骨疏康顆粒對經皮椎體后凸成形術后鄰近椎體再骨折的預防作用分析摘要

目的：探究骨疏康顆粒對經皮椎體后凸成形術（PVP）后鄰近椎體再骨折的預防作用。

方法：選擇2015年2月至2019年12月我院收治的經PVP治療的鄰近椎體骨折患者92例作為研究對象，隨機分為觀察組與對照組，每組46例。對照組給予常規治療，觀察組在常規治療的基礎上，口服骨疏康顆粒。比較兩組治療前后患者VBA、OP值、疼痛評分和再骨折率差異。

結果：觀察組治療1個月后，其VBA、OP值均顯著高于對照組，且治療后6個月、1年后，觀察組再骨折率更低，差異均具有統計學意義（P<0.05）；治療前兩組疼痛評分差異無統計學意義（P>0.05），治療后觀察組疼痛評分顯著低于對照組（P<0.05）。

結論：經PVP后口服骨疏康顆粒能夠顯著提高患者VBA、OP值，降低患者再骨折率，改善患者疼痛癥狀，具有一定的臨床應用價值。

關鍵詞：經皮椎體后凸成形術，顆粒，骨疏康，再骨折，預防

Abstract

Objective:ToinvestigatethepreventiveeffectofBoshukanggranulesonadjacentvertebralfracturesafterpercutaneousvertebroplasty(PVP).

Methods:Atotalof92patientswithadjacentvertebralfracturestreatedwithPVPinourhospitalfromFebruary2015toDecember2019wererandomlydividedintotheobservationgroupandthecontrolgroup,with46patientsineachgroup.Thecontrolgroupwastreatedwithconventionaltherapy,andtheobservationgroupwasgivenBoshukanggranulesorallyonthebasisofconventionaltherapy.ThedifferencesinVBA,OPvalue,painscoreandincidenceofre-fracturebetweenthetwogroupsbeforeandaftertreatmentwerecompared.

Results:After1monthoftreatment,theVBAandOPvalueintheobservationgroupweresignificantlyhigherthanthoseinthecontrolgroup,andtheincidenceofre-fractureintheobservationgroupwaslowerthanthatinthecontrolgroupat6monthsand1yearaftertreatment,andthedifferenceswerestatisticallysignificant(P<0.05).Therewasnostatisticaldifferenceinpainscorebetweenthetwogroupsbeforetreatment(P>0.05),andthepainscoreintheobservationgroupwassignificantlylowerthanthatinthecontrolgroupaftertreatment(P<0.05).

Conclusion:OraladministrationofBoshukanggranulesafterPVPcansignificantlyimprovetheVBAandOPvalueofpatients,reducetheincidenceofre-fracture,andimprovethepainsymptomsofpatients,whichhascertainclinicalapplicationvalue.

Keywords:Percutaneousvertebroplasty,granules,Boshukang,re-fracture,preventionPercutaneousvertebroplasty(PVP)isaminimallyinvasiveprocedurewidelyusedforthetreatmentofvertebralcompressionfractures(VCFs).However,re-fractureafterPVPremainsasignificantconcern,whichaffectsthequalityoflifeofpatientsandincreasesthehealthcareburden.Inrecentyears,traditionalChinesemedicine(TCM)hasbeenwidelyusedtoenhancethetherapeuticeffectandreducetheincidenceofadversereactions.

Boshukanggranules,aTCMformula,havebeenshowntohaveanti-inflammatory,analgesic,andbone-strengtheningeffects.Inthisstudy,weevaluatedtheefficacyofBoshukanggranulesinpreventingre-fracturesafterPVP.

OurresultsshowedthattheoraladministrationofBoshukanggranulessignificantlyimprovedtheVBAandOPvalueofpatients,suggestingitsbeneficialeffectonbonedensity.Inaddition,theincidenceofre-fracturewassignificantlylowerintheobservationgroupcomparedtothecontrolgroup,implyingtheprotectiveeffectofBoshukanggranulesonbonestructure.

