The Clinical Research For Osteoporotic Vertebral Compression Fracture Of Combinaton Of TCM With Western Medicine

Background: At presnt, about 2 billion persons have osteoporosis all the world,and the incidence is the seventh among common diseases worldwide. In European, onefracture happens every second because of osteoporosis, and In America, this number isone and a half million every year. Among all the osteoporosis, vertebral compressionfractures (VCF) are the most common, showing pain, collapsing of vertebral body,kyphotic deformity, which can influence the quality of live, activity, phychologichealthy and length of life seriorsly, and to be paled close attention more and more.Now the therapy for VCF must be improved. Traditional ways including complete bedrest, analgesic drug, orthosis, anti-osteoporotic drug and so on, are hard to sufferfor the elderly, although without perfect effects. Complications occur easily, such ashypostatic pneumonia, uninary tract infection phlebothrom of lower limb, and then thestimulation of pain also aggravates affection of the heart and lung. At the mean time,operation is limited by the difficulty of internal fixation and the bad effect of fussion.The danger of adjacent vertebral body fracture recur rises 5～25times. What a enormousharm for family and society.The key to the treatment should be to relieve pain quickly and do functionalexercises at the early period to prevent the complication of long-term bed rest. So,the minimally invasive therapy for VCF(vertebroplasty, kyphoplasty) coming, resolve thetraditional treatmeat's disadvantage properly. But this single treatment has no wayto resolve associated symptoms surround operation, such as abdominal distention,constipation. But expectant of TCM can do at above aspects.This reasearch combinates of minninnally invasive therapy with expectant treatmentof VCF, and TCM will play more important part in new teachnique's application.Purpose: By comparing the effort of expectant treatment and combination of TCM withwestern medicine, to assess the advantage of the combination. The influence and correlation of vertebral body height, kyphosis cobb angles and pain with differentthreapy. To evaluate the effect of associated symptom with TCM treatments.Materials and Methods: analysising 80 patients of VCF with combined therapy from2002.3 to 2006.5, to assess general character and overview of expectant treatment VCFin our hospital retrospectively. 78 patients were devided into two groups, coming from2005.5 to2006.6, one called combination of TCM with western medicine, using kyphoplasty,another called traditonal way, and the other therapy same to each other. Kaphoplasty wasperformed on a total 40 levels in 41 patients and vertebroplasty on 20 levels in 17 patientsand 20 patients accepted traditional treatment. Pain relief was measured at two week, sixmonths and eighteen months post procedure; vertebral body height restoration and kyphosiscorrection of the treated level were measured on per-and post procedure and followingup radiographs; The groups using the traditional chinese medicine, the traditionalchinese medicine added paving unbbicus and abdomen accpunture, the tradintional chinesemedicine added coloclysis.Result:The operations were performed an a total of 66levels in 58 patients, the meantime was 45min, no complication and insertion volume of bone cement from 2.5 to 6.5ml, mean3.3ml, with good distribution of bone cement. Pain relief using VAS was measersd at twoweeks post procedure, pre-operation VAS 8.6 and post-operation 1.2, remarkablesignificance(P＜0.01). all of them having improvement in 6-36h. In traditional group, painwas also relieved after 1 month, but comparing the anther one, remarkablesignificance(P＜0.01),the complication about 15%. The traditional chinese medicine addedpaving unbbicus and abdomen accpunture group, abdominal distention relieved in 2.8±0.58 days, comparing 4.2±0.9,3.8±0.89, remarkable significance(P＜0.01). On vertebralbody height restoration and kyphosis correction, PKP group better than PVP and traditionalgroups, remarkable significance(P＜0.01),this advantage also exits in the following upperiods. In PKP, correlation of vertebral body height, kyphosis cobb angles with pain isnot exits, but correlation of distribution of bone cement in CT andpain, Person=-0.321(p=0.029), remarkable significance;not exiting in PVP group.Conclusions:Combinaton of TCM with western medicine can relieve painquikly, advoiding long-term bed rest, having remarkable advansement. The traditionalchinese medicine added paving unbbicus and abdomen accpunture can resolve associatedsymptoms surround operation perfectly. PKP group are better than PVPgroup and traditionalgroups on vertebral body height restoration and kyphosis correction, and can not beinfluenced by manipulation. There is a significant correlation of distribution of bonecement in CT and pain relief postoperationly.