[1]李玲慧,王达,刘治泽,等.手法复位对骨质疏松性椎体压缩骨折椎体成形术后疼痛及脊柱功能的影响及安全性评价[J].西部中医药,2024,37(11):82-87.[doi:10.12174/j.issn.2096-9600.2024.11.17]
　LI Linghui,WANG Da,LIU Zhize,et al.Evaluation of the Efficacy and Safety of Manipulative Reduction on Pain and Spinal Function after Vertebroplasty for OVCF[J].Western Journal of Traditional Chinese Medicine,2024,37(11):82-87.[doi:10.12174/j.issn.2096-9600.2024.11.17]
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手法复位对骨质疏松性椎体压缩骨折椎体成形术后疼痛及脊柱功能的影响及安全性评价
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
37
期数:
2024年11期
页码:
82-87
栏目:
二次研究
出版日期:
2024-11-15

文章信息/Info

Title:
Evaluation of the Efficacy and Safety of Manipulative Reduction on Pain and Spinal Function after Vertebroplasty for OVCF
作者:
李玲慧1,2, 王达1, 刘治泽1, 王晓阳1, 谢榕1, 彭啸1, 王尚全1,2, 李光华1
1.中国中医科学院望京医院，北京 100102
2.中医正骨技术北京市重点实验室，北京 100102
Author(s):
LI Linghui1,2, WANG Da1, LIU Zhize1, WANG Xiaoyang1, XIE Rong1, PENG Xiao1, WANG Shangquan1,2, LI Guanghua1
1.Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
2.Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine, Beijing 100102, China
关键词:
骨质疏松性椎体压缩骨折; 经皮椎体成形术; 手法复位; Meta分析
Keywords:
osteoporotic vertebral compression fractures; percutaneous vertebroplasty; manipulative reduction; Meta analysis
分类号:
R274.1
DOI:
10.12174/j.issn.2096-9600.2024.11.17
文献标志码:
A
摘要:
目的应用系统评价的方法对手法复位联合经皮椎体成形术（percutaneous vertebroplasty，PVP）治疗骨质疏松性椎体压缩骨折的疗效及安全性进行分析，为临床提供研究证据。 方法通过计算机系统检索在2024年3月之前公开发表在PubMed、Cochrane图书馆数据库、EMBASE数据库、SinoMed文献服务系统、CNKI数据库、万方数据库、中国科技期刊数据库中有关手法复位联合PVP治疗骨质疏松性椎体压缩骨折的随机对照研究。由2位研究人员对文献进行独立筛选和数据提取，并参照Cochrane协作网标准，对纳入的随机对照试验逐一进行质量评价，对符合纳入标准的相关研究采用RevMan 5.4.1软件进行Meta分析。 结果最终共纳入18篇随机对照试验，共1702例患者，其中手法复位联合PVP组857例，PVP组845例。Meta分析结果显示：手法复位联合PVP与单纯PVP组相比较，近期视觉模拟量表（visual analogue scale，VAS）评分［均数差值（mean difference，MD）=-0.57，95%置信区间（confidence interval，CI）：-1.07～-0.07，P=0.03）、远期VAS评分（MD=-0.78，95%CI：-1.09～0.47，P＜0.000 01）、近期Oswestry功能障碍指数（the oswestry disability index，ODI）评分（MD=-3.99，95%CI：-4.91～-3.07，P＜0.000 01）、远期ODI评分（MD=-7.02，95%CI：-7.99～-6.05，P＜0.000 01）、椎体后凸Cobb角（Cobb′s angle，Cobb）（MD=-6.07，95%CI：-8.10～-4.03，P＜0.000 01）、骨水泥渗漏发生率［比值比（odds ratio，OR）=0.33，95%CI：0.17～0.67，P=0.002）等诸多方面均有显著性差异（P＜0.05）。 结论手法复位联合PVP在改善骨质疏松性椎体压缩骨折患者术后疼痛、脊柱功能方面具有显著优势，安全性较好。
Abstract:
ObjectiveTo analyze clinical effects and the safety of manipulative reduction and PVP in the treatment of osteoporotic vertebral compression fractures (OVCF) using systematic evaluation, in order to provide research evidence for clinical application. MethodsRandomized controlled trial(RCT) on manipulative reduction and PVP in treating OVCF, released before March, 2024, were retrieved from PubMed, Cochrane, EMBASE, SinoMed, CNKI, Wanfang and VIP by computer. The literature was screened and the data was extracted indepen-dently by two researchers, to perform quality evaluation of the included RCT according to Cochrane collaboration tool, and to conduct the Meta analysis of the relevant studies which met the inclusion criteria using RevMan 5.4.1 software. ResultsThe study has included 18 RCTs consequently, and 1702 patients, among them, there were 857 cases in manipulative reduction and PVP group, and 845 cases in PVP group. The results of Meta analysis showed that: when manipulative reduction and PVP group was compared with single PVP group, significant differences could be found in the aspects: recent VAS scores (MD=-0.57, 95%CI:-1.07～-0.07, P=0.03), long-term VAS scores (MD=-0.78, 95%CI:-1.09～-0.47, P<0.000 01), recent ODI scores (MD=-3.99, 95%CI:-4.91～-3.07, P<0.000 01), long-term ODI scores (MD=-7.02, 95%CI:-7.99～-6.05, P<0.000 01), Cobb′s (MD=-6.07, 95%CI:-8.10～-4.03, P<0.000 01), and the incidence of bone cement leakage (OR=0.33, 95%CI:0.17～0.67, P=0.002) (P<0.05). ConclusionManipulative reduction combined with PVP has significant advantages in improving postoperative pain and spinal function after OVCF with better safety.

相似文献/References:

[1]陈迪坤,徐展望△.经皮椎体成形术联合中药治疗骨质疏松性胸腰椎压缩骨折临床观察[J].西部中医药,2013,26(11):93.
　CHEN Dikun,XU Zhanwang.Clinical Observation on Percutaneous Vertebroplasty Combined with TCM in Treating Osteoporotic Vertebral Compression Fracture[J].Western Journal of Traditional Chinese Medicine,2013,26(11):93.
[2]张彦军,邓强,李盛华,等.陇中正骨手法联合PVP治疗骨质疏松性椎体骨折临床疗效观察[J].西部中医药,2018,31(10):13.
　ZHANG Yanjun,DENG Qiang,LI Shenghua,et al.Clinical Observation on Longzhong Bone-setting Manipulation Plus PVP in Treating Osteoporotic Vertebral Fracture[J].Western Journal of Traditional Chinese Medicine,2018,31(11):13.

备注/Memo

备注/Memo:
李玲慧（1986—），女，博士学位，博士后，硕士研究生导师，副主任医师。研究方向：中医药防治骨与关节疾病的临床和基础研究。中国中医科学院优秀青年科技人才培养专项（ZZ17-YQ-014）。
更新日期/Last Update: 2024-11-15