中医药现代化

益肾化瘀续骨方联合地舒单抗对老年骨质疏松性腰椎压缩性骨折手术患者IL-6、β-CTX及骨密度的影响

  • 张斌 ,
  • 胡伟 ,
  • 谈荣珍 ,
  • 杨盼盼 ,
  • 胡俊 ,
  • 袁忠 ,
  • 江共涛
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  • 1.南昌市洪都中医院,骨科,(江西 南昌 330000 )
    2.南昌市洪都中医院,药剂科,(江西 南昌 330000 )

收稿日期: 2024-05-11

  网络出版日期: 2024-10-22

基金资助

江西省中医药管理局科技计划项目(2022B484);江西省卫生健康委科技计划项目(202311307)

Effects of Yishen Huayu Xugu prescription combined with Dixumab on IL-6, β-CTX and bone mineral density in elderly patients operated for osteoporotic lumbar vertebral compression fractures

  • Bin ZHANG ,
  • Wei HU ,
  • Rongzhen TAN ,
  • Panpan YANG ,
  • Jun HU ,
  • Zhong YUAN ,
  • Gongtao. JIANG
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  • Department of Orthopedics,Hongdu Traditional Chinese Medicine Hospital in Nanchang City,Nanchang 330000,Jiangxi,China

Received date: 2024-05-11

  Online published: 2024-10-22

摘要

目的 探讨益肾化瘀续骨方在老年骨质疏松性腰椎压缩性骨折手术患者治疗中的应用价值。 方法 所有老年骨质疏松性腰椎压缩性骨折患者均于2022年3月至2023年8月在我院就诊并随机分组,经体质辨识属于肾虚血瘀证,两组均85例,入组后均采用经皮椎体后凸成形术,术后对照组采用西医常规治疗,观察组联合益肾化瘀续骨方治疗,方剂水煎取汁 300 mL,分为两份,早晚餐后温服,治疗12周。治疗12周后比较疗效。 结果 治疗后两组血清D-二聚体(D-dimer,D-D)为5.02 ± 0.63、白细胞介素-17(interleukin-17,IL-17)为(53.68 ± 5.47)、β-胶原特殊序列(β-CTX)为(0.37 ± 0.06)、白细胞介素-6(interleukin-6,IL-6)为(69.38 ± 8.27)低于对照组,骨形态发生蛋白-2(BMP-2)为2.69 ± 0.31、25羟基维生素D为(58.93 ± 7.17)、血管内皮生长因子(VEGF)为(309.81 ± 51.49)各项数值较对照组更高,观察组改善更显著(P < 0.05);治疗后6、12周时两组骨密度(BMD)T值升高,观察组改善更显著,差异具统计学意义(P < 0.05);治疗后两组中医总症状积分、Cobb角、腰椎功能障碍指数(ODI)更低,观察组改善更显著(P < 0.05);治疗后观察组总有效率95.29%(81/85),对照组总有效率85.88%(73/85),差异有统计学意义(P < 0.05)。 结论 益肾化瘀续骨方对于老年骨质疏松性腰椎压缩性骨折手术患者有积极意义,更有助于减轻炎症反应,调控骨代谢,改善腰椎功能,促进病情好转,进而提高临床疗效。

本文引用格式

张斌 , 胡伟 , 谈荣珍 , 杨盼盼 , 胡俊 , 袁忠 , 江共涛 . 益肾化瘀续骨方联合地舒单抗对老年骨质疏松性腰椎压缩性骨折手术患者IL-6、β-CTX及骨密度的影响[J]. 实用医学杂志, 2024 , 40(19) : 2766 -2771 . DOI: 10.3969/j.issn.1006-5725.2024.19.017

Abstract

Objective To investigate the application value of Yishen Huayu Xugu prescriptionin the management of osteoporotic lumbar compression fracture among elderly patients. Methods From March 2022 to August 2023, all elderly patients with osteoporotic lumbar compression fractures were enrolled in our hospital and randomly assigned into two groups. The patients were diagnosed with kidney deficiency and blood stasis syndrome through physical identification. After admission, both groups (85 cases each) underwent percutaneous kyphoplasty. The control group received conventional Western medicine treatment post-surgery, while the observation group was administered Yishen Huayu Xugu prescription. This herbal formula was prepared by decocting 300 mL of juice in water, divided into two doses, and taken warmly after breakfast and dinner for a duration of 12 weeks. Therapeutic effects were compared after completion of the 12-week treatment period. Results After treatment, the serum levels of D-dimer (D-dimer, D-D) were (5.02 ± 0.63), interleukin-17 (IL-17) was (53.68 ± 5.47), β-collagen special sequence (β-CTX) was (0.37 ± 0.06, interleukin-6 (IL-6) was (69.38 ± 8.27) compared to the control group; bone morphogenetic protein-2 (BMP-2) was (2.69 ± 0.31), 25-hydroxyvitamin D was (58.93 ± 7.17), and vascular endothelial growth factor (VEGF) was (309.81 ± 51.49) which were higher than those in the control group with more significant improvement observed in the intervention group (P < 0.05). Bone mineral density (BMD) increased at both week 6 and week12 after treatment with a more pronounced improvement seen in the intervention group(P < 0.05). After treatment, the observation group exhibited a more significant reduction in the total Traditional Chinese Medicine (TCM) symptom score, Cobb Angle, and ODI, compared to the control group (P < 0.05). Furthermore, the observation group demonstrated a higher total effective rate of 95.29% (81/85) compared to 85.88% (73/85) in the control group after treatment, with a statistically significant difference between the two groups (P < 0.05). Conclusion The Yishen Huayu Xugu prescription holds significant positive implications for this particular medication, as it exhibits enhanced efficacy in reducing inflammation, regulating bone metabolism, improving lumbar function, promoting disease amelioration, and enhancing clinical outcomes.

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