展筋活血方配合塔形墊自然牽引法治療單純性胸腰椎壓縮性骨折的臨床研究
發(fā)布時間：2018-09-04 05:55
【摘要】：目的:觀察展筋活血方配合塔形墊自然牽引法治療單純性胸腰椎壓縮性骨折的臨床療效,探討展筋活血方配合塔形墊自然牽引法在治療單純性胸腰椎壓縮性骨折的機理。方法:將符合《中華人民共和國中醫(yī)藥行業(yè)標(biāo)準(zhǔn)·中醫(yī)病癥診斷療效標(biāo)準(zhǔn)·胸腰椎骨折》的80例住院病人通過隨機數(shù)字表法分為兩組,每組40例,分別為A組:對照組、B組:展筋活血方配合塔形墊自然牽引組,A組40例中,男性18例,女性22例,平均年齡((?)±S下同)67.0±5.1歲;B組40例中,男性14例,女性26例。平均年齡66.0±4.8歲。兩組患者的一般情況無統(tǒng)計學(xué)差別。A組予骨康膠囊口服,入院1周后在醫(yī)師指導(dǎo)下行“五點支撐”法功能鍛煉;B組予塔形墊自然牽引,并服用展筋活血方:當(dāng)歸12g,川芎10g,懷牛膝9g,枳殼15g,姜黃15g,羌活15g,血竭10g,炒白術(shù)20g,茯苓15g,白芷15g,麝香0.1g(沖)。根據(jù)骨折分期調(diào)整,如前期消腫止痛加:漢防己20g,枳實9g,酒大黃15g;中期活血化瘀加:桃仁10g、紅花10g、赤芍15g;后期補益肝腎加:骨碎補15g、續(xù)斷20g、熟地15g,入院1周后在醫(yī)師指導(dǎo)下行“五點支撐”法功能鍛煉。12周為一療程。觀察指標(biāo)包括反應(yīng)壓縮椎體壓縮程度的楔變度數(shù);反應(yīng)患者愈合的時間t(單位:周);反應(yīng)脊柱側(cè)彎程度的Cobb角度數(shù);反應(yīng)患者對治療效果的滿意程度的胸腰椎壓縮性骨折療效評價PRO量表的積分。分別測量治療前后兩組的楔變度及Cobb角,觀察兩組患者的骨折愈合的時間,及分別在12周、24周后對兩組病人進行隨訪,統(tǒng)計兩組患者的PRO積分,將兩組數(shù)據(jù)進行統(tǒng)計學(xué)分析,楔變度、Cobb角、PRO積分進行組間及組內(nèi)比較,骨折愈合時間進行組間比較。結(jié)果:1兩組患者治療前Cobb角無明顯差異,無統(tǒng)計學(xué)意義;A組患者治療前、后Cobb角無明顯變化,組內(nèi)比較治療前、后Cobb角變化無統(tǒng)計學(xué)意義(P0.05);B組患者治療前、后Cobb角變化明顯,組內(nèi)比較治療前、后Cobb角變化具有顯著差異,有統(tǒng)計學(xué)意義(P0.05);兩組患者治療后的Cobb角比較具有顯著差異,有統(tǒng)計學(xué)意義(P0.05);2兩組患者治療前楔變度無明顯差異,無統(tǒng)計學(xué)意義;A組患者治療前、后楔變度有變化,組內(nèi)比較治療前、后楔變度差異有統(tǒng)計學(xué)意義(P0.05);B組患者治療前、后楔變度變化明顯,組內(nèi)比較治療前、后楔變度變化具有顯著差異,有統(tǒng)計學(xué)意義(P0.05);兩組患者治療后的Cobb角比較具有顯著差異,有統(tǒng)計學(xué)意義(P0.05);3以X線片上顯示的骨折愈合時間為標(biāo)準(zhǔn),A組患者的骨折愈合時間平均值較B組患者的骨折愈合時間平均值大,且B組患者前期愈合病例數(shù)明顯多于A組,兩組數(shù)據(jù)具有顯著差異,具有統(tǒng)計學(xué)意義(P0.05);4分別在12周、24周后對兩組病人以問卷調(diào)查的形式進行隨訪,以百分制胸腰椎壓縮性骨折療效評價量表為尺度,得到PRO積分,兩組患者在12周、24周后的PRO積分組內(nèi)比較及組間比較均具有差異,具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1對照組與展筋活血方配合塔形墊自然牽引組從影像學(xué)方面比較,展筋活血方配合塔形墊自然牽引治療單純性胸腰椎壓縮性骨折在對傷椎椎體高度的恢復(fù)及脊柱生理曲度的恢復(fù)方面,明顯優(yōu)于常規(guī)保守治療組A組。2對照組與展筋活血方配合塔形墊自然牽引組從椎體骨折愈合時間方面比較,展筋活血方配合塔形墊自然牽引治療單純性胸腰椎壓縮性骨折在對傷椎椎體骨折愈合時間上,較常規(guī)保守治療組A組明顯縮短。3兩組患者在采取兩種不同的治療方法治療后,通過隨訪展筋活血方配合塔形墊自然牽引組的病人滿意度明顯高于常規(guī)保守治療組A組。
[Abstract]:Objective:To observe the clinical effect of Zhanjin Huoxue Prescription combined with tower pad natural traction in the treatment of simple thoracolumbar vertebral compression fracture and explore the mechanism of Zhanjin Huoxue Prescription combined with tower pad natural traction in the treatment of simple thoracolumbar vertebral compression fracture. 80 patients with thoracolumbar fracture > were divided into two groups by random number table method, each group of 40 cases, respectively, group A: control group, group B: Zhanjin Huoxue Fang combined with natural traction tower pad group, group A 40 cases, 18 males, 22 females, the average age (?) + S below the same) 67.0 [5.1 years old; group B 40 cases, 14 males, 26 females. Group A was given Gukang Capsule orally for one week and then was given "five-point support" functional exercise under the guidance of doctors. Group B was given natural traction with tower pad and took Zhanjin Huoxue Recipe: Angelica sinensis 12g, Ligusticum Chuanxiong 10g, Achyranthes bidentata 9g, Fructus aurantii 15g, Curcuma Longae 15g, Qianghuo 15g, Dragon blood 10g, Fried Baizhu 20g, Poria Cocos 15g, etc. Radix Angelicae Dahuricae 15g, Musk 0.1g (Chong). Adjusted according to fracture stages, such as early swelling and pain relief plus: Hanfang-chi 20g, Fructus Aurantii 9g, Rhubarb 15g; mid-term Huoxue Huayu plus: peach kernel 10g, safflower 10g, red peony 15g; late tonifying liver and kidney plus: Gushubu 15g, intermittent 20g, ripe ground 15g, after one week in the hospital under the guidance of the "five-point support" method of functional exercise. Observational indices included the wedge degree of vertebral compression, the healing time t (unit: week), the Cobb angle of scoliosis, and the score of PRO scale for evaluating the curative effect of thoracolumbar vertebral compression fractures. Obb angle, observe the time of fracture healing of two groups of patients, and 12 weeks, 24 weeks after