| Objective:Osteoporosis is one of the common complications of spinal cord injury patients.It easily lead to pathological fracture, and there is lack of efficacy for better prevention and control measures. By observing the changes in bone mineral density and bone metabolism related indicators,this study is to evaluate the clinical curative effect and discuss the mechanism of action of ambulation training preventing and treating osteoporosis after spinal cord injury.Methods:Using randomized controlled single-blinding methods,34patients included in the standard of the subject were randomly divided into treatment group and control group,17cases in each group and a total of3cases of loss. Actually, there are16cases of the treatment group and the control group15cases included. Two groups were both performed with routine rehabilitation training, moxibustion and drugs treatment. Based on these, the treatment group were with ambulation training. The two groups were treated one times a day,10days for a period of treatment and a total of six courses.Lumbar spine and femoral BMD, respectively tartrate resistant acid phosphatase5b (TRACP5b), bone alkaline phosphatase (BALP),2525-hydroxyitamin D [25(OH) D], blood calcium, blood phosphorus and alkaline phosphatase (ALP) were detected before treatment,1month and2months treatment. The data of two groups before and after treatment and its percentage change were statistically analysed.Results:1.Compared between the two groups, L4vertebral body (L4), L1-L4vertebral body (L1-L4), femoral, femoral neck and femoral bone mineral density of the two groups were compared at the same time point, there was no statistically significant difference (P>0.05); Compared within the group, the femoral neck and femoral bone density of the control group is decreased obviously before and after2months of treatment(P<0.05),and the mean of the femoral neck and femoral bone density of the treatment group droped, but no statistical significance (P>0.05). Changes in the L4, L1-L4and the femoral bone mineral density of the two groups were not statistically significant (P>0.05).From the perspective of the percentage change of bone mineral density before and after the treatment, the difference of femoral neck and femoral bone mineral density percentage change of the two groups was statistically significant (P<0.05), and the control group was significantly less than the treatment group (According to the calculation formula of this paper shows that the closer the percentage change is to100,the smaller the variation is.Less than100shows that the BMD of after treatment is less than that of before treatment,and more than100shows that the BMD of after treatment is more than that of before treatment), namely the extent of decline was more obvious. The percentage changes of L4, L1-L4and the femoral bone mineral density of the two groups had no statistically significant difference (P>0.05).2. Compared between groups, the TRACP5b of the control group after2months of treatment was significantly higher (P<0.05), BALP and25(OH) D compared no differences between the two groups (P>0.05); Compared in the group, that is, compared with before treatment, the TRACP5b of the control group after2months of treatment increased significantly (P<0.05), and that of the treatment group was no significant change (P>0.05), but the mean declined slightly,and the TRACP5b of the two groups were higher than normal in each time point; Compared within the group, the BALP and25(OH) D of two groups were no difference(P>0.05), and the average at each time point was in the normal range. From a percentage change before and after2months of the treatment to analyze, the percentage change of TRACP5b of the control group (139.98%) was significantly greater than the treatment group (97.12%), the percentage change of the BALP and25(OH) D in the two groups has no difference (P>0.05).3.The blood calcium,blood phosphorus and ALP whether between the two groups or within the group in comparison were no differences before and after treatment(P>0.05), and the average at each time point was in the normal range.Conclusion:Ambulation training can reduce the extent of the decline in femoral neck and femoral bone mineral density of the patients with spinal cord injury. Ambulation training can inhibit the increasing of TRACP5b of patients with spinal cord injury, namely the inhibition of bone resorption.On the lumbar spine and femoral bone mineral density BALP,25(OH) D blood, blood calcium, phosphorus and ALP in patients with spinal cord injury,the influence of ambulation training is not obvious. Ambulation training, therefore, to prevent and treat of secondary OP caused by SCI have clinical curative effect,but have different influences to different bone below injury level, and its mechanism is probably related to inhibition of bone resorption. |
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