补肾健脾化瘀法治疗原发性骨质疏松症的疗效及对骨代谢指标的影响

发布时间：2018-06-04 04:53

本文选题：补肾健脾 + 化瘀　；参考：《中华中医药学刊》2017年05期

【摘要】：目的:探讨补肾健脾化瘀法对原发性骨质疏松症(POP)的疗效及对骨代谢指标的影响。方法:将70例2010年1月—2014年12月收治的患者随机分为对照组和治疗组,每组35例。对照组采用碳酸钙D3片口服,治疗组在对照组基础上联合口服中医补肾健脾化瘀药方(黄芪,生地,淫羊藿,鹿角胶,龟胶,补骨脂,山药,水蛭等)。3个月为1个疗程,2个疗程后观察两组患者骨痛、功能改善、骨密度、骨代谢指标及不良反应情况。结果:治疗6个月后,治疗组及对照组患者的骨痛评分、Oswestry功能障碍指数、腰椎L2-4及髋部的骨密度值较治疗前均显著减小(P0.01,P0.05),且治疗组患者疗效明显优于对照组,差异有统计学意义(P0.05)。治疗组治疗后血清BALP及TRACP-5b较治疗前及对照组明显下降(P0.05),血清CT水平较治疗前及对照组显著增高(P0.05),血清Ca、P及BGP含量较治疗前及对照组无明显统计学差异(P0.05),而对照组治疗前后各项骨代谢指标变化均无统计学意义(P0.05)。治疗期间两组患者不良反应发生率无明显统计学差异(P0.05)。结论:补肾健脾化瘀法联合碳酸钙D3能有效改善骨痛、患者功能及骨代谢,升高骨密度且不良反应少,值得临床推广。
[Abstract]:Objective: to investigate the effect of tonifying kidney, strengthening spleen and removing blood stasis on primary osteoporosis and its effect on bone metabolism. Methods: 70 patients from January 2010 to December 2014 were randomly divided into control group and treatment group with 35 cases in each group. The control group was treated with calcium carbonate D3 tablets, and the treatment group was treated with traditional Chinese medicine prescription of tonifying kidney, strengthening spleen and removing blood stasis (Astragalus membranaceus, Shengdi, Epimedium, antler gum, turtle glue, psoralen, yam) on the basis of control group. After 2 courses of treatment, bone pain, function improvement, bone mineral density, bone metabolism index and adverse reaction were observed. Results: after 6 months of treatment, the Oswestry dysfunction index, bone mineral density of lumbar L2-4 and hip decreased significantly in the treatment group and the control group, and the curative effect of the treatment group was better than that of the control group. The difference was statistically significant (P 0.05). The levels of serum BALP and TRACP-5b in the treatment group were significantly lower than those before the treatment and the control group, while the serum CT level was significantly higher than that in the control group and the treatment group. There was no significant difference in the contents of serum caprop and BGP between the treatment group and the control group (P 0.05), while in the control group, there was no significant difference between the two groups. Before and after treatment, there was no significant change of bone metabolism index (P 0.05). There was no significant difference in the incidence of adverse reactions between the two groups during the treatment period (P 0.05). Conclusion: the method of tonifying kidney, invigorating spleen and removing blood stasis combined with calcium carbonate D3 can effectively improve bone pain, function and metabolism of bone, increase bone mineral density and have less adverse reactions, so it is worth popularizing in clinic.
【作者单位】：安吉县人民医院骨科;
【基金】：浙江省科技厅项目(2015c33263)
【分类号】：R580

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