张利锋　杜凯　申艺龙　郭义志

【摘要】 目的 研究益肾补骨汤对胸腰椎压缩性骨折患者术后骨代谢及骨密度的影响。方法 选择2019年1月至2020年1月手术治疗的100例胸腰椎压缩性骨折患者作为研究对象，依据随机数字表分为对照组和观察组，各50例。对照组予西医常规治疗，观察组在对照组基础上加用益肾补骨汤治疗，持续治疗2个月。对比治疗前和治疗2个月结束时两组血清甲状旁腺激素（PTH）、血清降钙素（CT）、骨钙素（BGP）以及骨密度水平。结果 治疗2个月后，两组血清BGP、CT水平均低于治疗前，PTH水平均高于治疗前，且观察组血清BGP、CT水平低于对照组，PTH水平高于对照组，差异有统计学意义（P<0.05）;治疗2个月后，两组骨密度水平高于治療前，且观察组高于对照组，差异有统计学意义（P<0.05）。结论 益肾补骨汤可调节胸腰椎压缩性骨折术后患者骨代谢，改善骨密度。

【关键词】 胸腰椎压缩性骨折;益肾补骨汤;骨代谢;骨密度

中图分类号：R683.2

【Abstract】 Objective To study the effects of Yishen Bugu decoction on bone metabolism and bone mineral density in patients with thoracolumbar vertebral compression fracture after operation. Methods From January 2019 to January 2020， 100 patients with thoracolumbar vertebral compression fracture who underwent surgery for treatment were selected as research subjects. According to random number table， they were divided into control group and observation group， with 50 cases in each group. The control group were treated with routine Western medicine， while the observation group were treated with Yishen Bugu decoction on the basis of the control group. Both groups were treated continuously for 2 months. And then， the levels of serum parathyroid hormone （PTH）， serum calcitonin （CT）， bone gla protein （BGP） and bone mineral density were compared between the two groups before treatment and at the end of 2 months. Results After 2 months of treatment， the serum BGP and CT levels in the two groups were lower than those before treatment， the PTH levels were higher than those before treatment， and the serum BGP and CT levels of the observation group were lower than those of the control group， and the PTH level was higher than that of the control group， differences were statistically significant （P < 0.05）. After 2 months of treatment， the bone mineral density of the two groups was higher than that before treatment， and that of the observation group was higher than that of the control group， differences were statistically significant （P < 0.05）. Conclusion Yishen Bugu decoction can regulate the index of bone metabolism and improve bone mineral density in patients with thoracolumbar vertebral compression fracture after operation.

【Key words】 thoracolumbar vertebral compression fracture; Yishen Bugu decoction; bone metabolism; bone mineral density

胸腰椎压缩性骨折是一种较为常见的脊柱骨折，好发于中老年人群，多为骨质疏松所引发，患者椎体前半部分压缩变形，严重影响患者的日常生活[1]。目前，临床针对胸腰椎压缩性骨折患者的治疗多以手术为主，以纠正畸形、促进骨折复位为治疗目标，取得了不错的效果，但由于患者年老体弱、身体功能较差，术后恢复不佳，故术后需辅以药物治疗。既往临床多以碳酸钙D3片和阿仑膦酸钠片治疗为主，通过补充人体所需钙量和骨量达到治疗目的，但西药存在诸多副作用，不宜长期服用[2]。祖国医学认为，胸腰椎压缩性骨折属“骨痹”范畴，临床多见肝肾亏损证，故治疗应以补益肝肾、强筋壮骨为主。而益肾补骨汤具有补肾健脾、补骨壮骨的功效[3]。……