Qiguijiangu Decoction With Percutaneous Vertebral Plasty With Functional Exercise In The Treatment Of Osteoporosis Vertebral Compression Fractures Of The Clinical Observation

ObjectiveExplore qigui jiangu decoction with percutaneous vertebral plasty (PVP) and functional exercise in the treatment of osteoporosis vertebral compression fractures (OVCF) clinical curative effect.MethodsAdopt prospective study, At2012.3-2013.09collection qingyuan city hospital90cases of hospitalized patients with OVCF, Randomly divided into3groups:Group A (PVP)30cases; Group B (PVP+qiguijianggu decoction+lumbar pad); Group C (PVP+qiguijiangu decoction+lumbar pad+functional exercise)30cases. All of the patients have obvious low back pain and injury history, medical history collection, body in check, X-ray, CT, MRI and bone mineral density detection, diagnosis of OVCF, without the spinal cord and nerve root injury, vertebral body wall after complete, no sedation placeholder. All patients were pain score (VAS) vision, central measuring calculation fanterior edge and high compression rate, Cobb Angle measurement, bone mineral density measurement, the final overall curative effect assessment.Results1. Three groups of patients with postoperative pain symptoms ease or disappear in24hours, PVP analgesic effect is significant (P<0.05). On the third day after three groups of patients with pain VAS score is not seen obvious difference (P>0.05),3months and6months after the waist pain, weakness, fatigue symptoms obviously (P all<0.05), are all group C> group B> group A,6months postoperative VAS scores compared with on admission, group A was significantly higher after3days (P<0.05), B and C group slightly higher than the postoperative3days (P>0.05), no statistical significance, That PVP+qiguijiangu decoction can relieve the waist pain symptoms for a long time, and functional exercise effect is better, and pure PVP effect is relatively poor.2. on admission,3days after operation, postoperative3months,6months after routine thoracic or lumbar positive side X-ray review, and to measure calculation injured vertebral front high compression ratio.(1)Anterior wall injury vertebral compression ratio comparison:after3days, compared with that on admission when they hurt slightly better than group A (P<0.05), on admission is obviously better than the B and C group (P<0.05); On the third day after anterior wall three groups of patients with vertebral compression rate, B and C group was better than group A (P<0.05), no obvious difference between B and C (P>0.05); After6months follow-up group A vertebral anterior wall compression ratio significantly worse in3days postoperatively (P<0.05), B and C group no significant different (P>0.05). Prompt PVP can restore responsibility vertebral height of front, combined with lumbar pad better effect, pure PVP cannot keep fanterior flange height for a long time, postoperative PVP decoction qiguijiangu decoction can be sustained and effective fanterior flange height.(2) By central vertebral compression injury rate comparison:after3day compared with on admission, slightly better than group A (P>0.05) on admission, no statistical significance, on admission is obviously better than the B and C group (P<0.05); For the third day, three group of patients after injury in central vertebral compression ratio, B and C group is superior to group A (P<0.05), no obvious difference between B and C (P>0.05); Postoperative3,6months follow-up3central group of injured vertebral compression rate and postoperative3days have no obvious difference (P>0.05). Pure PVP difficult to restore responsibility in central vertebral height, PVP+combined with lumbar pad can restore responsibility in central vertebral height.(3) Cobb Angle of comparison:After3days, compared with that on group A. slightly better than on admission (P<0.05), on admission is obviously better than the B and C group (P<0.05); For the third day, three group of patients after Cobb Angle of comparison, B and C group was better than group A (P<0.05), no significant difference between B and C (P>0.05); After6months follow-up Cobb Angle slightly larger than group A, B, C group but three groups no obvious difference compared with postoperative3days (P>0.05). Prompt PVP can restore spinal Cobb Angle, correct protrusion deformity after vertebral body, PVP, qiguijianggu decoction and functional exercise can keep the risk of vertebral height.3. Bone mineral density measurement (BMD) comparison:Admitted to hospital with postoperative follow-up of six months, the three groups, group A slightly lower than the preoperative, prompt PVP may not be able to avoid the loss of bone mass to continue, B and C group and preoperative slightly better than preoperative (P>0.05), prompted qiguijiangu decoction can maintain bone mass, preventing osteoporosis, further effective treatment for osteoporosis.4. The overall curative effect evaluation:After six months after treatment,3patients cure rate comparison, group C> B> A group, the overall effect of group C> B> A group, the difference was statistically significant (P<0.05).Conclusion1. PVP treatment can quickly alleviate symptoms of senile osteoporosis vertebral compression fractures pain, can be part of the recovery after injury vertebral height and correcting protrusion deformity, PVP+lumbar pad effect is better.2. qiguijiangu decoction treatment effect is good, after long-term follow-up found that it can invigorate the circulation of kidney and strong muscle and bone, functional exercise can strengthen the power of the waist and back muscle, is beneficial to maintain the stability of the spine, two groups of treatment can enhance the analgesic effect of PVP operation, to be effective in preventing injury vertebral height loss, increase bone mass, is worth popularizing clinically.