| Objective: to observe the value of Longzhong Sunshang Capsule in preventing and treating residual low back pain and vertebral refracture after percutaneous kyphoplasty(PKP)for osteoporotic vertebral compression fractures.Methods: a total of 72 patients with osteoporotic vertebral compression fracture admitted from September 2015 to December 2016 in the Department of Spinal Orthopedics of Gansu Provincial traditional Chinese Medicine Hospital were selected.According to the syndrome differentiation of TCM,by using the method of random digital table,they were divided into two groups: the experimental group(n=36)and control group(n=36).All the patients were treated with PKP operation,and all the patients were given health education and guidance exercise after operation.The control group was given anti-osteoporosis treatment with western medicine after operation,and the experimental group was treated with Longzhong Sunshang Capsule on the basis of the treatment in the control group.Both groups were treated for 6months.The changes of visual analogue score(VAS)were observed in two groups before and after 3days,3 and 6 months after operation.The changes of QCT bone density(BMD)was compared between the two groups before and 6 months after operation.The changes of bone turnover index [OC,DPD/Cr] were compared between the two groups before and after 3 and 6 months after operation.The patients were followed up for at least 9 months and the incidence of vertebral re-fracture was calculated.SPSS 21.0 software was used to analyze the observed data.Results:(1)There was no significant difference(P>0.05)in baseline data between the two groups,such as sex,age,distribution of injured vertebrae segment and degree of fracture compression,and they were comparable.(2)VAS score: The VAS scores of each observation point after operation in both groups were significantly lower than those before operation,and with the prolongation of treatment time,the decrease range of the trial group was more obvious than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference(P > 0.05)in VAS scorebetween the two groups at 3day after operation.3 and 6 months after the operation,the VAS score in the test group was compared with the control group,and the difference was statistically significant(P<0.05).(3)BMD value: The BMD value of the two groups increased in different degree after 6 months compared with that before treatment,and the difference was statistically significant(P<0.05)compared with that before treatment.The increase of BMD in the experimental group was more obvious than that in the control group,and the difference was also statistically significant(P<0.05).(4)Bone turnover index: The OC value of each observation point after operation in both groups increased to some extent compared with that before operation,and with the prolongation of treatment time,the rising range of the experimental group was more obvious than that of the control group,and the difference was statistically significant.(P<0.05)The OC value of the experimental group was compared with the control group at 3 and 6 months after the operation,and the difference was statistically significant(P<0.05).The DPD/Cr values of each observation point in the two groups were decreased in different degrees compared with those before operation,and with the prolongation of treatment time,the decrease of DPD/Cr in the experimental group was more obvious than that in the control group,and the difference was statistically significant(P<0.05).The changes of bone turnover index [OC,DPD/Cr] were compared between the two groups before and after 3 and 6months after operation;The differences were statistically significant(P<0.05).(5)The incidence of re-fracture: these two groups been averagely followed up for(10.23±1.56)months after operation.During the follow-up period,total 7 patients had vertebral re-fracture,the rate was 9.72%.Among them,the test group has 2 cases(5.56%)occurred within 5~6 months after operation,the average time was 174 days;the control group has 5 cases(13.89%),mainly occurred within 2~4 months after operation,two incidences of postoperative vertebral re-fracture had no significant difference(P<0.05),but the number of re-fractures in test group is lower than control group,also can delay the interval time of vertebral re-fracture.Conclusion: the treatment of Longzhong Sunshang Capsule in patients withosteoporotic vertebral compression fracture after PKP can further alleviate the residual low back pain.And can increase BMD,improve bone metabolism,can delay the interval time of vertebral re-fracture after operation,in reducing the incidence of vertebral re-fracture,there has a certain preventive value,the further long-term follow-up of large sample randomized controlled study to be taken. |
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