| Objective:(1)To observe the clinical effect of Jiawei Bazhen Decoction combined with percutaneous vertebroplasty(pvp)in the treatment of elderly osteoporotic vertebral compression fractures.(2)To explore the application value of dialectical treatment of osteoporotic vertebral compression fractures in the elderly.Method:Eighty patients with OVCF were treated with PVP from December 2016 to December2018 in the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine.They were divided into treatment group and control group according to the order of visiting and random number table.Each group had 40 cases.The treatment group was treated with modified Bazhen Decoction+pvp,while the control group was treated with PVP alone.The experimental group began to take modified Bazhen Decoction,all of which were decocted with water.One dose per day,once in the morning and once in the evening,for 60 days.Continuous medication lasted until about 2 months after pvp.Visual analogue scale(vas)score,Oswestry dysfunction index,Cobb angle,anterior vertebral height ratio,bone mineral density and quality of life were observed and recorded on the 3rd,3rd and 6th month after pvp.Result:All operations were successfully completed.The treatment group consisted of 11 males and 29 females,with an average age of 86.54 + 1.71 years;the control group(pvp): 14 males and 26 females,with an average age of 85.93 + 1.12 years.In both groups,80 cases were injected with 3.1-8.1 ml of bone cement,with an average of 3.4x 1.lml.The operation time was 33-64 minutes for each responsible vertebra,with an average of 43.8.2 minutes.A small number of patients with bone cement leakage after operation did not affect the effect of surgery,and no nerve root symptoms were found.Vas score: after treatment,the VAS score of each observation point in the two groups was significantly lower than that before operation,and with the prolongation of time,the decrease of the treatment group was more obvious,the difference was statistically significant(p < 0.05).3 days after treatment,there was no significant difference between the treatment group and the control group(p > 0.05);3 months and 6 months after treatment,there was significant difference between the treatment group and the control group(p < 0.05).ODI score: There were significant differences in ODI score between the two groups at3 days,3 months and 6 months after treatment(p < 0.05).There was no significant difference in ODI score between the treatment group and the control group 3 days after treatment(p > 0.05).There was significant difference between the treatment group and the control group 3 months and 6 months after operation(p < 0.05).Bone mineral density: There was no significant difference between the two groups at3 days after treatment and before operation(p > 0.05);there was significant difference between the two groups at 3 months after operation and before operation(p < 0.05);there was significant difference between the treatment group and the control group at6 months after operation(p < 0.05).Imaging indicators: There was no significant difference in the ratio of anterior vertebral height and Cobb angle between the two groups before operation(p > 0.05),which was comparable.Three days,three months and six months after treatment,the height ratio and Cobb angle of the compressed vertebral front in the two groups were significantly improved compared with those before operation(p < 0.05),with statistical difference;but three days,three months and six months after treatment,the height ratio of the compressed vertebral front in the treatment group and the Cobb angle in the control group had no significant difference(p > 0.05).Clinical efficacy: compared with the control group,the treatment group was significantly better than the control group(p < 0.05).A kind of Quality of life score: Compared with pre-operative quality of life score 6 months after operation,the effect of treatment group was more significant than that of control group,and there was a significant improvement in material life status and physical function compared with pre-operative score(p < 0.05).Conclusion:Jiawei Bazhen Decoction has certain effect on restoring bone mineral density,promoting fracture healing and delaying high loss of responsible vertebra in elderly OVCF patients with deficiency of Qi and blood.However,it plays a more obvious role in improving motor dysfunction,relieving lumbar pain,reducing the incidence of vertebral re-fracture after operation and improving the quality of life.It is worthy of further promotion and application in clinic.Chinese style... |
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