Effect Of Youguiwan On Adjacent Vertebral Refracture After Operation Of Osteoporotic Vertebral Compression Fracture Of Kidney-Yang Deficiency Type

Objective:The purpose of this study was to observe the effects of Youguiwan decoction on the prevention of Osteoporosis vertebral compression fracture（OVCF）caused by kidney-Yang deficiency and Percutaneous vertebroplasty（PVP）Clinical effect of postoperative adjacent vertebral refracture.Methods:A total of 80 patients with OVCF of single vertebra(T₁₀-L₂)who were treated in the Second Department of Orthopedics of our hospital from April 2022 to September 2022 were selected and divided into a control group and an experimental group by the random number table method,with 40 cases in each group.All the research objects were performed PVP by the same group of doctors.The control group after surgery to calcitriol capsule 0.25ug/bid and calcium carbonate D3 tablets 600mg/bid;The experimental group was treated with Youguiwan decoction after meals on the basis of the control group.The duration of medication in the two groups was three months,continue to follow-up after three months.The bone mineral density,three bone turnover markers,quantitative score of TCM syndrome type,adjacent vertebral refracture,and Low back pain visual analogue scale were recorded and analyzed.SPSS23.0 software was used to analyze the data.Results:（1）Comparison of basic information:There was no statistical significance in demographic characteristics,observation indicators and other baseline values between the two groups（P>0.05）,indicating that the two groups were comparable.（2）Comparison of bone mineral density:During the observation period,the level of bone mineral density in both groups was improved compared with that before treatment.However,there was no statistical significance compared with before treatment（P>0.05）,and there was no statistical significance between the two groups（P>0.05）.（3）Three comparison of bone turnover markers:During the observation period,the contents of bone formation indexes amino-terminal propeptide of type I procollagen and osteocalcin were increased,while the content of bone resorption indexes serum cross-linked C-terminal telopeptide of type I collagen was decreased in the two groups,and the differences between the two groups before and after medication were statistically significant（P<0.05）.（4）Comparison of TCM syndrome type quantization score between the two groups:During the observation period,the symptoms of kidney-Yang deficiency in both groups were improved,the difference was statistically significant（P<0.05）,and the improvement effect of the experimental group was more obvious than that of the control group,the difference was statistically significant（P<0.05）;The total effective rate of 89.2%in experimental group was significantly higher than 42.1%in control group,the difference was statistically significant（P<0.05）.（5）Comparison of adjacent vertebral refracture between the two groups:During the observation period,the incidence of adjacent vertebral refracture in the control group was21.05%,and that in the experimental group was 2.70%,the difference between the two groups was statistically significant（P<0.05）.（6）Comparison of low back pain visual analogue scale between the two groups:During the observation period,As time went by,the low back pain visual analogue scale between the two groups decreased gradually,and there were statistically significant differences between the two groups at 1week,3months and 6months after medication（P<0.05）;After 1week of medication,the pain relief degree of the two groups was basically the same,and there was no statistical significance between the two groups（P>0.05）.After3months and 6months of medication,there was statistical significance between the two groups（P<0.05）,and the score of the test group was lower than that of the control group.Conclusions:Youguiwan can regulate bone metabolism,promote bone formation,inhibit bone absorption,improve the clinical symptoms of patients with kidney-Yang deficiency,relieve pain,and reduce the incidence of adjacent vertebral refracture after PVP surgery.Therefore,youguiwan is of great significance in treating secondary adjacent vertebral refracture after PVP in patients with kidney-Yang deficiency OVCF.