Retrospective Analysis Of Medical Records Of Patients With Osteoporotic Thoracolumbar Fractures (OVCF)

Objective:To explore the characteristics and clinical effects of osteoporotic thoracolumbar fracture(OVCF)in the past 5 years in the clinical work of the Department of orthopedics,and to compare the common points and differences in the treatment of osteoporotic thoracolumbar fracture through the massage department,the geriatric department,the acupuncture and moxibustion department and the treatment of the osteoporotic thoracolumbar fracture.Department of orthopedics in the treatment of osteoporotic thoracolumbar fractures and need to improve learning,improve the treatment of inadequacies of the Department of orthopedics.Through refining and subliming the essence of the treatment of various departments,a set of better treatment scheme is summed up,which provides support and basis for the follow-up clinical diagnosis and treatment and the disease characteristic disease construction.At the same time,it also provides guidance for the improvement of treatment effect and the better clinical work in the future clinical work.Methods: The medical records of patients with osteoporotic thoracolumbar compression fractures(OVCF)or severe osteoporosis were collected from October2011 to October 2016 in the first diagnosis of the Yunnan Provincial Hospital of traditional Chinese medicine(the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine).The inclusion criteria were definite etiology,clinical symptoms and signs,and patients' medical records were diagnosed with related clinical imaging data;the exclusion criteria were inconsistent diagnosis and treatment,undiagnosed cases,other parts of bone,and old thoracolumbar fractures were not within the scope of this study.The clinical data of patient records were selected as the research object,and the sex,age,the days of hospitalization,the statistics of bone density,vertebral fracture,the characteristics of Chinese and Western medicine,the functional rehabilitation exercise,the re fracture of the vertebral body,the clinical effect and so on were analyzed.The medical records of osteoporotic thoracolumbar fractures(OVCF)were retrospectively analyzed.Results:1.The sex distribution of osteoporotic thoracolumbar compression fractures is predominantly female,the proportion of men and women is close to 1:3,and there is no difference in sex distribution in the Department of orthopedics,the Department of massage,the geriatrics department and the acupuncture and moxibustion Department(P > 0.05).2.the age of the onset of the onset of all ages,the age of 70-80 years old,the majority of the elderly,Department of orthopedics and the Department of massage,geriatrics,acupuncture and moxibustion at the age of no difference(P > 0.05).3.the days of hospitalization were different in the Department of orthopedics,the Department of massage,the Department of geriatrics and the Department of acupuncture and moxibustion(P<0.05).The statistics showed that the number of hospitalized days in the Department of orthopedics was less than that of the massage department,the geriatric department and the Acupuncture Department.4.the distribution of syndrome type,four departments are kidney deficiency blood stasis,kidney yang deficiency accounted for a large proportion,and male kidney yang deficiency mainly,women with kidney deficiency and blood stasis mainly.There is no difference in the distribution of TCM syndromes between Department of orthopedics,massage department,geriatric department and Acupuncture Department(P > 0.05).5.vertebral fracture is the highest incidence of vertebral fracture in T12,L1,L2 and T11,and there is a majority of vertebral fractures in the number of vertebral fractures.6.bone mineral density distribution,Department of orthopedics,massage,geriatrics,acupuncture and moxibustion department had no difference in bone mineral density at all ages(P > 0.05).7.According to the frequency of traditional Chinese medicine in different departments,the treatment of traditional Chinese medicine in Chinese and Western medicine is based on the frequency of traditional Chinese medicine in different departments.Acupuncture analgesia;medical therapy with Tonifying the liver and kidney,replenishing qi and blood,blood stasis and tongluozhitong.The use of Chinese medicine decoction in Department of orthopedics and other three departments has significant difference(P<0.05),and the utilization rate of the Department of orthopedics is significantly lower than the other three departments.2.According to the principle of nutrition bone metabolism and blood activating in the various departments of Western medicine infusion,it was found that there was no difference between the Department of orthopedics and the three departments in the use of nutrient bone metabolism drugs(P > 0.05).The blood activating drugs were significantly different from the Department of orthopedics,the massage department and the geriatric department(P < 0.01),and the Acupuncture Department did not have the difference.Heterosexual(P > 0.05).The use of calcitonin was different in the Department of orthopedics,the massage department and the geriatric department(P <0.05).There were significant differences in the Department of orthopedics and Acupuncture Department(P < 0.01),and the use rate of the drug was higher than that of the other three departments.