| 周军挺,丁晓媚,张丽蓉,叶一萍.补肾活血中药治疗绝经后骨质疏松症临床研究[J].浙江中西医结合杂志,2017,27(5): |
| 补肾活血中药治疗绝经后骨质疏松症临床研究 |
| Clinical study of using Bushen Huoxue traditional Chinese medicine to treat post-menopausal osteoporosis |
| 投稿时间：2016-09-27 修订日期：2016-11-26 |
| DOI： |
| 中文关键词: 补肾活血中药 绝经 骨质疏松症 临床研究 |
| 英文关键词:Bushen Huoxue traditional Chinese medicine Menopause Osteoporosis Clinical study |
| 基金项目:浙江省中医药科技项目(No. 2012ZA134) |
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| 摘要点击次数: 1056 |
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| 中文摘要: |
| 目的：探讨补肾活血中药治疗绝经后骨质疏松症的临床疗效。方法：选取2015年3月~2016年3月我院收治的130例绝经后骨质疏松症患者，将其按照随机数字法分为观察组和对照组，每组65例，对照组给予口服碳酸钙D3片进行治疗，观察组在对照组基础上给予补肾活血中药进行治疗，两组均治疗3个月，观察两组治疗前及治疗后患者临床症状（腰背疼痛、腰膝酸软、夜尿增加、畏寒肢冷、神疲倦怠）、骨密度指标（腰椎L2-4、股骨颈、股骨大转子、Ward’s三角）、骨代谢指标（骨碱性磷酸酶( B-ALP)、抗酒石酸酸性磷酸酶( TRACP)），并对治疗3个月的临床疗效及治疗期间的不良反应进行评估。结果：治疗后观察组组腰背疼痛、腰膝酸软、夜尿增加、畏寒肢冷、神疲倦怠症状评分分别为（1.15±0.43）分、（0.45±0.37）分、（0.60±0.42）分、（0.55±0.31）分、（0.62±0.34）分均较治疗前的（2.57±0.71）分、（1.15±0.61）分、（1.00±0.32）分、（1.21±0.44）分、（1.07±0.51）分显著下降（t≥5.919，均P<0.05），治疗后对照组组腰背疼痛、腰膝酸软、夜尿增加、畏寒肢冷、神疲倦怠症状评分分别为（2.01±0.61）分、（0.90±0.51）分、（0.83±0.31）分、（0.91±0.53）分、（0.92±0.41）分均较治疗前的（2.60±0.82）分、（1.18±0.66）分、（1.05±0.41）分、（1.24±0.51）分、（1.06±0.44）分显著下降（t≥2.547，均P<0.05），但观察组治疗后下降更为明显（t≥3.784，均P<0.05）。治疗后观察组总有效率为91.8%显著性高于对照组的75.4%（?2=5.471，P<0.05）。治疗后观察组腰椎L2-4、股骨颈、股骨大转子、Ward’s三角骨密度分别为（0.97±0.14）g/cm2、（0.87±0.11）g/cm2、（0.85±0.10）g/cm2、（0.86±0.08）g/cm2均较治疗前的（0.77±0.12）g/cm2、（0.72±0.14）g/cm2、（0.71±0.06）g/cm2、（0.67±0.06）g/cm2显著增加（t≥6.792，均P<0.05）；治疗后对照组腰椎L2-4、股骨颈、股骨大转子、Ward’s三角骨密度分别为（0.77±0.12）g/cm2、（0.77±0.14）g/cm2、（0.75±0.10）g/cm2、（0.75±0.10）g/cm2均较治疗前的（0.76±0.11）g/cm2、（0.69±0.12）g/cm2、（0.68±0.09）g/cm2、（0.66±0.09）g/cm2显著增加（t≥6.792，均P<0.05）但观察组治疗后增加更为明显（t≥3.314，均P<0.05）。治疗后观察组B-ALP、TRACP分别为（19.32±3.34）IU/L2、（5.12±1.01）IU/L2均显著低于对照组（22.33±3.03）IU/L2、（6.23±1.12）IU/L2（t≥5.381，均P<0.05）。对照组不良反应发生率为15.4%显著性高于观察组的4.6%（?2=4.188，P<0.05）。结论：在钙剂治疗基础上采用补肾活血中药治疗可以显著改善绝经后骨质疏松症的临床症状，同时可改善患者骨代谢和骨密度，临床疗效好，不良反应发生率低。 |
| 英文摘要: |
| Objective: To evaluate the clinical efficacy of using Bushen Huoxue traditional Chinese medicine to treat post-menopausal osteoporosis. Methods: From March 2015 to March 2016 in our hospital 130 cases of postmenopausal osteoporosis patients were selected and randomly divided into the control group and the observation group (65 cases in each group); The control group were given oral calcium carbonate D3 tablets for treatment, while the observation group were given traditional Chinese medicine on basis of the control group treatment; Both groups were all treated for three months. Before and after treatment in the two groups clinical symptoms (low back pain, weak waist, nocturia increasion, chills and fatigue Shenpi), bone density (lumbar spine