摘要目的:探讨自拟补肾健骨汤对老年骨质疏松椎体压缩性骨折术后患者骨转换标志物水平的影响。方法:前瞻性队列研究。将符合入选标准的2020年4月－2021年12月北京中医药大学房山医院骨质疏松性椎体压缩性骨折术后患者92例，采用随机抽签法分为2组，每组46例。对照组术后给予西医常规疗法治疗，观察组在对照组基础上加服自拟补肾健骨汤。2组均治疗3个月。分别于治疗前后进行中医症状评分，采用中国人骨质疏松症生存质量简明量表（COQOL）、VAS量表、腰部Oswestry功能障碍指数（ODI）评估患者的预后；采用邻苯二甲醛对比显色法检测Ⅰ型前胶原氨基末端前肽（PINP）、Ⅰ型胶原交联端肽β特殊序列（β-CTX）、骨形成蛋白6（BMP6）水平；记录治疗期间的不良反应，评价临床疗效。结果:观察组总有效率为95.7%（44/46）、对照组为82.6%（38/46），2组比较差异有统计学意义（ χ 2= 4.04， P=0.044）。观察组治疗后骨折不连、腰背疼痛、畏寒酸软、面色苍白评分低于对照组（ t值分别为4.84、4.09、4.87、4.14 ，P<0.01）；COQOL、VAS、ODI评分低于对照组（ t值分别为6.26、10.57、6.15 ，P<0.01）；观察组治疗后PINP［（44.93±5.86）μg/L比（49.76±6.02）μg/L， t=3.90］、β-CTX［（0.49±0.17）μg/L比（0.68±0.20）μg/L， t=4.91］水平低于对照组（ P<0.05）；BMP6［（81.23±9.14）μg/L比（75.14±8.25）μg/L， t=3.36］水平高于对照组（ P<0.05）。治疗期间，观察组不良反应发生率为13.0%（6/46）、对照组为8.7%（4/46），2组比较差异无统计学意义（ χ 2=0.45， P=0.503）。 结论:自拟补肾健骨汤结合西医常规疗法可调节老年骨质疏松椎体压缩性骨折术后患者骨转换标志物水平，改善患者腰椎功能和生活质量，提高临床疗效。

abstractsObjective:To investigate the effect of self-made Bushen Jiangu Decoction on bone transformation markers in elderly patients with osteoporotic vertebral compression fracture after operation, and to evaluate the clinical efficacy.Methods:Prospective cohort study. A total of 92 patients with osteoporotic vertebral compression fracture after operation in Fangshan Hospital of Beijing University of Chinese Medicine from April 2020 to December 2021 who met the inclusion criteria were divided into 2 groups by random drawing method, with 46 in each group. The control group was treated with routine western medicine after operation, and the observation group was treated with self-made Bushen Jiangu Decoction on the basis of the control group. Both groups were treated for 3 months. TCM symptom scores were performed before and after treatment, and the prognosis of the patients was evaluated with the Chinese Osteoporosis Quality of Life (COQOL), VAS scale, and the Oswestry Dysfunction Index (ODI). The levels of amino terminal propeptide (PINP), cross-linked terminal peptide β special sequence (β-CTX) and bone morphogenetic protein 6 (BMP6) of type Ⅰ procollagen were determined by contrast chromogenic method with o-benzaldehyde. The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results:The total effective rate was 95.7% (44/46) in the observation group and 82.6% (38/46) in the control group, and there was a significant difference between the two groups ( χ 2=4.04 , P=0.044). After treatment, the scores of fracture nonunion, pain in back and loin, chilliness and lassitude, and pallor in the observation group were significantly lower than those in the control group ( t values were 4.84, 4.09, 4.87, 4.14, respectively, P<0.01). The scores of COQOL, VAS and ODI in the observation group were significantly lower than those in the control group ( t values were 6.26, 10.57 and 6.15, respectively, P<0.01). The levels of PINP [(44.93±5.86)μg/L vs. (49.76±6.02)μg/L, t=3.90] and β-CTX [(0.49±0.17) μg/L vs. (0.68±0.20) μg/L, t=4.91] in observation group were significantly lower than those in the control group after treatment ( P<0.05). The level of BMP6 [(81.23±9.14) μg/L vs. (75.14±8.25) μg/L, t=3.36] in observation group was significantly higher than that of the control group ( P<0.05). During the treatment,the incidence of adverse reactions in the observation group was 13.0% (6/46), while that in the control group was 8.7% (4/46), and there was no significant difference between the two groups ( χ 2=0.45, P=0.503). Conclusion:The self-made Bushen Jiangu Decoction combined with conventional western medicine therapy can adjust the level of bone transformation markers in elderly patients with osteoporotic vertebral compression fractures, improve the lumbar function and quality of life, and improve the clinical efficacy.