The Research On The Criterion Of Clinical Effect About Thoracolumbar Compression Fractures External Reseted

Objective:There is no uniform therapeutic standard for the External reseted of thoracolumbar vertebral compression fracture.Most of the current clinical efficacy evaluation scales are directly derived from foreign low back pain scores or quality of life scores.Is it suitable for domestic populations and thoracolumbar vertebral compression fractures?and there is no relevant clinical evidence.In this study,We select the common curative effect scales after extensive literature review for thoracolumbar vertebral compression fractures,and investigated the scores of patients with thoracolumbar vertebral compression fractures before and after treatment.The reliability,validity,and reflectivity of the scales will be analysised and comparing the distribution of severity of patients before and after treatment.Discuss the quality of the rating scale and its applicability to patients with thoracolumbar vertebral compression fractures.Method:Based on the theoretical knowledge of thoracolumbar vertebral compression fractures,three common scales for thoracolumbar vertebral compression fractures were screened by reviewing a large number of literatures:Activies of daily living(ADL),Oswestry Dysfunction Index(ODI),and Roland-Morris dysfunction questionnaire(RDQ).Cases of thoracolumbar vertebral compression fractures treated in Shenzhen Traditional Chinese Medicine Hospital from April 2018 to March 2019 and meeting the "Diagnostic and Efficacy Standards for TCM Syndrome" were selected.All the selected cases were treated with External reseted,intravenous infusion,traditional Chinese medicine,and traditional Chinese medicine.The patients were evaluated before and after treatment.A total of 148 prescriptions were obtained before and after treatment.And collecting 50 copies of the effective questionnaire for healthy people.The Cronbacha’ s a coefficient and the split-half reliability coefficient were used to analyze the reliability of the scale,the factor analysis method was used to analyze the validity of the scale,and the Wiliconxon Z test was used to analyze the reactivity by comparing the scores of the pre-treatment observation group and healthy groups.Diagnostic consistency analysis of the scale by Kappa coefficient.The Wiliconxon Z test method was used to compare the distribution of severity before and after treatment.Result:The results of reliability analysis showed that the Cronbacha’ s a coefficients of the ADL scale,ODI scale and RDQ scale were 0.801,0.969,and 0.811,respectively,and the split-half reliability coefficients were 0.758,0.969,and 0.811,respectively.The validity analysis showed that the number of ADL scale factors was 3;the cumulative variance contribution rate was 61.521%,the ODI scale factor number was 1,the cumulative variance contribution rate was 79.578%,and the RDQ scale factor number was 7,cumulative the variance contribution rate was 71.404%.The ADL scale,ODI scale,and RDQ scale were compared observation group and healthy groups.The observation group score was significantly higher than the health group,the differences were statistically significant(P=0.000<0.05),and the Z values were-8.095,-9.136,-8.921.Consistency test results show that the ADL scale is generally consistent with the ODI scale(Kappa value is 0.379),the ADL scale is moderately consistent with the RDQ scale(Kappa value is 0.429),and the ODI scale is highly consistent with the RDQ scale(Kappa value is 0.742).The severity of the disease before treatment,ADL compared with ODI,the degree of severity of the disease was milder,the difference was statistically significant(Z=-7.181,P=0.000<0.05),ADL compared with RDQ,the degree of severity of the disease was milder and the difference was statistically significant(Z=-0.160,P=0.873>0.05).There was no significant difference between ODI and RDQ(Z=-0.160,P=0.000<0.05).The severity of the disease after treatment,ADL compared with ODI,the degree of severity of the disease was more serious,the difference was statistically significant(Z=-4.110,P=0.000<0.05).There was no significant difference between ADL and RDQ(Z=-1.412,P=0.158>0.05).ODI compared with RDQ,the degree of severity of the disease was milder and the difference was statistically significant(Z=-0.160,P=0.000<0.05).Conclusion:For the quality of the scale,the ADL,ODI,and RDQ scales have good reliability;the structural validity of the three scales is acceptable,among which ODI is the best,RDQ is the second,and ADL is the worst;The three scales have good reactivity.For the pre-treatment diagnostic consistency,the ADL scale is generally consistent with the ODI scale,the ADL scale is moderately consistent with the RDQ scale,and the ODI scale is highly consistent with the RDQ scale.For the evaluation of thoracolumbar vertebral compression fractures,the ODI scale evaluation purpose is relatively simple,while the RDQ scale evaluation range is the most comprehensive.For the evaluation of the severity of the patient’ s condition before treatment,the severity of the disease with ADL was slightly milder than ODI and RDQ.For the evaluation of the severity of the patient’ s condition after treatment,the severity of the disease with ODI was slightly milder than ADL and RDQ.Clinically,for the evaluation of the curative effect of patients with thoracolumbar vertebral compression fractures,each of the three scales has advantages and disadvantages,and the appropriate scale should be selected according to the actual situation.