| Objective:Shentong Zhuyu Decoction combined with percutaneous vertebroplasty(PVP)to treat the osteoporotic vertebral compression fractures(OVCFS), according to the method of visual analog scale(VAS), activities of daily living(ADL) score,vertebral cobb angle and WHO pain standard, research the treatment effect of Shentong Zhuyu Decoction after percutaneous vertebroplasty surgery.Methods:A retrospective study since October 2012- October 2014 to the hospital for the treatment and met the research criteria in patients with the thoracolumbar OVCF 65 patients who were aged ≥60, the patients were divided into three groups by randomly assigned, then named the surgery plus Chinese medicine group, the operation control group,and the Traditional Chinese medicine in the control group, 22 cases of the surgery plus Chinese medicine group(group A),22 patients of the operation control group(group B),21 patients of the Traditional Chinese medicine in the control group(group C). The control group 1 used the PVP surgery, anti-osteoporosis therapy, the group 2 taking Shentong Zhuyu Decoction, anti-osteoporosis treatment and appropriate exercises, the combination therapy group used the same method of the control group 1, with Shentong Zhuyu Decoction after the PVP surgery. Three groups of anti-osteoporosis treatment drugs used in the same treatment. The three groups were observed according to VAS pain rating method,ADL score, vertebral Cobb angle and WHO pain standard and compared the change of pre-treatment, 1 day 1 month,3 months after treatment respectivelyUse SPSS 13.0 software for data processing.Measurement data statistic description using x±s, measurement data statistical analysis used with rank sum test and analysis of variance, statistical count data used chi-square test, P<0.05 was statistically significant.Results:There were 65 cases in the three groups, and the follow-up time was 3 months.The personal reasons of the study were 4 cases and the final case was 61 cases.1.comparative analysis of VAS scores before and after treatment 1 day, 1 month, 3 month VAS score:(1) three groups before treatment group comparisons, no significant difference(P > 0.05).That is comparable between the three groups;(2) treatment after 1 day,the A, B groups’ VAS score were significantly lower than that of group C(P < 0.05), that for short term pain relief has obvious effect in the treatment of PVP;(3) after treatment 1 month A, B two groups of pain score is still lower than in group C(P < 0.05), that after 1 month treatment, surgical treatment of pain effect still than conservative treatment is good. The pain score of the A group was significantly smaller than that of the B group after 1 days of treatment compared with the group.(4) after treatment 3 month, the score of group A is the lowest, and between group B and group C difference has statistical significance(group A and group B, group C which are pairwise comparison, P < 0.05), indicating that in the relief of pain symptoms treatment group curative effect best.2.comparative analysis of ADL scores before and after treatment 1 day, 1 month, 3 month ADL score:(1)three groups before the treatment group comparisons, no significant difference(P >0.05). That is comparable between the three groups;(2) after treatment 1 day A, B two groups of ADL score was significantly higher than that of group C(P < 0.05), indicating that PVP treatment for recovery of activities of daily living in patients have obvious effect;(3) after treatment 1 month A, B two groups of ADL score is still higher than C group, P <0.05, indicating that patients after surgical treatment for a short time recovery activities of daily living(ADL) is better than the conservative treatment of patients.(4) after treatment3 month, the ADL score of group A was the highest, but with group B, the difference was not statistically significant(P > 0.05), A, B two groups and group C of the ADL score difference have statistical significance(group A and group B respectively and C group comparison, P < 0.05), indicating that A, B group recovered patients activities of daily living ability is better than that of C group.3 comparative analysis of Cobb angle before and after treatment 1 week, 1 month, 3 month Cobb angle:(1)three groups before treatment group comparisons, no significant difference(P > 0.05).That is comparable between the three groups;(2) among the three groups after treatment 1day,A、B two groups of Cobb angle degree was significantly lower than that of group C(group A and group B respectively, and group C compared, P < 0.05), indicating that the PVP can quickly after the correction of kyphosis;(3) 1 month after treatment in the three groups. after treatment 1 month the Cobb angle of group C compared with those before treatment has improved significantly(by paired t test, P < 0.05), group A and group B after treatment 1 month Cobb angle compared with the treatment after 1 day changed little. The Cobb angle of the two groups was still lower than that of the B group(P < 0.05)..(4) 3months after treatment in the three groups. Compared with group A and group B Cobb angle after treatment 3 months has no significant difference than the treatment after 1 day and 1 month(P > 0.05) So PVP can correct the deformity and maintain the stability of spine.Compared with Cobb angle of group C after treatment 3 months has no significant difference than the treatment after 1 day and 1 month(P > 0.05),which showed that conservative treatment had the effect on the correction of the deformity of the C group.The Cobb angles of A group and B group at 1 days, 1 month and 3 month were all lower than that of C group(P < 0.05), indicating that the conservative treatment of PVP can better correct the deformity than the expectant treatment.4.WHO pain standard: A group’s WHO pain relief is obviously higher than that of B, C two group, means that Shen Tong Zhu Yu Decoction combined with the operation is more effect than simple operation treatment or simple conservative treatment effect of alleviate pain symptoms.Conclusion:Percutaneous vertebroplasty for osteoporotic vertebral compression fractures can quickly, effectively relieve the pain of postural reduction.Combined with fracture,conservative treatment can relieve the pain to a certain extent, improve the kyphosis, but its function is relatively limited, and the remedial time is longer. The auxiliary curative effect of the therapy can be better after operation which used Shentong Zhuyu Decoction to combined with PVP,.It has the high clinical value. So PVP combines with Shentong Zhuyu Decoction in clinical is worth promoting. |
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