Moreover,thepainscoreintheobservationgroupwassignificantlylowerthanthatinthecontrolgroupaftertreatment,suggestingtheanalgesiceffectofBoshukanggranules.Thus,Boshukanggranuleshavesignificantclinicalapplicationvalueinthepreventionofre-fractureafterPVP.

Inconclusion,thisstudyprovidesevidencefortheefficacyofBoshukanggranulesinpreventingre-fracturesandimprovingpainsymptomsafterPVP.Furtherclinicaltrialswithlargersamplesizesandlongerfollow-upperiodsarenecessarytoconfirmourfindingsandestablishtheoptimaldoseanddurationoftreatmentAdditionally,thesafetyprofileofBoshukanggranulesshouldalsobeevaluatedinlargerclinicaltrialstoensurethatitdoesnotcauseanyadversesideeffects.Itisimportanttonotethatwhiletheresultsofthisstudyarepromising,theyshouldnotbeconsidereddefinitiveproofoftheefficacyofBoshukanggranulesinpreventingre-fracturesafterPVP.

FuturestudiesshouldalsoinvestigatethemechanismofactionofBoshukanggranulesinpreventingre-fracturesandimprovingpainsymptoms.Thiswillhelptobetterunderstandtheunderlyingbiologyofthetreatmentandmayleadtothedevelopmentofmoreeffectivetherapies.

Insummary,thefindingsfromthisstudysuggestthatBoshukanggranulesmaybeasafeandeffectiveadjunctivetherapyforpreventingre-fracturesandimprovingpainsymptomsafterPVP.However,largerclinicaltrialsareneededtoconfirmtheseresultsandestablishtheoptimaltreatmentregimenInadditiontothepotentialbenefitsofBoshukanggranulesinpreventingre-fracturesandalleviatingpainafterPVP,thereareseveralotherimportantfactorstoconsiderwhenevaluatingtheutilityofthistreatment.Onekeyconsiderationisthecost-effectivenessofBoshukanggranulescomparedtootheravailabletherapies.Whilethepriceofthesegranulesmayvarydependingontheregionandsupplier,theyaregenerallyaffordableandaccessibletopatientsinChina.However,cost-effectivenessanalysesshouldbeperformedtodeterminewhetherthepotentialbenefitsofBoshukanggranulesjustifytheircostrelativetootheroptions.

AnotherimportantconsiderationisthepotentialforadverseeffectsassociatedwithBoshukanggranules.Whilethepresentstudydidnotreportanyseriousadverseevents,itispossiblethatlong-termuseofthistreatmentcouldleadtonegativeeffectsonotheraspectsofhealth.Forexample,theherbsincludedinBoshukanggranulesmayinteractwithothermedicationsorsupplements,potentiallyleadingtodruginteractionsandunwantedsideeffects.Whenconsideringtheuseofthisoranyothercomplementarytherapy,patientsshouldconsultwiththeirhealthcareprovidertoensurethatitissafeandappropriatefortheirindividualneeds.

Finally,itisimportanttonotethatwhilethepresentstudyhighlightsthepotentialbenefitsofBoshukanggranulesasanadjunctivetherapyforPVP,thesefindingsarebasedonarelativelysmallsamplesizeandshouldbeconfirmedbylarger,well-designedclinicaltrials.FurtherresearchisneededtoelucidatetheunderlyingmechanismsofBoshukanggranulesanddetermineoptimaltreatmentregimens,aswellastoensurethatthepotentialbenefitsofthistherapyoutweighanyrisksorcostsassociatedwithitsuse.

Inconclusion,theresultsofthisstudysuggestthatBoshukanggranulesmaybeasafeandeffectiveadjunctivetherapyforpreventingre-fracturesandimprovingpainsymptomsafterPVP.Whilefurtherresearchisneededtoconfirmthesefindingsandestablishoptimaltreatmentregimens,thepotentialbenefitsofthistreatmentmakeitapromisingoptionforpatientswithvertebralfractures.Patientsandhealthcare