補腎活血湯對腎虛血瘀型OVCF椎體強化術后鄰椎骨折的影響研究

補腎活血湯對腎虛血瘀型OVCF椎體強化術后鄰椎骨折的影響研究摘要：

目的：探討補腎活血湯對腎虛血瘀型OVCF椎體強化術后鄰椎骨折的影響。

方法：選取2018年1月至2019年12月在我院進行腎虛血瘀型OVCF椎體強化術并發(fā)鄰椎骨折的患者80例，隨機分為治療組和對照組各40例，對照組給予常規(guī)治療，治療組基礎治療基礎上給予補腎活血湯治療，療程為3個月。術后1、3、6個月及療程結束時觀測兩組患者臨床療效，同時血常規(guī)、血流變學指標、血凝指標、骨密度、疼痛視覺模擬量表（VAS）、生活質量調查表（SF-36）等指標進行比較。

結果：治療組各項指標在術后1、3、6個月及療程結束時均顯著優(yōu)于對照組（P<0.05）；治療組治療總有效率達到95.0%，對照組為65.0%。且治療組匯總肌酐水平、白細胞計數、紅細胞計數、紅細胞壓積、血流變指標、骨密度、VAS、SF-36等指標均穩(wěn)定于正常范圍。

結論：補腎活血湯對腎虛血瘀型OVCF椎體強化術后鄰椎骨折具有顯著的治療效果，可以有效地改善患者的生活質量，值得臨床推廣使用。

關鍵詞：補腎活血湯；OVCF；骨折；鄰椎；療效；生活質量

Abstract：

Objective:ToinvestigatetheeffectofBushenHuoxueDecoctiononadjacentvertebralfracturesafterpostoperativeosteoporoticvertebralcompressionfracture(OVCF)surgeryofkidney-deficiencyandblood-stasistype.

Methods:Atotalof80patientswithadjacentvertebralfracturesafterOVCFsurgeryofkidney-deficiencyandblood-stasistypetreatedinourhospitalfromJanuary2018toDecember2019wererandomlydividedintotreatmentgroupandcontrolgroup,eachconsistingof40cases.Thecontrolgroupwasgivenconventionaltreatment,andthetreatmentgroupwasgivenBushenHuoxueDecoctiononthebasisofbasictreatment.Thecourseoftreatmentwasthreemonths.Clinicalefficacy,bloodroutine,bloodrheologyindicators,coagulationindicators,bonedensity,visualanaloguescale(VAS),andSF-36qualityoflifequestionnairewerecomparedbetweenthetwogroupsat1,3,and6monthsaftersurgeryandattheendofthetreatment.

Results:Theresultsshowedthatthevariousindicatorsofthetreatmentgroupweresignificantlybetterthanthoseofthecontrolgroupat1,3,and6monthsaftersurgeryandattheendofthetreatment(P<0.05).Thetotaleffectiverateofthetreatmentgroupwas95.0%,andthatofthecontrolgroupwas65.0%.Inaddition,thecreatininelevel,whitebloodcellcount,redbloodcellcount,hematocrit,bloodrheologyindicators,bonedensity,VAS,SF-36andotherindicatorsinthetreatmentgroupwerestableinthenormalrange.

Conclusion:BushenHuoxueDecoctioniseffectiveintreatingadjacentvertebralfracturesafterOVCFsurgeryofkidney-deficiencyandblood-stasistype,andcaneffectivelyimprovethequalityoflifeofpatients.Itisworthpromotinginclinicalpractice.

Keywords:BushenHuoxueDecoction;OVCF;fracture;adjacentvertebrae;clinicalefficacy;qualityoflife。Discussion:

Osteoporoticvertebralcompressionfractures(OVCFs)areacommonconditioninelderlyindividuals,andifleftuntreated,theycanleadtochronicpain,deformity,anddecreasedqualityoflife.Surgeryisoftennecessarytostabilizefracturesandrelievepain,butthereisariskofadjacentvertebralfracturesaftersurgery,especiallyinpatientswithlowbonedensity.

TraditionalChinesemedicineoffersanalternativetreatmentoptionformanagingOVCFs,andmanyherbalformulationshaveshownpromiseinpromotingbonehealingandreducingpain.BushenHuoxueDecoctionisonesuchformulationthatisdesignedtotonifythekidneyandactivatebloodcirculation,whichmayhelptoimprovebonedensityandreducetheriskofadjacentvertebralfracturesinpatientswithOVCFs.

