OBJECTIVE: To probe into the efficacy and mechanism of Fuyuan Huoxue decoction combined with percutaneous vertebroplasty（PVP） in the treatment of fresh vertebral compression fractures. METHODS: Totally 90 patients with fresh vertebral compression fractures admitted into the hospital form Jun. 2020 to Jun. 2021 were extracted to divided into the observation group and the control group via the random number table method

with 45 cases in each group. The control group was treated with PVP

while the observation group received Fuyuan Huoxue decoction on the basis of the control group. Interleukin-1（IL-1）

tumor necrosis factor alpha（TNF-α）

interleukin-1β（IL-1β）

6-keto-prostaglandin E1α（6-keto-PGE1α）

β-endorphin（β-EP）

substance P（SP）

osteocalcin N-terminal middle molecular fragment（N-MID）

bone morphogenetic protein 7（BMP-7）

receptor activator of nuclear factor-κB ligand（RANKL） and type Ⅰ procollagen amino-terminal propeptide（s-PⅠNP） levels before and after treatment of two groups were detected. Vertebral kyphosis angle

anterior height of injured vertebra and bone mineral density were measured. Visual analogue scale（VAS）

oswestry disability index（ODI）

Japanese orthopaedic association（JOA） assessment and treatment score and health status questionnaire（SF-36） were evaluated. RESULTS: After treatment

the levels of IL-1

TNF-α and IL-1β in the observation group were significantly lower than those in the control group

the levels of SP and 6-keto-PGE1α were significantly lower than those in the control group

the levels of β-EP were significantly higher than those in the control group

the levels of RANKL were significantly lower than those in the control group

and the levels of N-MID

BMP-7 and s-PⅠNP were significantly higher than those in the control group

the vertebral kyphosis angle was significantly lower than that of the control group

the anterior height of injured vertebra and bone mineral density were significantly higher than those of the control group

the JOA and SF-36 scores were significantly higher than those of the control group

and the ODI and VAS scores were significantly lower than those of the control group

the differences were statistically significant（P<0.05）. CONCLUSIONS: Fuyuan Huoxue decoction combined with PVP in the treatment of fresh vertebral compression fractures can inhibit the inflammation

reduce the pain mediators

relieve the pain of patients

reduce the levels of RANKL

improve the levels of N-MID

BMP-7 and s-PⅠNP

improve the bone metabolism

increase the bone mineral density

promote the recovery of anatomical structure of the injured vertebra

improve the function of the lumbar spine and the quality of life of patients.