| Objectives:By analyzing and comparing the observation indexes of the subjects before and after treatment at each follow-up time,we evaluated the efficacy of bushenhuoxue decoction combined with alendronate sodium vitamin D3 tablets in patients after posterior lumbar fusion with bone loss,and provided a basis for further research and clinical application.Methods:Forty-four cases were included in this study,and the subjects were randomly divided into 22 cases each in the treatment and control groups by the numerical table randomization method.The control group was given oral calcium carbonate vitamin D3 tablets and alendronate sodium vitamin D3 tablets after PLIF,and the treatment group was given oral calcium carbonate vitamin D3 tablets,alendronate sodium vitamin D3 tablets and bushenhuoxue decoction for 3 months and 6 months after PLIF.The patients’ VAS scores were recorded before treatment,on postoperative day 2,3 months after treatment,and 6 months after treatment.The patients’ modified ODI scores,bone alkaline phosphatase(BALP),osteocalcin(BGP),and type I procollagen amino-terminal peptide(PINP)were recorded before treatment,3 months after treatment,and 6 months after treatment.The patients’ pre-and post-treatment Bone density was measured before and 6 months after treatment.Statistical analysis was performed using the statistical software SPSS25.0 to evaluate the clinical efficacy.Results:1.Comparison of general conditions of subjects in the two groups.Statistical comparison between the treatment group and the control group in terms of patient age,gender,and operated segments(number of vertebrae)showed no statistically significant differences(P>0.05),and the two groups were comparable at baseline.2.Comparison of VAS scores at each follow-up time after treatment between the two groups.Intra-group comparison between the two groups:the VAS scores of patients in both groups decreased significantly(P<0.05)at each follow-up time after treatment compared with those before treatment,and the VAS scores of both groups decreased significantly(P<0.05)at 3 months after treatment and 6 months after treatment compared with those at 2 days after surgery,and the VAS scores of both groups had a significant decrease(P<0.05)at 6 months after treatment compared with those at 3 months after treatment.There was no statistical difference in VAS scores between the two groups before treatment,on the second postoperative day and 3 months after treatment(P>0.05),and the difference was statistically significant(P<0.05)in the treatment group compared with the control group at 6 months after treatment,with better improvement in pain symptoms in the treatment group.3.Comparison of improved ODI scores at each follow-up time after treatment between the two groups of patients.Intra-group comparison between the two groups:the modified ODI scores of patients in both groups improved significantly at 3 months after treatment and 6 months after treatment compared with those before treatment(P<0.05),and the modified ODI scores of both groups decreased significantly at 6 months after treatment compared with those at 3 months after treatment(P<0.05).Comparison between the two groups:The modified ODI scores at 3 and 6 months after treatment in the treatment group were significantly lower than the ODI scores at the same follow-up time points in the control group(P<0.05),with better recovery of low back function in the treatment group.4.Comparison of bone mineral density between the two groups of patients at each follow-up time after treatment.Intra-group comparison between the two groups:Both groups of subjects showed a significant increase in BMD at the 6-month follow-up compared to the pre-treatment period(P<0.05).Inter-group comparison between the two groups:There was a significant increase in BMD levels in the treatment group compared to the control group at the 6-month follow-up(P<0.05).5.Comparison of BALP for each follow-up time after treatment between the two groups.Intra-group comparison between the two groups:there was no significant difference in BALP levels at 3 months after treatment and 6 months after treatment in the control group compared with that before treatment(P>0.05),and there was no significant difference in BALP levels at 6 months after treatment in the control group compared with that at 3 months after treatment(P>0.05).There was no significant difference in BALP levels in the treatment group at 3 months after treatment compared with that before treatment(P>0.05),and there was significant improvement in BALP levels in the treatment group at 6 months after treatment compared with that before treatment and at 3 months after treatment(P<0.05).Comparison between the two groups:BALP levels were significantly improved in the treatment group at 3 and 6 months after treatment compared with the control group at the same time points(P<0.05).6.Comparison of BGP at each follow-up time after treatment between the two groups.Intra-group comparison between the two groups:the BGP level at 3 months after treatment in the control group showed no significant change compared with that before treatment(P>0.05),and the BGP level at 6 months after treatment in the control group showed significant improvement compared with that before treatment and 3 months after treatment,and the difference was statistically significant(P<0.05).The BGP levels in the treatment group showed an increase at 3 months and 6 months after treatment compared with those before treatment(P<0.05),and the BGP levels in the treatment group showed a significant increase at 6 months after treatment compared with those at 3 months after treatment(P<0.05).Comparison between the two groups:BGP levels were significantly higher in the treatment group at 3 and 6 months after treatment compared with the control group at the same time points(P<0.05),and bone formation was more active in the treatment group.7.Comparison of PINP at each follow-up time after treatment between the two groups.Intra-group comparison between the two groups:there was no significant difference in PINP water at 3 months after treatment compared with pre-treatment in both groups(P>0.05),and the level of PINP at 6 months after treatment was significantly higher in both groups compared with pre-treatment and 3 months after treatment(P<0.05).Comparison between the two groups:There was no significant difference in PINP between the treatment group and the control group at 3 months after treatment(P>0.05),and the level of PINP was significantly higher in the treatment group than in the control group at 6 months after treatment(P<0.05).It showed that more collagen synthesized in the bone and higher osteoblast activity in the treatment group.Conclusion:The combination of bushenhuoxue decoction and alendronate sodium vitamin D3 tablets has significant efficacy on clinical symptoms and lumbar back function of patients after postoperative lumbar spine fusion with bone loss,and improved their quality of life.It can also improve patients’ bone transition status,promote bone formation and increase bone density,which is worthy of clinical promotion and further investigation. |
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