Clinical Observation Of Jinkui Shenqi Wan Combined With Axial Stress Stimulator To Prevent Osteoporosis After Spinal Cord Injury

Objective: To evaluate the clinical efficacy of Jinkui Shenqi Wan, stress stimulator, and combined treatment for the prevention of osteoporosis after spinal cord injury.Methods: From February 2013 to June 2014, 100 patients, 83 cases were male and 17 females, with an average age of 37.85±10.52 (20～55 years old), with spinal cord injury were included which met the inclusion criteria. They were randomly divided into four groups: stress group(stress stimulator), medicine group(Jinkui Shenqi Wan), combination group(stress stimulator combined with Jinkui Shenqi Wan) and control group, according to their admission sequence by SPSS software. The stress group was treated with stress stimulator twice a day postoperatively,250N, 1Hz, 30 minutes each time. The medicine group was treated with Jinkui Shenqi Wan twice a day postoperatively,4g each time. The combination group were treated with Jinkui Shenqi Wan and stress stimulator, while the stess frequency, strength and the dose of Jinkui Shenqi Wan was the same as stress and medicine group. Evaluate the distal femur and proximal tibia bone density, serum alkaline phosphatase, serum osteocalcin, urinary hydroxyproline, urinary deoxypyridinoline after the first postoperative day, 1 month, 3 months, 6 months post-operation respectively. Evaluate the new fractures below the neurological level of injury at 3 and 6 month postoperatively. All the date were evaluated by SPSS18. software statistics.Results: During follow-up, only two cases of new fractures was found in stress group and control group, so, there were no significant difference between the four groups. There were statistical significant that the BMD of distal femur, proximal tibia of stress group, combination group are better than the control group, 3 months postoperatively. The BMD of distal femur, proximal tibia of stress group, medicine group and combination group are better than the control group have statistical significant, 6 months postoperatively. So as the stress group, combination group have a better distal tibial BMD than medicine group.Blood alkaline phosphatase, serum osteocalcin, osteogenic activity indicators, have a mild rise 1 month postoperatively, then fell to normal level after 6 months post operation, but the change have no significant difference. There was no significant difference among the four groups, too. Osteoclast activity indicators: Urinary hydroxyproline values of stress group and combination group were significantly lower than the control group, 3 months postoperatively. There were statistical significant that the urinary hydroxyproline value of the stress group, medicine group and combination group were lower than the control group, the combination group lower than the medicine group, 3 months, 6 months postoperatively. 6 months post-operation, the urinary deoxypyridinoline value of stress group, medicine group and combination group were lower than the control group, the stress group and combined group lower than medicine group, combination group lower than stress group, all have statistical significant.Conclusion: Capacity enhancement of osteoclasts and no significant change of osteogenesis capacity is the cause of osteoporosis after spinal cord injury. Jinkui Shenqi Wan, axial stress stimulator, and combined treatment all can prevent osteoporosis after spinal cord injury. And Jinkui Shenqi Wan combined with the axial stress stimulator have a better result than any single treatment. Therefore, Jinkui Shenqi Wan combined with the axial stress stimulator could be used routinely as a treatment for prevent osteoporosis after spinal cord injury.