the follow-up of two groups of patients, statistical analysis of two groups of patients with PRO score, wedge change, Cobb angle, PRO score were compared between groups and within the group, fracture healing time was compared between the two groups before treatment. There was no significant difference in Cobb angle before and after treatment in group A. There was no significant change in Cobb angle before and after treatment in group A. There was no significant difference in Cobb angle before and after treatment in group B (P 0.05). Obb angle comparison has significant difference, with statistical significance (P 0.05); 2 groups of patients before treatment, wedge degree of no significant difference, no statistical significance; A group of patients before treatment, after the wedge degree of change, group comparison before treatment, after the wedge degree of difference was statistically significant (P 0.05); B group before treatment, after the wedge degree change significantly, group comparison before and after treatment, the difference was significant. Posterior wedge change had significant difference (P 0.05); there was significant difference in the Cobb angle between the two groups after treatment (P 0.05); 3 According to the fracture healing time on X-ray, the average fracture healing time in group A was larger than that in group B, and the average fracture healing time in group B was larger than that in group B before treatment. The number of patients with primary healing was significantly higher than that of group A, and there was significant difference between the two groups (P 0.05). 4 The patients in the two groups were followed up by questionnaires after 12 weeks and 24 weeks respectively. The score of PRO was obtained by using the 100% thoracolumbar vertebral compression fracture efficacy evaluation scale. There were significant differences between the two groups (P 0.05). Conclusion: 1 Compared with the control group and the Zhanjin Huoxue Fang combined with the tower pad natural traction group, Zhanjin Huoxue Fang combined with the tower pad natural traction treatment of simple thoracolumbar vertebral compression fractures in the recovery of vertebral height and spinal physiological curvature recovery. Comparing the healing time of vertebral body fracture between the control group and the traditional conservative treatment group A, the healing time of simple thoracolumbar vertebral body fracture treated by the combination of the two groups was shorter than that of the conventional conservative treatment group A. The patients in the two groups were significantly shortened. 3 After two different treatment methods, the patients'satisfaction in the group of Zhanjin Huoxue Fang combined with natural towering pad was significantly higher than that in the group of conventional conservative treatment A.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.1
本文編號：2221211
[Abstract]:Objective:To observe the clinical effect of Zhanjin Huoxue Prescription combined with tower pad natural traction in the treatment of simple thoracolumbar vertebral compression fracture and explore the mechanism of Zhanjin Huoxue Prescription combined with tower pad natural traction in the treatment of simple thoracolumbar vertebral compression fracture. 80 patients with thoracolumbar fracture > were divided into two groups by random number table method, each group of 40 cases, respectively, group A: control group, group B: Zhanjin Huoxue Fang combined with natural traction tower pad group, group A 40 cases, 18 males, 22 females, the average age (?) + S below the same) 67.0 [5.1 years old; group B 40 cases, 14 males, 26 females. Group A was given Gukang Capsule orally for one week and then was given "five-point support" functional exercise under the guidance of doctors. Group B was given natural traction with tower pad and took Zhanjin Huoxue Recipe: Angelica sinensis 12g, Ligusticum