the clinical efficacy, bone metabolism and vertebral function recovery of the two groups were observed and compared before and after treatment. Results Compared with those before treatment, the indexes of bone mineral density(BMD), anterior vertebral body height(AVBH), kyphosis angle(Cobb) and visual analog score(VAS) of pain of the two groups were improved after treatment, and the levels of BMD and AVBH in the observation group were significantly higher than those of the control group, and the levels of Cobb and VAS in the observation group were significantly lower than those in the control group(P<0.05 or 0.001). Compared with those before treatment, the World Health Organization Quality of life scale(WHO-QOL-100), Barthel index(BI) and Oswestry dysfunction index(ODI) of the two groups were improved after treatment, and the WHO-QOL-100 and BI in the observation group were significantly higher than those of the control group, and the ODI index was significantly lower than that of the control group(P<0.01 or 0.001). Compared with those before treatment, osteoprotegerin(OPG), osteocalcin(BGP), alkaline phosphatase(ALP) and type Ⅰ collagen cross-linked carboxyl terminal peptide(CTX-Ⅰ) of the two groups were improved after treatment, and the levels of OPG, ALP and BGP in the observation group were significantly higher than those of the control group, and the level of CTX-Ⅰ was significantly lower than that of the control group(P<0.05 or 0.001). Conclusion Jiuhuosiwu decoction combined with percutaneous vertebroplasty can quickly alleviate the pain of patients, promote the recovery of vertebral function, and improve the activity and quality of life of patients by improving the bone metabolism indexes of patients, and it has satisfactory therapeutic effect on senile osteoarthritis thoracolumbar compression fractures.更多还原