(4)in the use of Chinese medicine,the Department of orthopedics and the massage department,the geriatric department and the Department of acupuncture and moxibustion had the highest frequency of use of Jin Tian Ge capsule,ancient bone wound healing agent,bone Shu Kang capsule,To Huangken bone slice.(5)oral administration of Western medicine used four departments to treat calcium supplementation,calcium absorption and pain relief.The use of calcium in the massage department and the Department of orthopedics(P < 0.05),the use of anti-inflammatory and analgesic drugs in the Department of orthopedics and Acupuncture Department is different(P < 0.05),the use of calcium absorbent and massage family is different(P < 0.05),inhibition of bone absorbent and other three families have no difference(P > 0.05).(6)the difference between the combined application of calcium and calcium absorbent in the basic treatment(P < 0.05)in the Department of orthopedics,the Department of massage,the geriatrics department and the acupuncture and moxibustion department.The combined use of calcium and calcium absorbents in the basic treatment in the Department of orthopedics is higher than that of the other three subjects.8.acupuncture and moxibustion at the most used acupuncture points are: Gan Shu,Shenshu,life gate,three jiao Shu,waist Yang Guan,large intestine Yu,Guan Yuanyu,ring jump,committee,flying.The main meridian: Bladder Meridian of foot Shaoyang gallbladder meridian,stomach meridian,meridian,kidney meridian of foot shaoyang.9.the most used acupuncture points for acupuncture and moxibustion treatment are: Shenshu,life gate,waist Yang Guan,large intestine Yu,Guan Yuan Yu,ring jump,Central Committee,hanging clock,Kunlun,flying.The main point is the meridian of foot Taiyang bladder meridian of foot Shaoyang meridians,meridian,stomach meridian of foot yangming.The most commonly used massage therapies in massage department are: Zen,rolling,kneading,pushing,holding,plucking and rubbing.There were 89 patients who did not use massage.10.In the guidance of functional rehabilitation exercise,there are differences in the Department of orthopedics and the massage department(P< 0.05),the Department of orthopedics and the Acupuncture Department and the geriatrics department are very different(P<0.01),and the guidance of functional rehabilitation exercises is better than the massage department,the geriatric department and the Acupuncture Department.11.There is a difference between the Department of orthopedics and the massage department,the geriatric department and the Acupuncture Department(P < 0.05),and the re fracture rate of the vertebral body is less than that of the massage department,the geriatric department and the Acupuncture Department.12.on the treatment effect,there is no difference between Department of orthopedics,massage department,geriatrics department and Acupuncture Department(P > 0.05).Conclusion: 1.This subject,based on the review of the medical records system of each department for nearly 5 years,reviewed the knowledge and treatment characteristics of the treatment of osteoporotic thoracolumbar fractures,and analyzed the treatment methods of the disease: the basic treatment for relieving symptoms is anti inflammatory and analgesic drugs,and the principle of Chinese Medicine is to replenish liver and kidney and promote blood circulation,which can be strengthened on this basis.Tongluozhitong drugs(Angelica,Radix Clematidis,Sang Jisheng use).With the bladder meridian acupuncture and acupoint therapy by foot Shaoyang gallbladder meridian and Du,improve the clinical treatment effect.2.The combination of anti osteoporosis drug characteristics and clinical efficacy of various departments summed up the better effect of anti osteoporosis treatment combined medication,basic treatment(calcium + vitamin D and its derivatives)+inhibition of bone absorption drugs(biphosphonate salts or calcitonin)combined application.Combined with the acupuncture of Foot Yangming stomach meridian to regulate the absorption of calcium in the intestines and strengthen the function of the back muscles in the process of anti osteoporosis,shorten the course of the disease,improve the clinical effect,strengthen the bone and prevent the rate of re fracture.3.Through the retrospective analysis of the medical records of the last 5 years,we can see that although the Department of orthopedics and other departments have obvious effect on the treatment of symptomatic improvement,there are still many deficiencies in the treatment of anti osteoporosis.The use of combined drugs is low in the process of the basic treatment which is not fully popularized and throughout the whole anti osteoporosis treatment.Big improvement space.It is necessary to strengthen the responsibility consciousness of anti osteoporosis of medical staff,strengthen the publicity and education of the patients' understanding of osteoporosis and the importance of anti osteoporosis,improve the compliance of the patients,improve the clinical effect of anti osteoporosis,reduce the rate of re fracture,reduce the burden of family and society,and improve the quality of life of the patients.