Chuanxiong 10g, Achyranthes bidentata 9g, Fructus aurantii 15g, Curcuma Longae 15g, Qianghuo 15g, Dragon blood 10g, Fried Baizhu 20g, Poria Cocos 15g, etc. Radix Angelicae Dahuricae 15g, Musk 0.1g (Chong). Adjusted according to fracture stages, such as early swelling and pain relief plus: Hanfang-chi 20g, Fructus Aurantii 9g, Rhubarb 15g; mid-term Huoxue Huayu plus: peach kernel 10g, safflower 10g, red peony 15g; late tonifying liver and kidney plus: Gushubu 15g, intermittent 20g, ripe ground 15g, after one week in the hospital under the guidance of the "five-point support" method of functional exercise. Observational indices included the wedge degree of vertebral compression, the healing time t (unit: week), the Cobb angle of scoliosis, and the score of PRO scale for evaluating the curative effect of thoracolumbar vertebral compression fractures. Obb angle, observe the time of fracture healing of two groups of patients, and 12 weeks, 24 weeks after the follow-up of two groups of patients, statistical analysis of two groups of patients with PRO score, wedge change, Cobb angle, PRO score were compared between groups and within the group, fracture healing time was compared between the two groups before treatment. There was no significant difference in Cobb angle before and after treatment in group A. There was no significant change in Cobb angle before and after treatment in group A. There was no significant difference in Cobb angle before and after treatment in group B (P 0.05). Obb angle comparison has significant difference, with statistical significance (P 0.05); 2 groups of patients before treatment, wedge degree of no significant difference, no statistical significance; A group of patients before treatment, after the wedge degree of change, group comparison before treatment, after the wedge degree of difference was statistically significant (P 0.05); B group before treatment, after the wedge degree change significantly, group comparison before and after treatment, the difference was significant. Posterior wedge change had significant difference (P 0.05); there was significant difference in the Cobb angle between the two groups after treatment (P 0.05); 3 According to the fracture healing time on X-ray, the average fracture healing time in group A was larger than that in group B, and the average fracture healing time in group B was larger than that in group B before treatment. The number of patients with primary healing was significantly higher than that of group A, and there was significant difference between the two groups (P 0.05). 4 The patients in the two groups were followed up by questionnaires after 12 weeks and 24 weeks respectively. The score of PRO was obtained by using the 100% thoracolumbar vertebral compression fracture efficacy evaluation scale. There were significant differences between the two groups (P 0.05). Conclusion: 1 Compared with the control group and the Zhanjin Huoxue Fang combined with the tower pad natural traction group, Zhanjin Huoxue Fang combined with the tower pad natural traction treatment of simple thoracolumbar vertebral compression fractures in the recovery of vertebral height and spinal physiological curvature recovery. Comparing the healing time of vertebral body fracture between the control group and the traditional conservative treatment group A, the healing time of simple thoracolumbar vertebral body fracture treated by the combination of the two groups was shorter than that of the conventional conservative treatment group A. The patients in the two groups were significantly shortened. 3 After two different treatment methods, the patients'satisfaction in the group of Zhanjin Huoxue Fang combined with natural towering pad was significantly higher than that in the group of conventional conservative treatment A.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.1
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