Clinical Study Of Zuogui Pills Combined With Zoledronic Acid On Osteoporotic Vertebral Compression Fractures After PKP

Objective: To observe the clinical efficacy of Zuogui Pill combined with zoledronic acid on osteoporotic vertebral compression fractures after percutaneous kyphoplasty(PKP).Methods:The patients were diagnosed as osteoporotic vertebral compression fractures in the Southwestern Medical University Affiliated Chinese Medicine Hospital from September 2015 to June 2017 and TCM syndrome type were part of "kidney Yin deficiency syndrome ".According to the inclusion criteria,they were randomly divided into 3 groups(groups A,B and C)with 30 patients in each group.Group A was treated with PKP+ Zuogui Pills + conventional anti-osteoporosis therapy,group B with PKP+ zoledronic acid + conventional anti-osteoporosis therapy,and group C with PKP+ Zuogui Pills + zoledronic acid + conventional anti-osteoporosis therapy.Among them,group A and B lost one person,and group C lost two.A total of 86 patients including 29 patients in group A,29 patients in group B,and 28 patients in group C were actually completed.The patients were 64 to 83 years old,with an average age of(71.66±5.03)years.There were 33 males and 53 females.VAS score,ODI score,BMD and the incidence of adjacent vertebral fractures in the three groups were recorded.Results:1.There were no statistical differences among the three groups before surgery in general conditions(such as surgical method,gender,age,etc.)(P > 0.05).2.VAS scores: Compared with the VAS scores before treatment in each group,the VAS scores at each observation point after treatment in each group was significantly lower than that before treatment(P < 0.05).After four weeks of treatment,the VAS scores had no statistical differences among the three groups(P > 0.05).After twelve weeks and twenty four weeks of treatment,there were statistical differences among the three groups(P=0.000).Furtherly,there were no statistical differences between group A and group B(P > 0.05),while group C were compared with group A and group B,differences have statistical significance(P=0.000).3.ODI scores: Compared with the ODI scores before treatment in each group,the ODI scores at each observation point after treatment in each group was significantly lower than that before treatment(P < 0.05).After four weeks of treatment,the ODI scores had no statistical differences among the three groups(P > 0.05).After twelve weeks and twenty four weeks of treatment,there were statistical differences among the three groups(P=0.000).Furtherly,there were no statistical differences between group A and group B(P > 0.05),while group C were compared with group A and group B,differences have statistical significance(P=0.000).4.BMD: Compared with the BMD before treatment in each group,the BMD at each observation point after treatment in each group was significantly higher than that before treatment(P < 0.05).After twelve weeks of treatment,the BMD had no statistical differences among the three groups(P > 0.05).After twenty four weeks of treatment,there were statistical differences among the three groups(P=0.000).Furtherly,the BMD is increased obviously in group B than group A,with statistical significance(P=0.015).The BMD is increased obviously in group C than group B after twenty four weeks of treatment,with statistical significance(P=0.026).5.The incidence of adjacent vertebral fractures:within 1 month of treatment,there was no new vertebral fracture in each group;Within 6 months of treatment,the number of new fracture cases in groups A,B and C was 5,3 and 1,respectively,the differences among the three groups have no statistical significance(P > 0.05).Within 12 months of treatment,the number of new fracture cases in groups A,B and C was 10,7 and 2,respectively,the differences among the three groups have statistical significance(P < 0.05).Furtherly,group B were compared with group A and group C,differences have no statistical significance(P>0.05).There were statistical differences between group A and group C(P=0.011).Conclusion: Zuogui pills combined with zoledronic acid have a reasonable clinical effect of the anti-osteoporosis after PKP,which can significantly relieve the lumbar pain of patients,improve lumbar dysfunction,increase the level of BMD,and reduce the incidence of adjacent vertebral fractures.They have a accurate efficacy and are worthy of being widely used in clinic.