补肾健骨汤联合骨填充囊袋扩张椎体成形术治疗Ⅱ期Kummell病的临床观察

目的 观察补肾健骨汤联合骨填充囊袋治疗Ⅱ期Kummell病的临床疗效。方法 将2016年3月至2017年3月我院收治的80例Ⅱ期Kummell病患者随机分为对照组和观察组，每组各40例。对照组行骨填充囊袋（Vessel-X）扩张椎体成形术，观察组在手术基础上给予补肾健骨汤治疗。于术前、术后第 2 天、术后1周、术后3周、术后6周、术后12周进行随访，以病椎为中心拍摄正侧位X线片，并在X线片中测量患者手术前及手术后病椎前缘高度及Cobb角，依据视觉模拟评分（visual analogue scale，VAS）、Oswestry功能障碍指数（oswestry dability index，ODI）进行疗效评价。结果 所有患者均成功完成手术，术后第2天，两组患者VAS、ODI评分较术前明显降低，椎体前缘高度、病椎Cobb角较术前增加，差异具有统计学意义（P<0.05）；在术后1周、3周、6周、12周，观察组VAS、ODI评分低于对照组，差异具有统计学意义（P<0.05）；而术后1周、3周、6周、12周随访时病椎前缘高度及Cobb角与术后第2 天相比，差异无统计学意义（P>0.05）。结论 骨填充囊袋扩张椎体成形术联合补肾健骨汤可以明显缓解Ⅱ期Kummell病患者的疼痛、促进功能恢复，同时骨填充囊袋扩张椎体成形术可有效维持病椎高度。

Clinical Effect of Bushen Jiangu Decoction Combined with Bone-Filling Mesh Container Vertebroplasty in the Treatment of Stage II Kummell's Disease

Objective To observe the clinical effect of Bushen Jiangu Decoction combined with bone-filling mesh container vertebroplasty in the treatment of stage II Kummell''s disease. Methods A total of 80 patients with stage II Kummell''s disease admitted to our hospital from March 2016 to March 2017 were randomly divided into control group and observation group, with 40 patients in each group. The control group was treated with bone-filling mesh container (Vessel-X) vertebroplasty, and the observation group was given Bushen Jiangu Decoction on the basis of operation. Follow-ups were performed prior to operation as well as at 2 days, 1 week, 3 weeks, 6 weeks, and 12 weeks after operation. The anteroposterior and lateral X-ray films were taken with the affected vertebra at the center of the view, and the anterior vertebral height and Cobb angle were measured on the X-ray films before and after operation. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the efficacy. Results Operations were successfully completed for all the patients. On the second day after operation, both groups had significantly reduced VAS and ODI scores and significantly increased anterior vertebral height and Cobb angle compared with those before operation (P<0.05). At 1, 3, 6, and 12 weeks after operation, the observation group had significantly lower VAS and ODI scores than the control group (P<0.05), but had no significantly different anterior vertebral height or Cobb angle compared with those on the second day after operation (P>0.05). Conclusion Bushen Jiangu Decoction combined with bone-filling mesh container vertebroplasty can substantially relieve the pain and promote functional recovery of patients with stage II Kummell''s disease, and the latter therapy can effectively maintain the height of the vertebra.