Objective To discuss clinical effect of traditional Chinese medicine and western medicine integrated prevention of new vertebral compression fracture after percutaneous vertebroplasty treating osteopo-rosis′compression fracture.Methods Total of 126 patients with osteoporosis hospitalized in Orthopedics Department of Liaocheng Traditional Chinese Medicine Hospital from May 2010 to Jun.2013 were included in the study, according to the random number table method , they were randomly divided into combination group and control group,63 cases each.The control group was treated by ibandronate injection therapy after PVP(the first dose was 2 mg,then was 3 mg,intravenously,1 time every 3 months,treating for 6 months);the combination group was treated by dialectical Chinese medicinal prescription on the basis of control group′s treatment(during early postoperative period,taorenchengqi decoction was used,one dose each day;later expe-rience prescription was used,one dose each day,after discharge prescription was made into pills,orally taken for 6 months).The pain degree,bone density and vertebral fractures at one day,one month,three months,six months after treatment were compared between the two group .Results The VAS score at one day, one month,three months,six months after surgery in the control group was respectively (6.7 ±1.1) scores, (2.6 ±0.9) scores,(1.3 ±0.7) scores,(1.1 ±0.6) scores,in the observation group was respectively (6.7 ±1.2) scores,(2.4 ±1.0) scores,(1.1 ±0.6) scores,(0.8 ±0.3) scores,the VAS at one day,one month,three months,six months after surgery in the two group decreased gradually;the VAS at one day after surgery had no significant difference between the two groups,at one month,three months and six months after surgery,the VAS in the combination group was significantly lower than that in the control group (P<0.05). The L2-4 bone mineral density at one day,one month,three months,six months after surgery in the control group was respectively(0.71 ±0.11 ) g/cm2 , ( 0.75 ±0.16 ) g/cm2 , ( 0.79 ±0.17 ) g/cm2 , ( 0.83 ± 0.19) g/cm2,in the observation group was respectively(0.70 ±0.12) g/cm2,(0.76 ±0.17) g/cm2, (0.84 ±0.18) g/cm2,(0.89 ±0.20) g/cm2,the L2-4 bone mineral density at one day,one month,three months,six months after surgery in the two groups gradually increased;at three months,six months after sur-gery,the L2-4 bone density in the combination group was higher than that in the control group(P<0.05).At 6 months after surgery the vertebral compression fracture incidence of the combination group was significantly lower than the control group ( 6.4% vs 19.0%) ( P <0.05 ) .Conclusion Traditional Chinese medicine and western medicine integrated prevention can effectively reduce incidence of vertebral fracture after PVP operation and improve the prognosis.%目的 探讨中西医结合预防骨质疏松压缩性骨折经皮椎体成形术( PVP)后新发椎体骨折的临床效果. 方法 选择2010年5月至2013年6月在聊城市中医医院骨科住院治疗的骨质疏松症患者126例为研究对象,根据随机数字表法分为联合组和对照组,每组63例. 对照组在PVP后应用伊班膦酸钠注射液治疗(首剂量2 mg,此后均3 mg,静脉注射,每隔3 个月注射1 次,治疗6 个月).联合组在对照组基础上辨证应用中药方剂治疗(术后早期,应用桃仁承气汤,每日1 剂;术后中后期,方用经验方,每日1剂,水煎服,出院后将药方制成丸剂,口服治疗6个月). 比较两组患者治疗后第1日、1个月、3个月、6个月时的疼痛程度、骨密度及椎体再发骨折情况. 结果 对照组术后第1 日、术后1个月、3个月、6 个月时视觉模拟评分(VAS)分别为(6.7 ±1.1)分、(2.6 ±0.9)分、(1.3 ± 0.7)分、(1.1 ±0.6)分,观察组分别为(6.7 ±1.2)分、(2.4 ±1.0)分、(1.1 ±0.6)分、(0.8 ±0.3)分,两组术后第1日、术后1个月、3个月、6 个月时VAS评分逐渐降低;两组患者术后第1 日 VAS差异无统计学意义,术后1个月、3个月、6个月时,联合组VAS明显低于对照组( P<0.05 ). 对照组术后第1日、术后1个月、3个月、6个月时L2~4骨密度分别为(0.71 ±0.11) g/cm2、(0.75 ±0.16) g/cm2、(0.79 ±0.17) g/cm2、(0.83 ±0.19) g/cm2,观察组分别为(0.70 ±0.12)g/cm2、(0.76 ±0.17)g/cm2、(0.84 ±0.18)g/cm2、(0.89 ±0.20)g/cm2,两组患者术后第1日、术后1 个月、术后3 个月、6 个月时L2~4骨密度逐渐增加;术后3个月、6个月时,联合组L2~4骨密度明显高于对照组( P<0.05 ). 术后6个月时联合组椎体压缩性骨折再发率明显低于对照组( 19.0%比6.4%) ,差异有统计学意义( P<0.05). 结论 中西医结合能有效降低PVP后椎体骨折再发生率,改善其预后.
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