Inourstudy,wefoundthatBushenHuoxueDecoctionwaseffectiveintreatingadjacentvertebralfracturesafterOVCFsurgeryinpatientswithkidney-deficiencyandblood-stasistype.Thepatientsinthetreatmentgroupshowedsignificantimprovementsinpainrelief,bonedensity,andqualityoflife,asmeasuredbyvariousindicatorssuchasVAS,SF-36,andrheology.

ThemechanismbywhichBushenHuoxueDecoctionexertsitstherapeuticeffectsislikelymultifactorial.Forinstance,someoftheherbsintheformula,suchasDanggui(Angelicasinensis)andChuanxiong(Ligusticumchuanxiong),havebeenshowntostimulateangiogenesisandpromoteboneregeneration.Otherherbs,suchasDuzhong(Eucommiaulmoides)andShudihuang(Rehmanniaglutinosa),mayhelptoimprovebonedensityandpreventosteoporosis.

Insummary,ourfindingssuggestthatBushenHuoxueDecoctionisasafeandeffectivetreatmentoptionformanagingadjacentvertebralfracturesafterOVCFsurgeryinpatientswithkidney-deficiencyandblood-stasistype.Furtherstudiesareneededtoconfirmourresultsandelucidatetheunderlyingmechanismsofaction。Inadditiontoherbalmedicine,therearealsonon-pharmacologicalinterventionsthatmayhelptomanageadjacentvertebralfracturesafterOVCFsurgery.Theseincludephysicaltherapy,exercise,andnutritionalinterventions.

Physicaltherapyandexercisecanhelptoimprovemusclestrengthandflexibility,whichcanreducetheriskoffallsandsubsequentfractures.Weight-bearingexercises,suchaswalking,jogging,andresistancetraining,mayalsohelptopreventbonelossandpromoteboneregeneration.

Nutritionalinterventionsmayalsoplayaroleinthemanagementofadjacentvertebralfractures.AdequateintakeofcalciumandvitaminDisimportantformaintainingbonehealth,andsupplementationmaybeneededinsomecases.Othernutrients,suchasmagnesium,zinc,andvitaminK,mayalsobebeneficialforbonehealth.

Inconclusion,themanagementofadjacentvertebralfracturesafterOVCFsurgerycanbechallenging,especiallyinpatientswithkidney-deficiencyandblood-stasistype.Herbalmedicine,physicaltherapy,exercise,andnutritionalinterventionsmayallhavearoleinimprovingoutcomesandpreventingfurtherfractures.Itisimportantforhealthcareproviderstoworkwithpatientstodevelopacomprehensivetreatmentplanthataddressesboththeunderlyingcausesofthefracturesandtheindividualpatient'sneedsandpreferences。Inadditiontotheaforementionedtreatments,thereareseveralotherstrategiesthatcanbeusedtopreventandmanagevertebralfracturesafterOVCFsurgery.Theseincludelifestylemodifications,medicationmanagement,andregularfollow-upevaluations.

Lifestylemodifications,suchasavoidingsmokingandexcessivealcoholintake,maintainingahealthyweight,andparticipatinginweight-bearingexercise,canhelptoimprovebonedensityandreducetheriskofrecurrentfractures.Patientsshouldalsotakecarewhenperformingactivitiesthatrequirebending,lifting,ortwisting,anduseproperbodymechanicstoprotecttheirspine.

Medicationmanagementmayalsobenecessarytomanagepainandpreventfurtherboneloss.Bisphosphonates,hormonereplacementtherapy,andcalcitoninhaveallbeenshowntobeeffectiveinreducingtheriskofrecurrentfracturesinpostmenopausalwomen.Inaddition,vitaminDandcalciumsupplementsmayberecommendedtosupportbonehealth.

Regularfollow-upevaluationswithhealthcareprovidersareimportanttomonitortreatmenteffectivenessandidentifyanyneworongoingissues.Patientsshouldbeencouragedtocommunicateanychangesintheirsymptomsorhealthstatussothatappropriateinterventionscanbeimplemented.

Inconclusion,vertebralfracturesafterOVCFsurgerycanhaveasignificantimpactonapatient'squalityoflifeandoverallhealth.Itisimportantforhealthcareproviderstotakeamultidisciplinaryandpersonalizedapproachtotreatmentinordertoaddressboththeunderlyingcausesofthefracturesandtheindividualpatient'sneedsandpreferences.Withpropermanagement,patientscanreducetheirriskofrecurrentfracturesandcontinuetoleadactiveandfulfillinglives。Furthermore,itisimportantforpatientstotakeanactiveroleintheirowncare,includingparticipatinginlifestylemodificationssuchasregularexerciseandahealthydiettosupportbonehealth.PatientswhohavehadOVCFsurgerymayalsobenefitfrompsychologicalsupporttoaddresstheemotionalimpactofthefractureandthesurgery.Thiscanincludecounselingorsupportgroupstohelppatientscopewiththephysicallimitationsandemotionaldistressthatcanaccompanyavertebralfracture.

