| Objective: This project collects basic data of patients with 0steitis condensans ilii(OCI),analyzes the risk factors that affect the occurrence and development of OCI disease,and provides reference for further in-depth research on the pathogenesis of OCI and disease prevention;At the same time,we observed the clinical efficacy of Shujinhuoluo lotion combined with Diclofenac sodium in the treatment of symptomatic OCI,analyzed its effectiveness and safety,in order to provide a new research idea for the in-depth exploration of clinical diagnosis and treatment of OCI.Methods: 70 OCI patients with clinical symptoms who met the inclusion criteria and were admitted to the Spinal Orthopedics Department of Gansu Provincial Hospital of Traditional Chinese Medicine from March 2021 to November 2022 were selected.The general information of the patients,including age,gender,body mass index(BMI),number of female patients giving birth,and mode of production,as well as the depth of CT sclerosis at the time of the visit,were recorded.The correlation between the onset and severity of the disease(CT sclerosis depth)of OCI patients and the general information of the patients was analyzed using analysis software,Further analyze the risk factors that affect the occurrence and development of the disease;At the same time,7 0 patients were randomly divided into the control group and the treatment group,with 3 5 cases in each group.The treatment group was given Shujinhuoluo lotion combined with Diclofenac sodium sustained-release capsule orally,while the control group was given only Diclofenac sodium sustained-release capsule orally.Both groups were given medication for 3 weeks,and follow-up was conducted 3 months after the end of treatment.By analyzing and comparing the imaging indicators(CT sclerosis depth,bone marrow edema(BME)on MRI)before and three months after treatment,as well as the clinical symptom indicators(including VAS score,JOA score,and sitting forward flexion test value)before,after1 week,2 weeks,3 weeks,and 3 months of treatment,the therapeutic effects of the two treatment regimens were compared.The obtained data was statistically analyzed using SPSS25.0,and the P<0.05 difference was statistically significant.Results:1.Risk factors affecting onset: Among the total number of patients included in the study,the proportion of women(92.86%)is much higher than that of men(7.14%);Among female patients,the proportion of postpartum women(90.77%)is much higher than that of non postpartum women(9.2 3 %);Among the multiparous women,the proportion of women who delivered naturally(8 9.8 3 %)was much higher than that of women who delivered Caesarean section(10.17%).There was no significant difference between male and female patients in terms of age and CT hardening depth(P>0.05).2.Risk factors that affect the severity of the disease: Overall,the average value of CT sclerosis depth on the right side is larger than that on the left side,and the difference is statistically significant(P<0.05);The correlation between CT depth of sclerosis and BMI was statistically significant(P<0.001),with Rs=0.456>0,and the linear regression relationship between the two was statistically significant(B=0.647,P<0.05).The correlation analysis and multiple linear regression analysis between CT depth of sclerosis,age,and gender were not statistically significant(P>0.05);For female patients,the correlation between CT sclerosis depth,BMI,and number of births was statistically significant(BMI: P<0.001,Rs=0.452>0;number of births: P<0.001,Rs=0.479),and the linear regression analysis between CT sclerosis depth,BMI,and number of births was statistically significant(BMI: B=0.375,P<0.05;number of births: B= 1.550,P<0.001),The correlation between CT sclerosis depth and age was not statistically significant(P>0.0 5),while linear regression analysis between CT sclerosis depth and age was statistically significant(B=-0.122,P<0.001).3.There was no significant difference(P>0.05)between the control group and the treatment group in terms of baseline data such as age,gender,preoperative imaging examination(CT sclerosis depth,BME),and clinical symptoms(VAS score,JOA score,and sitting forward flexion test value),and the two groups were comparable.4.Comparison of imaging indicators(BME,CT sclerosis depth): Inter group comparison:After treatment,the BME of the treatment group was smaller than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in CT sclerosis depth between the two groups of patients after treatment(P>0.05);Intragroup comparison: BME after treatment in both groups was lower than before treatment,and the difference was statistically significant(P<0.001).The difference in CT sclerosis depth between the two groups of patients before and after treatment was not statistically significant(P>0.05).5.Pain score comparison: Inter group comparison: The VAS scores of the treatment group were lower than those of the control group after 1 week,2 weeks,and 3 months of treatment,and the difference was statistically significant(P<0.05).After 3 weeks of treatment,the difference in VAS scores between the two groups was not statistically significant(P> 0.0 5);Intragroup comparison: During the medication period(within 3 weeks of treatment),as the treatment progressed,the VAS scores of the two groups of patients after each course of treatment decreased compared to before,and the difference was statistically significant(P<0.001).The follow-up results after 3 months of treatment showed that the VAS scores of the control group increased compared to the end of treatment,and the difference was statistically significant(P<0.001),The VAS score of the treatment group showed no statistically significant difference compared to the end of medication(P>0.05).6.Comparison of functional impairment indicators(JOA score,sitting forward flexion test value): Inter group comparison: The JOA score and sitting forward flexion test value of the treatment group were higher than those of the control group after 1 week,2 weeks,3 weeks,and 3 months of treatment,and the difference was statistically significant(P<0.05);Intragroup comparison: During the medication period(within 3 weeks of treatment),as the treatment progressed,the JOA score and sitting forward flexion test values of the two groups of patients after each treatment course increased compared to before,and the difference was statistically significant(P<0.001).The follow-up results after 3 months of treatment showed that the JOA score and sitting forward flexion test values of the control group decreased compared to the end of medication,and the difference was statistically significant(P<0.001),There was no statistically significant difference in the JOA score and sitting forward flexion test values between the treatment group and the end of medication(P>0.05).7.Comparison of total efficacy: Both groups of treatment were effective,and the cure rate and effective rate of the treatment group were higher than those of the control group,with a statistically significant difference(P<0.001).Conclusions:1.Gender,whether women give birth or not and the mode of production are the risk factors affecting the incidence of OCI.The incidence rate of women is higher than that of men,the incidence rate of women who have given birth is higher than that of women who have not given birth,and the incidence rate of natural birth is higher than that of Caesarean section;Left and right side differences and BMI are risk factors that affect the severity of all patients’ conditions.Generally,the condition on the right side is more severe than that on the left side.The larger the BMI index,the more severe the patient’s condition is.Age and number of births are risk factors that affect the severity of female patients’ condition.In a comprehensive environment,the older the age,the milder the severity of OCI,and the more women give birth,the more severe the condition of OCI patients.2.Both Shujinhuoluo Lotion combined with Diclofenac sodium and Diclofenac sodium alone are effective in the treatment of OCI.The combination of drugs is superior to the simple oral western medicine in terms of reducing bone marrow edema and improving dysfunction in patients with OCI,as well as the long-term efficacy after drug withdrawal.In the short term,the effect of the combination of drugs on improving pain is better than that of the simple oral western medicine.With the prolongation of the medication cycle,the effect of the two treatment methods on improving pain tends to be the same,But neither treatment method can change the depth of CT sclerosis in OCI patients. |
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