| Objective:This trial used Zengye Chengqi Decoction,Senna Leaf Tea Drink,and acupuncture to treat elderly patients with thoracolumbar compression fractures complicated by constipation.To observe and compare the time of first defecation,clinical symptoms and signs before and after treatment in each group.Points,VAS pain score,lumbar JOA score changes and effective rate.Analyze and compare the curative effect and difference of the three kinds of Tongfu methods for the treatment of constipation due to thoracolumbar compression fractures in the elderly,as well as the relief of pain and the improvement of thoracolumbar function in such patients.It is hoped that this study will provide a theoretical basis for the application of the Tongfu method in the treatment of thoracolumbar compression fractures in the elderly,and promote the application and promotion of the Tongfu method in clinical practice.Method:A total of 66 elderly patients with thoracolumbar compression fractures and constipation who were hospitalized from September 2019 to December 2020 in the Department of Orthopedics,Jiangsu Provincial Hospital of Traditional Chinese Medicine were selected.According to the principle of randomized parallel control,the eligible cases were randomly divided into group A,group B,and group C.All patients in the three groups have not undergone surgical treatment.Patients in group A were treated with Zengye Chengqi Decoction;patients in group B were treated with senna leaf instead of tea;patients in group C were treated with acupuncture and moxibustion.The scores of TCM syndrome,VAS pain score,lumbar JOA score,and the first laxative time before and after treatment were recorded for the three groups.The recorded data will be statistically analyzed.Results:There were 22 people in each of the three groups,including 1 case in group A,2 cases in group B,2 cases in group C,and 61 cases in actual sample size.Before treatment,the age,gender,clinical symptoms and signs scores of the three groups of patients were statistically compared within and between groups,and there was no significant difference(P>0.05),and they were comparable.The comparison of curative effect after 2 days of treatment is as follows:(1)The changes in the scores of clinical symptoms and signs of constipation in each group before and after treatment are as follows:the average score difference of group A is 16.95±2.80,the average score difference of group B is 13.50±3.78,and the score difference of group C is The mean value was 15.10±2.86.The scores of clinical symptoms and signs before and after treatment in the three groups changed significantly(P<0.05);it can be seen that the three groups of treatment can effectively improve the patient’s constipation status.In addition,the changes in VAS score and lumbar JOA score before and after treatment in each group were significantly different(P<0.05),indicating that the three groups of treatment can effectively alleviate and improve the pain caused by fractures and the functional changes of lumbar spine.(2)First defecation time:group A 5.12±1.24h,group B 3.08±0.78h,group C 3.70±0.77h,after statistical analysis,the first defecation time of the three groups was statistically significant(P<0.05),and two more The comparison between the two shows that there is a statistically significant difference between the A group and the B and C groups(P<0.05),but there is no significant difference between the B and C groups(P>0.05),indicating that the senna leaf tea and acupuncture treatment It is more effective than Zengye Chengqi Decoction in accelerating the time of first bowel movement.(3)Differences in the scores of clinical symptoms and signs before and after treatment:the average scores of the three groups of patients were:16.95±2.80 in group A,10.08±3.78 in group B,and 13.20±2.86 in group C.After statistical analysis,the difference between the three groups was statistically significant(P<0.05),and further pairwise comparisons found that each group was also significantly different from each other,and the difference was statistically significant(P<0.05).It shows that the three treatments have the best effect in improving the clinical symptoms and physical signs of constipation,followed by acupuncture and moxibustion,and senna leaf substitute tea is less effective than the former two.(4)VAS score:The mean value of the difference in VAS scores before and after treatment in each group was:1.67±0.73 in group A;1.50±0.69 in group B;1.90±0.85 in group C,P=0.25>0.05,the difference was not statistically significant,indicating that the three groups were treated There was no significant difference in alleviating the pain symptoms of patients.(5)Lumbar JOA score:The mean difference of lumbar JOA scores before and after treatment in each group was:4.43±1.63 in group A;1.75±1.02 in group B;3.95±1.64 in group C,P<0.001.The difference between the three groups was significant after statistical analysis.Further pairwise comparisons showed that:Compared with group B,the difference between the two groups A and C,the P value was less than 0.05,and the difference between the two groups A and C,the P value greater than 0.05 was not statistically significant.It shows that in terms of improving the patient’s lumbar spine function,the therapeutic effects of the two groups A and C are better,the group B is not as good as the other two groups,and there is no significant difference in the therapeutic effect between the two groups A and C.(6)Effective rate:The effective rates of the three groups are;95.24%in group A,75.00%in group B,and 90.00%in group C.After statistical analysis,the difference between the three groups is significant(P<0.05).There were significant differences between the groups,and there was statistical significance(P<0.05).It shows that in terms of total effective rate,Zengye Chengqi Decoction has the highest effective rate,followed by acupuncture and moxibustion treatment,and the effective rate of senna leaf instead of tea is relatively low.Conclusion:The Tongfu method can effectively improve the symptoms of constipation due to thoracolumbar compression fractures in the elderly.In terms of shortening the first defecation time,senna leaf tea and acupuncture are more effective in the treatment;the improvement of constipation symptoms and the effective rate,increase fluid Chengqi Decoction works best.In addition,the study also found that the Tongfu method has a positive and effective effect in relieving and improving lumbar spine pain and functional damage caused by fractures. |
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