绝经后骨质疏松症肾虚血瘀证的舌象参数及青娥丸的干预研究

发布时间：2018-02-14 12:14

本文关键词： 绝经后骨质疏松症青娥丸舌象参数　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察绝经后骨质疏松症肾虚血瘀证患者的舌象参数变化和青娥丸的治疗作用,以期为建立具有中医特色的疗效评价体系提供客观依据。方法:2014年9月至2014年12月华中科技大学同济医学院附属协和医院骨质疏松症专病门诊确诊的绝经后骨质疏松症肾虚血瘀证患者48例,根据就诊顺序编号并按随机数字表法分为青娥丸治疗组和青娥丸模拟剂对照组,每组各24例。两组均给予钙尔奇D作为基础治疗,青娥丸治疗组服用青娥丸,青娥丸模拟剂对照组服用青娥丸模拟剂,疗程均为24周。分别于基线和治疗24周后对两组舌形参数(老嫩指数、胖瘦指数、齿痕指数、点刺指数、裂纹指数、瘀斑指数)、苔质参数(厚薄指数、润燥指数、腐腻指数、剥苔指数)、有效性评价指标(主要临床症状评分、腰背四肢疼痛VAS评分、中医证候计分、骨代谢标志物、骨密度)进行检测和比较。分别于基线、治疗8周、16周、24周后对一般体格检查(身高、体重、体温、呼吸、心率、血压等)、血常规、尿常规、大便常规、肝功能、肾功能,心电图等进行检测和比较。分别于基线及治疗24周后对安全性评价指标(性激素水平、乳腺B超、子宫B超、胸腰椎X线等)进行检测和比较。随时记录不良事件。结果:青娥丸能显著降低绝经后骨质疏松症肾虚血瘀证患者舌象胖瘦指数、齿痕指数、瘀斑指数、腰背疼痛VAS评分、主要临床症状计分、中医证候总计分、腰背疼痛和腰膝酸软症状程度,并能显著降低血清β-CTX水平,差异有统计学意义(P0.05);下肢痿弱、步履艰难、耳鸣症状程度无明显改善,差异无统计学意义(P0.05);舌象老嫩指数、点刺指数、裂纹指数、厚薄指数、润燥指数、腐腻指数及剥苔指数无明显改变,差异无统计学意义(P0.05);腰椎L2-L4及股骨颈骨密度值无明显增加,差异无统计学意义(P0.05)。青娥丸模拟剂对照组腰椎L2-L4及股骨颈骨密度值与基线比较明显降低,差异有统计学意义(P0.05)。青娥丸治疗组总有效率为75%。结论:青娥丸能显著降低绝经后骨质疏松症肾虚血瘀证患者舌象胖瘦指数、齿痕指数和瘀斑指数,改善腰背疼痛和腰膝酸软症状,显著降低β-CTX水平。
[Abstract]:Objective: to observe the changes of tongue parameters in postmenopausal osteoporosis patients with kidney deficiency and blood stasis syndrome and the therapeutic effect of Qing'e pill. Methods: from September 2014 to December 2014, the postmenopausal bone of the Union Medical College affiliated to Tongji Medical College of Huazhong University of Science and Technology was diagnosed in the Osteoporosis outpatient Clinic of the affiliated Medical College of Tongji University of Science and Technology, Huazhong University of Science and Technology. 48 patients with kidney deficiency and blood stasis syndrome, According to the number of patients, they were divided into two groups: the treatment group and the control group with 24 cases in each group. Both groups were treated with Calcidum D as the basic therapy, and the treatment group took the Qinge pill in the treatment group. The control group was treated with Qinge pill for 24 weeks. The tongue shape parameters (old tender index, fat thin index, tooth mark index, prick index, crack index) were measured at baseline and 24 weeks after treatment. Index of ecchymosis, index of moss quality (thickness index, moistening index, greasy index, exfoliation index, effective evaluation index (main clinical symptom score, VAS score of back and back pain, TCM syndrome score, biomarker of bone metabolism), Bone mineral density (BMD) was measured and compared at baseline, 8 weeks, 16 weeks and 24 weeks after treatment. General physical examination (height, weight, body temperature, respiration, heart rate, blood pressure etc.), blood routine, urine routine, stool routine, liver function, renal function, etc. Electrocardiogram (ECG) was measured and compared at baseline and 24 weeks after treatment. Adverse events were recorded at any time. Results: Qinge pills could significantly reduce the fat tongue index, tooth mark index, ecchymosis index and VAS score of lumbar back pain in postmenopausal osteoporosis patients with kidney deficiency and blood stasis syndrome. The score of main clinical symptoms, the total score of TCM syndromes, the pain of back and back, the degree of acerbity and softness of waist and knee, and the level of serum 尾 -CTX were significantly decreased, the difference was statistically significant (P 0.05), the weakness of lower limbs, the difficulty of walking, and the degree of tinnitus symptoms were not obviously improved. There was no significant difference (P 0.05), while there was no significant change in tongue appearance index, puncturing index, crack index, thickness index, wetting index, greasy index and peeling index, but there was no significant difference between them, and there was no significant increase in bone mineral density of lumbar vertebrae L2-L4 and femoral neck. The bone mineral density of lumbar vertebrae L2-L4 and femoral neck in the control group was significantly lower than that in the baseline group. The difference was statistically significant (P 0.05). The total effective rate of Qing E pill group was 75. Conclusion: Qing E pill can significantly reduce the tongue fat index, tooth mark index and ecchymosis index of postmenopausal osteoporosis patients with kidney deficiency and blood stasis syndrome. To ameliorate the pain of the back of the waist and the soft symptoms of the waist and knee, and significantly reduce the level of 尾-CTX.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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