文献类型：期刊文献

中文题名：中医正骨手法联合经皮椎体成形术治疗骨质疏松性胸腰椎压缩性骨折49例临床观察

英文题名：Clinical observation on 49 cases of osteoporotic thoracolumbar compression fractures treated by TCM bone setting manipulation combined with percutaneous vertebroplasty

作者：温孝明[1];刘建军[1];任森[2];张岩[1];张兵刚[1];唐文华[1]

第一作者：温孝明

机构：[1]甘肃中医药大学附属医院骨科,甘肃兰州730020;[2]甘肃宝石花医院骨科,甘肃兰州730060

第一机构：甘肃中医药大学第二附属医院

年份：2022

卷号：39

期号：1

起止页码：74

中文期刊名：甘肃中医药大学学报

外文期刊名：Journal of Gansu University of Chinese Medicine

基金：卫生部医药卫生科技发展研究中心项目(W2014ZT280);甘肃中医药大学附属医院院内项目(ZQ2014-32)。

语种：中文

中文关键词：骨质疏松性胸腰椎压缩性骨折;中医正骨手法;经皮椎体成形术;椎体高度;Cobb角;视觉模拟评分法评分;Oswestry功能障碍指数;骨水泥渗漏率

外文关键词：osteoporotic thoracolumbar compression fractures(OTCFs);TCM bone setting manipulation;percutaneous vertebroplasty(PVP);vertebrae height;Cobb angle;visual analogue scale(VAS)score;Oswestry dysfunction index(ODI);bone cement leakage rate

摘要：目的观察中医正骨手法联合经皮椎体成形术(PVP)治疗骨质疏松性胸腰椎压缩性骨折(OTCFs)的临床疗效。方法对甘肃中医药大学附属医院2017年2月至2019年12月收治的128例OTCFs患者进行回顾性分析,根据治疗方法不同分为治疗组49例和对照组79例,治疗组采取中医正骨手法联合PVP治疗,对照组单纯采取PVP治疗,术后比较2组的骨水泥渗漏率、病椎椎体高度恢复率以及手术前后的视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)、病椎Cobb角、病椎椎体高度。结果 2组骨水泥渗漏率比较差异无统计学意义(P>0.05)。术后2组VAS评分、ODI均明显降低,病椎Cobb角明显缩小,与同组术前比较差异均有统计学意义(P<0.01),且治疗组病椎Cobb角缩小更明显,与对照组术后比较差异有统计学意义(P<0.01)。术后治疗组病椎椎体前缘、中间高度均明显增大,对照组病椎椎体前缘高度明显增大,与同组术前比较差异均有统计学意义(P<0.01),且治疗组病椎椎体前缘、中间高度明显大于对照组,2组术后比较差异均有统计学意义(P<0.01);治疗组病椎椎体前缘、中间高度恢复率明显大于对照组,2组比较差异均有统计学意义(P<0.01)。结论中医正骨手法联合PVP治疗OTCFs可明显缓解患者疼痛,有效恢复病椎椎体高度及腰椎功能,改善脊柱侧弯,且操作简便、治疗费用相对较低,值得临床推广应用。
Objective To observe the clinical efficacy of osteoporotic thoracolumbar compression fractures( OTCFs) treated by TCM bone setting manipulation combined with percutaneous vertebroplasty( PVP). Methods From February 2017 to December 2019,a retrospective study was undertaken to analyze 128 cases of OTCFs admitted into Affiliated Hospital of Gansu University of Chinese Medicine,who were divided into treatment group with49 cases and control group with 79 cases according to the different therapeutic methods. The treatment group was given TCM bone setting manipulation combined with PVP therapy,while the control group was simply given PVP therapy. After surgery,the bone cement leakage rate,the restoration rate of diseased vertebral height,along with visual analogue scale( VAS) score,Oswestry dysfunction index( ODI),Cobb angle of diseased vertebrae and diseased vertebral height before and after surgery were compared between the 2 groups. Results There was no statistically significant difference in bone cement leakage rate between the 2 groups( P >0.05). After surgery,VAS score,ODI and Cobb angle of the diseased vertebrae of the 2 groups decreased significantly,and the difference was statistically significant than that in the same group before surgery( P<0.01),moreover,Cobb angle of the diseased vertebrae decreased more significantly in the treatment group,and the difference was statistically significant than that in the control group after surgery( P<0.01). After surgery,the anterior margin and middle height of the diseased vertebrae in the treatment group significantly increased,while the anterior margin height of the diseased vertebrae in the control group significantly increased,and the difference was statistically significant than that in the same group before surgery( P<0.01),moreover,the anterior margin and middle height of the diseased vertebrae in the treatment group was significantly greater than that in the control group,and the difference was statistically significant between the 2 groups after surgery( P<0.01). The restoration rate of the anterior margin and middle height of the diseased vertebrae in the treatment group was significantly greater than that of the control group,and the difference was statistically significant between the 2 groups( P <0.01). Conclusion It can markedly alleviate the pain,effectively restore the height of the diseased vertebrae and lumbar vertebrae function and alleviate the scoliosis to combine TCM bone setting manipulation with PVP in the treatment of OTCFs with simple operation and relative low treatment cost,which deserves clinical promotion and application.