目的 探讨补肾壮督方联合阿仑膦酸钠及骨水泥分期灌注椎体后凸成形术对kummell病远期临床疗效和血清标志物的影响。方法 选取90例2019年1月-2020年3月因kummell病住院手术治疗的患者，随机分为试验组45例和对照组45例。对照组给予骨水泥分期灌注椎体后凸成形术，术后口服阿仑膦酸钠治疗，试验组术后加用补肾壮督方口服治疗。记录两组术中骨水泥注入量。采用VAS疼痛评分标准评估术后疼痛改善情况，采用ODI评分评估功能障碍改善情况。采用伤椎前缘高度比值和伤椎椎体楔形角评估脊柱稳定性。采用碱性磷酸酶（ALP），骨钙素（OC），骨保护素（OPG）评估治疗前后血清骨形成情况。结果 与对照组比较，试验组术后第3天VAS疼痛评分明显低于对照组，差异有统计学意义（P<0.05）；试验组术后第3天、术后6个月和术后12个月ODI评分明显低于对照组，差异有统计学意义（P<0.05）；试验组术后6个月和术后12个月伤椎前缘高度比值明显高于对照组，差异有统计学意义（P<0.05）；试验组术后6个月和术后12个月伤椎椎体楔形角明显低于对照组，差异有统计学意义（P<0.05）。试验组术后6个月和术后12个月碱性磷酸酶（ALP），骨钙素（OC），骨保护素（OPG）明显高于对照组，差异有统计学意义（P<0.05）。结论 补肾壮督方联合阿仑膦酸钠及骨水泥分期灌注椎体后凸成形术治疗kummell病可加快术后患者疼痛改善和功能恢复，促进骨形成，有效抑制患者中远期椎体压缩塌陷，维持脊柱稳定性。

Objective To investigate the effect of Bushenzhuangdu decoction combined with alendronate sodium and kyphoplasty by bone cement staged perfusion on long-term clinical efficacy and serum markers of Kummell disease.Methods 90 patients with Kummell disease treated with operation from January 2019 to March 2020 were randomly divided into experimental group (n=45) and control group (n=45). The control group was treated with kyphoplasty by bone cement staged perfusion and oral alendronate sodium after operation,the experimental group was treated additionally with Bushenzhuangdu decoction. The amount of bone cement injected during the operation was recorded on two groups. VAS pain score was used to evaluate the improvement of postoperative pain, and ODI score was used to evaluate the improvement of dysfunction. The ratio of anterior height of injured vertebral body and the wedge angle of injured vertebral body were used to evaluate spinal stability. Alkaline phosphatase (ALP), osteocalcin (OC) and osteoprotegerin (OPG) were used to evaluate the serum bone formation before and after treatment.Results Compared with the control group, the VAS pain score of the experimental group on the third day after operation was significantly lower than that of the control group (P < 0.05); The ODI scores of the experimental group at 3 days, 6 months and 12 months after operation were significantly lower than those of the control group (P < 0.05); The ratio of anterior height of injured vertebral body in the experimental group was significantly higher than that in the control group at 6 months and 12 months after operation, and the difference was statistically significant (P < 0.05); At 6 months and 12 months after operation, the wedge angle of injured vertebral body of the experimental group was significantly lower than that of the control group (P < 0.05). At 6 months and 12 months after operation, the Alkaline phosphatase (ALP), osteocalcin (OC) and osteoprotegerin (OPG) of the experimental group were significantly higher than that of the control group (P < 0.05).Conclusion Bushenzhuangdu decoction combined with alendronate sodium and kyphoplasty by bone cement staged perfusion in the treatment of Kummell disease can accelerate the postoperative pain improvement and functional recovery, promote bone formation. And it can effectively inhibit the mid and long-term vertebral body compression and collapse, maintain the stability of the spine.

海南省自然科学基金资助（820RC787）；2022年全国名老中医药专家传承工作室建设项目（国中医药人教函〔2022〕75号）。