中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (36): 5741-5745.doi: 10.3969/j.issn.2095-4344.0615

• 骨组织构建 bone tissue construction •    下一篇

仿生药物人工虎骨及钙剂在退行性腰椎滑脱椎间植骨融合治疗中的应用

胡  炜,阚顺利,曹泽岗,江泽华,张学利,朱如森   

  1. (天津市人民医院脊柱外科,天津市  300121)
  • 收稿日期:2018-08-07 出版日期:2018-12-28 发布日期:2018-12-28
  • 通讯作者: 朱如森,硕士,副主任医师,天津市人民医院脊柱外科,天津市 300121
  • 作者简介:胡炜,男,1980年生,河北省涿州市人,回族,2015年天津医科大学毕业,博士,副主任医师,主要从事脊柱外科基础与临床研究。
  • 基金资助:

    天津市卫生行业重点攻关项目(16KG158);天津市人民医院院级科研课题(2016YJZD003,2017YJ024)

Artificial tiger bone and calfor applied in intervertebral fusion after degenerative lumbar spondylolisthesis

Hu Wei, Kan Shunli, Cao Zegang, Jiang Zehua, Zhang Xueli, Zhu Rusen   

  1. (Department of Spine Surgery, Tianjin People’s Hospital, Tianjin 300121, China)
  • Received:2018-08-07 Online:2018-12-28 Published:2018-12-28
  • Contact: Zhu Rusen, Master, Associate chief physician, Department of Spine Surgery, Tianjin People’s Hospital, Tianjin 300121, China
  • About author:Hu Wei, MD, Associate chief physician, Department of Spine Surgery, Tianjin People’s Hospital, Tianjin 300121, China
  • Supported by:

    the Key Research & Development Project of Tianjin Municipal Health, No. 16KG158; the Scientific Research Project of Tianjin People’s Hospital, No. 2016YJZD003 and 2017YJ024

摘要:

文章快速阅读:

文题释义:
人工虎骨:是一种虎骨的仿生药物,具有与天然虎骨一致的成分及药理药效,能够祛风止痛和强筋骨,有效缓解骨质疏松所导致的腰酸背痛现象。其对于原发性骨质疏松症的治疗疗效确切,且无不良反应,适合慢性骨质疏松或腰痛患者的长期使用。
脊柱滑脱时稳定脊柱结构的3种因素:一是峡部的假关节,二是增生的纤维环和后纵韧带,三是髂腰韧带。因而,即使有滑脱也可能没有症状,常不需手术治疗,通常限制患者活动,进行腰背肌锻炼以及使用坚韧的腰围等保守方法治疗。当伴有下腰痛等症状则有手术指征,则采用脊柱融合手术。不少学者提出,对于严重的滑脱应先复位再融合,以防止滑脱的加重,改善外观和减轻腰腿痛。随着椎弓根螺钉固定技术的发展,脊柱滑脱的治疗技术不断有新的进展。

摘要
背景:
人工虎骨是一种虎骨的仿生药物,具有与天然虎骨一致的成分及药理药效,能够祛风止痛和强筋骨,有效缓解骨质疏松所导致的腰酸背痛现象。
目的:探究人工虎骨对退行性腰椎滑脱术后疼痛、功能障碍及植骨融合的作用效果。
方法:采用随机数字法将60例退行性腰椎滑脱症接受椎间植骨融合治疗的患者分为治疗组和对照组,每组各30例。治疗组给予人工虎骨粉及钙尔奇D,对照组只给予钙尔奇D。治疗前及治疗后7 d及1,6,12个月分别采用目测类比评分法、Oswestry功能障碍指数(Oswestry disability index,ODI)评估,治疗后12个月观察椎间植骨融合率。
结果与结论:①两组患者均顺利完成手术并接受不同药物干预;②治疗前两组目测类比、ODI评分差异无统计学意义;治疗后第6,12个月,治疗组目测类比评分和ODI评分显著优于对照组(P < 0.05);③治疗后12个月治疗组植骨融合率略优于对照组,但差异无显著性意义(P > 0.05);④人工虎骨用于接受椎间融合的退行性腰椎滑脱患者能够缓解疼痛、改善功能障碍,但不能明显增加椎间植骨融合率。

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程
ORCID: 0000-0002-8250-5103(胡炜)

关键词: 腰椎滑脱, 人工虎骨, 疼痛, 椎间植骨融合, 退行性病变, 健骨, 组织构建

Abstract:

BACKGROUND: Artificial tiger bone is a kind of tiger bone biomimetic drug, which is consistent with natural bone composition and pharmacological effects. It can effectively relieve pain and strengthen bones and muscles, which can also relieve back pain caused by osteoporosis.
OBJECTIVE: To investigate the therapeutic effect of artificial tiger bone in patients with degenerative lumbar spondylolisthesis undergoing internal fixation and interbody fusion procedure.
METHODS: Sixty cases of degenerative lumbar spondylolisthesis undergoing internal fixation and interbody fusion were randomly divided into two groups and treated with artificial tiger bone plus D-calfor (treatment group) or D-calfor alone (control group). Visual Analogue Scale, and Oswestry disability index at baseline, 7 days, 1, 6 and 12 months after treatment, and interbody fusion rate at 12 months after treatment were compared.
RESULTS AND CONCLUSION: All patients underwent internal fixation and interbody fusion procedure successfully and then treated with different drugs. No significant differences were observed in the two groups regarding the Visual Analogue Scale and Oswestry disability index scores at baseline. At 6 and 12 months after treatment, the scores in the treatment group were significantly superior to those in the control group (P < 0.05). Regarding the interbody fusion rate, the treatment group was slightly better than the control group (P > 0.05). To conclude, for patients with degenerative lumbar spondylolisthesis undergoing internal fixation and interbody fusion procedure, artificial tiger bone can alleviate pain and improve dysfunction, but cannot significantly increase interbody fusion rate.

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程

Key words: Spondylolisthesis, Lumbar Vertebrae, Spinal Fusion, Tissue Engineering

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