L2-4, femoral neck, trochanter, Ward's triangle), bone metabolism (bone alkaline phosphatase (B-ALP), tartrate-resistant acid phosphatase (TRACP)) were recorded and compared, as well as the clinical efficacy and adverse reactions during treatment. Results: In the observation group after treatment the scores of symptoms including low back pain, weak waist, nocturia increasion, chills, and nerve fatigue were （1.15±0.43）,（0.45±0.37）,（0.60±0.42）,（0.55±0.31） and（0.62±0.34）significantly lower than those before treatment （2.57±0.71）,（1.15±0.61）,（1.00±0.32）,（1.21±0.44） and （1.07±0.51） (t≥5.919, all P <0.05). significantly lower than those before treatment. After treatment in the control group the scores of symptoms including low back pain, weak waist, nocturia increasion, chills, and nerve fatigue were （2.01±0.61）,（0.90±0.51）,（0.83±0.31）,（0.91±0.53） and（0.92±0.41） significantly lower than those before treatment （2.60±0.82）,（1.18±0.66）,（1.05±0.41）,（1.24±0.51） and（1.06±0.44） (t≥2.547, all P <0.05). And those indexes in the observation group decreased significantly (t≥3.784, all P<0.05). After treatment, in the observation group the total effective rate was 91.8% significantly higher than that in the control group 75.4% (?2=5.471, P <0.05). In the observation group the lumbar vertebrae L2-4, femoral neck, femoral trochanter and Ward's triangular bone density were (0.97 ± 0.14) g / cm2, (0.87 ± 0.11) g / cm2, (0.85 ± 0.10) g / cm2 and (0.97 ± 0.14) g / cm 2 respectively significantly higher than those before treatment （0.77±0.12）g/cm2,（0.72±0.14）g/cm2,（0.71±0.06）g/cm2 and（0.67±0.06）g/cm2 (t≥6.792，all P<0.05). After treatment in the control group the lumbar vertebrae L2-4, femoral neck, femoral trochanter and Ward's triangular bone density were （0.77±0.12）g/cm2,（0.77±0.14）g/cm2,（0.75±0.10）g/cm2 and（0.75±0.10）g/cm2 respectively significantly higher than those before treatment （0.76±0.11）g/cm2,（0.69±0.12）g/cm2,（0.68±0.09）g/cm2 and（0.66±0.09）g/cm2 (t≥6.792，all P<0.05). In the observation group after treatment B-ALP and TRACP were (19.32±3.34) IU / L2 and (5.12 ± 1.01) IU / L2 significantly lower than those in the control group (22.33±3.03) IU / L2 and (6.23±1.12) IU / L2 (t≥5.381, all P<0.05). Adverse reactions rate in the control group was 15.4% significantly higher than 4.6% in the observation group (?2 = 4.188, P <0.05). Conclusions: Using Bushen Huoxue traditional Chinese medicine to treat post-menopausal osteoporosis based on calcium can significantly improve the clinical symptoms of post-menopausal osteoporosis, which could improve bone metabolism and bone mineral density, with better clinical efficacy and higher clinical safety. |
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