摘要
目的通过观察补肾壮骨丸在初次椎体成形术后患者中的使用,探讨其防治骨质疏松性椎体骨折术后伤椎再塌陷的临床疗效及用药安全性。方法采用单中心前瞻性队列研究,将在我科住院的、初次行椎体成形术的120例患者,依据患者接受不同治疗方案分为对照组(A组,n=60)与实验组(B组,n=60)。对照组术后予以碳酸钙D3片、骨化三醇胶囊、阿伦膦酸钠抗骨质疏松治疗;实验组在对照组的基础上联合补肾壮骨丸治疗。两组均连续治疗6个月,6个月后均采用正常抗骨质疏松方法序贯治疗。治疗后通过放射影像系统观察0、6、12个月后伤椎高度的变化;分别采集0个月、6个月、12个月外周静脉血7 mL,检测Ⅰ型原胶原N-端前肽、Ⅰ型胶原交联C-末端肽的含量以及炎症因子白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平。结果120例患者有117例患者完成最终随访,3例患者由于再次手术、自身原因等失去随访。(1)实验组延缓伤椎术后再塌陷的效果优于对照组;(2)补肾壮骨丸联合常规预防骨质疏松治疗可延缓伤椎术后再塌陷的机制可能是通过激活因子IL-6、TNF-α等炎症因子来抑制破骨细胞的形成,最终达到延缓伤椎术后再塌陷的目的。结论补肾壮骨丸防治初次椎体成形术后伤椎再塌陷的临床疗效显著,且用药安全、依从性好。
Objective To study the effect of Bushen Zhuanggu Pill in patients with osteoporotic vertebral compression fractures treated with primary vertebroplasty and explore its clinical efficacy and safety in preventing the recollapses of cemented vertebrae.Methods A total of 120 patients hospitalized for primary percutaneous augmentation in our department,were assigned into control group(Group A,n=60)and experiment group(Group B,n=60)based on different treatment options.The former was treated with calcium carbonate D3 tablets,calcitriol capsules,and alendronate to prevent osteoporosis after the operation and the latter with Bushen Zhuanggu pills on the basis of treatment for the control group.Both groups were treated continuously for 6 months,followed by sequential treatment for osteoporosis prevention for another 6 months.Radiographic images in the osteolysis zone around the femoral prosthesis were adjudicated concerning the changes in the height of wounded vertebrae at 0,6 and 12 months after treatment.A total of 7 mL of venous blood was collected from each participant at 0,6 and 12 months after treatment for detections of the levels of osteocalcin,β-C-terminal telopeptide of type I collagen,N-terminal propeptide of type I collagen,inflammatory factors interleukin-6(IL-6),C-reactive protein(CRP)and tumor necrosis factor-a(TNF-α).Results Totally,117 of the 120 patients completed the follow-ups,and 3 missed the follow-ups due to reoperation or unknown reasons.The experimental group was better than the control group in delaying the recollapse of cemented vertebrae.Bushen Zhuanggu Pills combined with calcium carbonate D3 tablets,calcitriol capsules,and alendronate to prevent osteoporosis delayed the recollapse of cemented vertebrae after primary percutaneous augmentation for the inhibition mechanism on the formation of osteoclasts by way of activating inflammatory factors such as IL-6,CRP,TNF-αand ultimately delaying the recollapse of cemented vertebrae.Conclusion Bushen Zhuanggu Pill has a good clinical effect in preventing the recollapse of cemented vertebrae after primary percutaneous augmentation in patients with osteoporotic vertebral compression fractures.
作者
吴钒
吴华珍
黄志辉
周大标
叶旭豪
李志钢
WU Fan;WU Huazhen;HUANG Zhihui;ZHOU Dabiao;YE Xuhao;LI Zhigang(Guangzhou University of Chinese Medicine,Guangzhou 510405,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2022年第1期111-115,共5页
The Journal of Practical Medicine
基金
湖北省卫生健康委中医类面上项目(编号:ZY2021M034)。
关键词
补肾壮骨丸
椎体成形术
椎体再塌陷
前瞻性队列研究
Bushen Zhuanggu Pill
percutaneous augmentation
recollapse of cemented vertebrae
prospective cohort study
