| 摘要: |
| ［摘要］ 目的 比较两种不同的保守治疗方案干预原发性骨质疏松性胸腰椎骨折的效果,寻找中西医结合非手术治疗原发性骨质疏松性胸腰椎骨折的优选方案。方法 选择90例原发性骨质疏松性胸腰椎骨折的患者，随机分为观察组30例及对照组60例，并从大将逐瘀汤加味方内服、固本疏肝壮骨方内服、中（草）药外敷（熨烫）等中医药疗法和口服钙尔奇片剂及阿法骨化醇软胶囊、肌注鲑鱼降钙素注射液等西医疗法中选取相应的治疗手段制定两种不同的中西医结合非手术治疗方案，分别用于观察组及对照组患者的治疗，观察和比较两组患者的疗效、生存质量及治疗的成本-效果。结果 两组临床疗效比较差异无统计学意义（P>0.05）；生命质量相关指标总评分比较差异无统计学意义（P>0.05），但两组治疗后心理健康及生命活力两个维度的评分较治疗前高，观察组优于对照组（P<0.01）;观察组的成本-效果（CEA）较对照组低（P<0.01）。结论 中西医结合非手术住院与居家康复和全程住院治疗方案对原发性骨质疏松性胸腰椎骨折的疗效均较好，但住院与居家康复相结合能使患者感觉更好、情绪更稳定、精力更充沛、生活更充实和快乐，并在卫生经济学方面有一定优势，值得进一步推广应用。 |
| 关键词: 胸腰椎骨折 骨质疏松 非手术疗法 卫生经济学 |
| DOI：10.3969/j.issn.1674-3806.2012.11.08 |
| 分类号:R 68 |
| 基金项目:广西科学研究与技术开发计划课题(编号：桂科攻10124001B-38)；广西卫生厅重点科研课题(编号：桂卫重2010087)；广西卫生厅中医药科技专项课题(编号：GZKZ 10-029) |
|
| Clinical study on the treatment of primary osteoporotic thoracolumbar vertebral fractures with integrated traditional chinese medicine and western medicine |
|
XU Jian-wen,ZHONG Yuan-ming,ZHANG Jia-li,et al.
|
|
Department of Orthopedics,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China
|
| Abstract: |
| ［Abstract］ Objective To compare the effect of two different conservative treatments to intervene primary osteoporotic thoracolumbar vertebral fractures,in order to search for the best scheme of non-surgical treatments of primary osteoporotic thoracolumbar vertebral fractures that combined Chinese medicine with Western medicine.Methods Ninety cases of primary osteoporotic thoracolumbar fractures were divided into two groups,one was 30 cases for observation group and another was 60 cases for control group. Two different kinds of non-surgical treatments were developed by selecting appropriate treatments from both traditional Chinese medicine such as Jiawei Dajiang Zhuyu Prescription,Guben Shugan Zhuanggu Prescription,external medicine(Ironing), and western medicines including caltrate-D tablets,alfacalcidol soft capsules,Salcatonin Injection. Then the two different kinds of non-surgical treatments were applied to the two groups,and the efficacy,the quality of life and cost-effectiveness of the two groups were evaluated.Results There was no significant difference for the clinical effect between the observation group and control group（P>0.05）; the total score for quality of life indicators was of no significant difference（P>0.05）,after treatment the effective scores of mental health and vitality in the two groups were higher than that before treatment（P<0.01）and the effective scores of mental health and vitality in the observation group was higher than that in the control group（P<0.01).The cost-effectiveness was better than that in control group（P<0.01).Conclusion For primary osteoporotic thoracolumbar vertebral fractures patients,good curative effect can be gained when they are treated with integrative medical therapy of non-surgical at hospital combined with rehabilitation at home and when treated with full hospitalization. However,the former may bring the patients a better feeling,more stable emotion,more vigor,and a happier life.and the advantage of the former outweigh the latter in terms of health economics and should be recommended for a wider use. |
| Key words: Thoracolumbar vertebral fractures Osteoporosis Non-surgical treatment Health economics |
