益肾复原方治疗肾精亏虚型老年性骨质疏松症的疗效评价

发布时间：2018-05-08 13:56

本文选题：益肾复原方 + 骨质疏松症　；参考：《浙江中医药大学》2016年硕士论文

【摘要】：目的通过董飞侠主任中医师治疗老年性骨质疏松症的经验方益肾复原方的临床研究,评价其临床疗效,为中药复方的临床应用奠定理论基础,丰富中医临床抗骨质疏松症的治疗方案。方法将60例临床符合纳入标准的老年性骨质疏松症且中医辨证为肾精亏虚证患者,随机分为治疗组30例,对照组30例。对照组给予钙尔奇D片、罗盖全胶丸、阿仑膦酸钠治疗。治疗组在对照组的基础上给予益肾复原方煎剂,每日1剂,每日2次,每次服用200ml。3个月为1个疗程,2个疗程后判断临床疗效,并观察记录其药物不良反应,于疗程结束后,复查实验室指标,并评价疗效。结果治疗组总体有效率为90%,对照组总体有效率为70%,经统计学分析差异有统计学意义(P0.05)。治疗前治疗组与对照组各中医证候评分比较无明显差异(P0.05)。治疗组与对照组在经过治疗后,治疗组在腰膝酸软、耳鸣耳聋、性欲减淡、发脱齿松、两足萎软、舌淡、脉弱等中医证候改善方面均优于对照组,在统计学上有显著差异(P0.05)。对于试验前、后血清Ca、P、ALP浓度变化情况,两组治疗前、后血清P、ALP的浓度无明显改变,差异无显著性意义(P0.05)；两组治疗前、后血清Ca的浓度明显改变,差异有显著性意义(P0.05),治疗后组间比较,治疗组较对照组更能提高患者Ca浓度(P=0.3720.05)；试验前、后血清PINP、β-CTx浓度变化情况,两组治疗前、后血清PINP、β-CTx的浓度明显改变,差异有显著性意义(P0.05)；治疗后组间比较,治疗组较对照组更能提高患者PINP浓度,降低β-CTx的浓度(P0.05)。对于股骨颈(Neck)、股骨粗隆(Troch)和腰椎(L1-L4)骨密度检测比较情况,治疗组中治疗前后组内比较,P0.05,存显著性差异。对照组中治疗前后组内比较,P0.05,有显著性差异。两组治疗后组间比较,P0.05,有显著性差异。结论益肾复原方治疗老年性骨质疏松症具有较好的疗效,能显著改善患者的临床症状,试验组和对照组都可以改善患者骨密度值,提高血清PINP,降低血清β-CTX,加用益肾复原方,改善效果更明显,该复方能安全有效治疗老年性骨质疏松症。
[Abstract]:Objective to evaluate the clinical effect of Fang Yishen Restoration recipe through the experience of Director Dong Feixia in the treatment of senile osteoporosis, so as to lay a theoretical foundation for the clinical application of traditional Chinese medicine. Enrich the Chinese medicine clinical anti-osteoporosis treatment plan. Methods 60 cases of senile osteoporosis with syndrome differentiation of deficiency of kidney essence were randomly divided into treatment group (n = 30) and control group (n = 30). The control group was treated with calcium D tablet, Luogai total rubber pill and alendronate sodium. On the basis of the control group, the treatment group was given Yishen Restoration decoction once a day, twice a day, each time taking 200ml.3 for a course of treatment. After two courses of treatment, the clinical efficacy was evaluated, and the adverse drug reactions were observed and recorded. To review the laboratory indexes and evaluate the efficacy. Results the total effective rate was 90 in the treatment group and 70 in the control group. There was no significant difference in the scores of TCM syndromes between the treatment group and the control group before treatment (P 0.05). After treatment, the treatment group and the control group were superior to the control group in improving the TCM syndromes, such as weak waist and knee, tinnitus and deafness, decreased libido, loose hair, weak feet, weak tongue, weak pulse and so on. There was significant difference in statistics between the treatment group and the control group (P 0.05). Before and after the treatment, the changes of serum calcium concentration in the two groups were not obvious, but there was no significant difference between the two groups before and after the treatment, and the changes of the serum Ca levels before and after treatment in the two groups were not significant, but there was no significant difference between the two groups before and after the treatment. The difference was significant (P 0.05). Compared with the control group, the serum PINP and 尾 -CTx concentrations in the treatment group were significantly higher than those in the control group, and the changes of serum PINP and 尾 -CTx levels before and after the treatment were significantly different between the two groups before and after treatment. After treatment, the concentration of PINP in the treatment group was higher than that in the control group, and the concentration of 尾 -CTX was lower than that in the control group. The bone mineral density (BMD) of Neckus femoris trochanter and L1-L4 in the treatment group was significantly higher than that in the control group before and after treatment (P 0.05). In the control group, there was a significant difference between the two groups before and after treatment (P 0.05). There was significant difference between the two groups after treatment (P 0.05). Conclusion Yishenghuangfang has good curative effect on senile osteoporosis, and can improve the clinical symptoms of the patients. Both the experimental group and the control group can improve the bone mineral density, increase serum PINP, decrease serum 尾 -CTX, and add Yishen Restoration recipe. The improvement effect is more obvious, this compound can treat senile osteoporosis safely and effectively.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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