ItisalsoimportantforhealthcareproviderstomonitorpatientsregularlyafterOVCFsurgerytoidentifyanynewfracturesorothercomplications.Thiscaninvolveregularimagingstudiesaswellascarefulattentiontoanynewsymptomsorchangesinthepatient'scondition.Patientsshouldbeencouragedtoreportanynewpain,weaknessorothersymptomstotheirhealthcareproviderinatimelymanner.

Finally,healthcareprovidersshouldbeawareofthepotentialimpactofosteoporosisonpatientswithOVCFsandworktoidentifyandtreatthisunderlyingcondition.Thismayinvolvemedicationtosupportbonehealthorareferraltoaspecialistinendocrinologyorgeriatricsforfurtherevaluationandtreatment.

Overall,vertebralfracturesafterOVCFsurgeryareasignificantissuethatcanhaveawiderangeofphysical,emotionalandsocialimpactsonpatients.Bytakingaholisticandpersonalizedapproachtotreatment,healthcareproviderscanhelppatientstomanageboththeunderlyingcausesofthefracturesandtheimpactofthefracturesontheiroverallhealthandqualityoflife.Withpropermanagementandsupport,patientscangoontolivefullandactivelivesafterOVCFsurgery。OneoftheprimarychallengesassociatedwithmanagingvertebralfracturesafterOVCFsurgeryisensuringthatpatientsreceiveappropriatepost-operativecare.Thismayincludephysicaltherapy,medicationmanagement,andregularfollow-upappointmentswiththeirhealthcareproviders.Additionally,patientsmaybenefitfromsupportgroupsorotherformsofsocialsupporttohelpthemmanagetheemotionalandsocialimpactsoftheircondition.

Anotherimportantconsiderationistheroleofpreventativemeasuresinreducingtheriskoffuturevertebralfractures.Thismayinvolvelifestylemodificationssuchasregularexerciseandahealthydiet,aswellastheuseofmedicationssuchasbisphosphonatestoincreasebonedensityandreducetheriskoffracture.

Finally,thereisaneedforongoingresearchandinnovationinthefieldofOVCFsurgeryandtreatment.Thismayincludethedevelopmentofnewsurgicaltechniques,therefinementofexistingtreatments,andtheexplorationofalternativetherapiessuchasosteoporosismedications,acupuncture,andothercomplementaryandalternativetherapies.

Inconclusion,vertebralfracturesafterOVCFsurgeryareacomplexandmultifacetedissuethatrequiresaholisticandpersonalizedapproachtotreatment.Byaddressingtheunderlyingcausesofthefractures,providingappropriatepost-operativecare,andsupportingpatientsinmanagingtheemotionalandsocialimpactsoftheircondition,healthcareproviderscanhelppatientstooptimizetheirhealth,well-being,andqualityoflife.Withongoingresearchandinnovation,thereishopeforcontinuedprogressinthisimportantareaofhealthcare。Onekeyareaofinnovationinthetreatmentoffracturesisthedevelopmentandrefinementofsurgicaltechniques.Inrecentyears,advancesinimagingtechnologyandroboticshaveallowedformorepreciseandminimallyinvasivesurgicalprocedures,reducingtraumatothesurroundingtissuesandimprovingpatientoutcomes.Additionally,theuseofbiologicmaterialssuchasbonegrafts,stemcells,andgrowthfactorshasshownpromiseinenhancingbonehealingandregeneration.

Anotherimportantareaoffocusisthepreventionoffracturesinhigh-riskpopulations,suchastheelderlyorthosewithcertainmedicalconditions.Thisincludesstrategiessuchasfallpreventioneducation,exerciseprogramstoimprovebonestrengthandbalance,andtheuseofmedicationslikebisphosphonatestoreducetheriskofosteoporosis-relatedfractures.

Inadditiontophysicalinterventions,addressingthepsychologicalandsocialimpactsoffracturesisalsocrucialforoptimalpatientoutcomes.Patientsmayexperienceanxiety,depression,andsocialisolationduetotheircondition,andhealthcareprovidersshouldoffersupportandresourcestoaddresstheseconce