| Objective:To discuss the relationship between the postoperative low back pain of osteoporotic vertebral fracture PKP and the disease of tendon.To explore the basis of anti-osteoporosis therapy and functional exercise,and to compare the efficacy of external acupotomy and external application of traditional Chinese medicine in the treatment of postoperative pain of vertebral fracture,providing ideas for early treatment and systematic treatment of postoperative pain of PKP.Methods:This study,which used random controlled study cases of source of 2017.12～2018.10 in the third affiliated hospital of Beijing university of chinese medical admission of osteoporosis vertebral fractures after PKP,hold 63 cases in low back pain,in strict accordance with the diagnostic criteria and meeting inclusion into groups,eliminating and excluding standard,having signed informed consent.Divided into two groups according to random number table method,the observation group were 32 cases and control group were 31 cases.Both in anti osteoporosis treatment with lumbar back muscle function exercise,the observation group used the needle knife therapy,while the control group treated with hot compress,to observed before and after treatment for 1 weeks after treatment and follow-up 1 month,2months of VAS score and JOA score index.Using Excel formed to input data and establish database.SPSS 19.0 statistical software was used for analysis.The therapeutic effects of the two groups were compared.Results:1.A total of 63 subjects with low back pain after PKP for osteoporosis vertebral fracture were included,including 15 males(23.8%of the total number)and 48 females(76.2%of the total number),with a male to female ratio of 5:16.The distribution of age group met the requirements of diagnostic criteria,including all the patients over 60 years old and postmenopausal women for 5-10 years,mainly distributed between 58-93 years old,with an average age of 77.29±8.24 years old.The duration,from injury to preoperative time,was 1-31 days,with an average duration of 14.53±12.09 days.There were 55 cases of single vertebral body fractures and 8 cases of 2 vertebral bodies or more fractures.The pain points in the two groups were distributed as spinous process,transverse process,articular process and lumbosacral.The basic data of the two groups were not statistically significant(P>0.05).2.According to the VAS score of the subjects,before treatment,there was no significant difference between the two groups,which was comparable(P>0.05).(2)Comparison between the two groups after treatment and during follow-up:The data of the two groups did not conform to the normal distribution by rank sum test.The results showed that there were significant differences between the two groups before and after treatment,which could be compared(P<0.05).This indicates that both treatments can effectively improve and maintain symptoms.(3)Comparisons between groups after treatment and during follow-up:The data of one week and two months after treatment were tested.The results showed that there was no significant difference between the two groups before and after treatment,and there was no comparability(P>0.05).However,one month after treatment,the data analysis showed that there was a significant difference between the two groups,with comparability(P<0.05).According to the median value and change trend of two groups of data in different time periods,the effect of needle knife treatment group on improving symptoms and maintaining is obviously better than that of traditional Chinese medicine external application group.3.According to the comparison of patients’JOA scores before and after treatment,(1)Before treatment:the results of the two groups showed that there was no significant difference between the subjects’ data before treatment,which was comparable(P>0.05).(2)After treatment and during follow-up,the data of the two groups before and after treatment had statistical significance(P<0.05).This shows that both groups of treatment can effectively improve and maintain lumbar spine function.The median of follow-up data showed that the total JOA score of the observation group increased and fluctuated significantly higher than that of the control group,which indicated that needle-knife therapy could effectively improve lumbar spine function.(3)After treatment and during follow-up,there was significant statistical difference between the two groups at 1 week after treatment(P<0.05).The results of follow-up showed that there was statistical significance and comparability between the JOA scores before and after treatment(P>0.05 in 1 month and 2 months after treatment).According to the median value of JOA score in different time periods,it can be found that the increase degree and fluctuation range of JOA total score in the observation group are higher than those in the control group,which indicates that acupotomology can better improve the function of the subjects in the follow-up period,which is better than the external application of traditional Chinese medicine.According to the data of clinical symptoms,signs and functional items in JOA score before and after treatment,(1)before treatment:there was no significant difference between each item of the two groups,with comparability(P>0.05).(2)Intragroup comparison after treatment and during follow-up:the results showed that there was a statistically significant difference in the data of each item before and after treatment between the two groups(P<0.05).This indicates that both groups of treatment can effectively improve their symptoms,signs and functions.(3)Intergroup comparison:in a short term,the results of the two groups showed that there was no significant difference in JOA scores before and after treatment,and there was no comparability(P>0.05).During the follow-up period,there was no significant difference in the results of physical signs and functional indicators(P>0.05).The results of clinical symptoms showed that there were significant differences in JOA scores before and after treatment(P<0.05).4.According to the efficacy evaluation results,the total effective rate before and after treatment was 100%in both the observation group and the treatment group.The results of 1 month after treatment showed that the apparent efficiency of 87.5%in the observation group was significantly higher than 83.87%in the control group.The improvement index before and after treatment showed significant difference between the two groups(P<0.05).The improvement index test results 1 month after treatment and 2 months after treatment showed no significant difference in efficacy between the two groups(P>0.05).The results indicated that the short-term effect of the two groups was significant,while the effect was not significantly improved during the follow-up period.5.All vital signs of subjects in the two groups were stable before and after treatment;No adverse reactions related to drugs or treatments were found in the two groups.Conclusion:1.Postoperative lower back pain of vertebral fracture belongs to the category of transfascial disease.2.Both acupotomy and external application of traditional Chinese medicine promoting blood circulation and dredging collaterals can effectively improve postoperative lower back pain of osteoporotic vertebral fracture.But the effect of acupotomology is more obvious and quick.3.Early diagnosis and treatment of postoperative pain of vertebral fracture,combined with anti-osteoporosis treatment,and auxiliary effective functional exercise can help reduce or eliminate pain,improve and maintain function,thus improving the quality of life.4.This study provides a new idea for early treatment and comprehensive and systematic treatment of postoperative low back pain of vertebral fracture treated with traditional Chinese medicine. |
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