健脾益气膏方治疗原发性骨质疏松的临床观察

发布时间：2018-06-16 05:40

本文选题：健脾益气膏方 + 原发性骨质疏松　；参考：《广西中医药大学》2016年硕士论文

【摘要】：目的:经过中医健脾益气膏方治疗原发性骨质疏松症的临床应用,观察其临床效果,为中医药临床治疗原发性骨质疏松症的临床治疗提供客观依据。方法:选取2014年9月-2015年1月广西中医药大学附属瑞康医院骨伤三区门诊及病房,收集符合脾胃气虚型原发性骨质疏松症的诊断标准和纳入标准的患者70例,按照随机数字表将入选的70例脾胃气虚型原发性骨质疏松症患者分为治疗35例和对照组35例,治疗组运用阿仑膦酸钠片和健脾益气膏方的综合疗法;对照组运单纯运用阿伦磷酸钠片的单纯疗法。一个疗程为8周,连用两个疗程后,观察两组原发性骨质疏松患者治疗前后的症状变化,并对原发性骨质疏松治疗前和治疗两个疗程后使用骨密度检测、VAS疼痛评分、血清钙和血清磷进行疗效评价并计算出治疗期间两组发生的不良率,所有数据经过统计分析软件SPSS20.0进行分析处理,评价两组治疗方法的效果是否有明显差异。结果:两组脾胃气虚型原发性骨质疏松患者经过治疗以后各项症状、体征都得到了明显改善。(1)使用健脾益气膏方和阿仑膦酸钠综合治疗的治疗组总有效率为91.4%,单纯使用阿仑膦酸钠治疗的对照组总有效率为62.9%。治疗组的总有效率明高于对照组,说明治疗脾胃气虚型原发性骨质疏松健脾益气膏方加阿仑膦酸钠临床疗效比较好。(2)对照组和治疗组两组患者中医症候积分在治疗8周和治疗16周后均有所下降,治疗8周后治疗组优于对照组,治疗16周后治疗组和对照组之间,治疗组临床效果明显好于对照组,p0.05。治疗组能更好的缓解脾胃气虚型原发性骨质疏松症患者的腰脊疼痛,酸软少力,神疲倦怠。肢体软弱乏力,渐致缓纵不收,食少便溏或久泻不止,甚者畏寒肢冷等症状。(3)对照组和治疗组两组视觉模拟积分显示,两组患者在治疗8周和16周之后均有临床效果,治疗8周后对照组和治疗组临床效果区别不大,但是治疗16周之后对照组和治疗组组间比较,治疗组治疗16周后疼痛缓解效果明显好于对照组。健脾益气膏方联合阿仑膦酸钠综合疗法对缓解脾胃气虚型原发性骨质疏松腰背疼痛具有显著的临床效果(4)对照组患者腰椎(l2-4)和股骨颈两个位置的骨密度经过16周治疗后,骨密度并没有明显改善。单纯使用阿仑膦酸钠对改善脾胃气虚型原发性骨质疏松的骨密度临床效果不明显。治疗组患者治疗八周后骨密度没有改善和治疗前区别不大,但是治疗16周后治疗组患者腰椎(l2-4)和股骨颈两个部位的骨密度均较治疗前有所改善。表明健脾益气膏方联合阿仑膦酸钠对改善脾胃气虚型骨质疏松需要长时间用药,但是治疗组较对照组能够更好的提高脾胃气虚型原发性骨质疏松患者的骨密度,增加骨的强性。(5)血清钙和血清磷在对照组和治疗组治疗八周和十六周后较前均没有得到明显的临床改善,疗效不明显,说明健脾益气膏方和阿仑膦酸钠在短时间内对改善骨生化指标不明显。结论:运用健脾益气膏方和阿仑膦酸钠综合疗法的临床效果明显优于对照组,且提高原发性骨质疏松患者整体的生存质量包括缓解疼痛、提高骨密度等方面较单纯使用阿仑膦酸钠更有优势。
[Abstract]:Objective: To observe the clinical effect of traditional Chinese medicine Jianpi Yiqi cream prescription in the treatment of primary osteoporosis, and to provide an objective basis for the clinical treatment of primary osteoporosis in Chinese medicine. Methods: in January, -2015 year of September 2014, Guangxi traditional Chinese medicine university was attached to the three District outpatient and ward of the bone injury in ruigkang hospital. 70 patients with spleen and stomach qi deficiency primary osteoporosis were divided into 70 cases of spleen and stomach qi deficiency primary osteoporosis, which were divided into 35 cases and 35 cases in the control group. The treatment group was treated with Alendronate Sodium Tablets and Jianpi Yi Qi Decoction, and the control group was used for simple operation. The simple therapy of Allen sodium phosphate. One course of treatment was 8 weeks. After two courses of treatment, the changes of symptoms before and after treatment in two groups of patients with primary osteoporosis were observed. Bone density detection, VAS pain score, serum calcium and serum phosphorus were evaluated and treated for treatment of primary osteoporosis before and after two courses of treatment. During the two groups, all data were analyzed and processed by statistical analysis software SPSS20.0. The results of the two groups of treatment methods were significantly different. Results: the symptoms and signs of the two groups of patients with spleen and stomach qi deficiency primary osteoporosis were obviously improved after treatment. (1) the use of Jianpi Yiqi ointment and opiate. The total effective rate of the treatment group was 91.4%. The total effective rate of the control group treated with alendronate alone was higher than that of the control group, which indicated that the treatment of spleen and stomach qi deficiency type of primary osteoporosis Jianpi Yiqi cream and alendronate was better than the control group. (2) the control group and the treatment group were two. (2) the control group and the treatment group were two. Group patients with TCM syndrome score decreased after 8 weeks of treatment and after 16 weeks of treatment. After 8 weeks of treatment, the treatment group was better than the control group. After 16 weeks of treatment, the clinical effect of the treatment group was better than the control group. The treatment group was better than the control group. The p0.05. treatment group could better alleviate the lumbar spine pain, soft and less of the spleen and stomach qi deficiency patients with primary osteoporosis. (3) the two groups of visual analog points in the control group and the treatment group showed that two groups of patients had clinical effects after 8 and 16 weeks of treatment, and the clinical effect of the control group and the treatment group was not very different after the treatment for 8 weeks, but the treatment 16 was 16. Compared with the control group after week, the pain relief effect of the treatment group after 16 weeks was better than that of the control group. The combined therapy of Jianpi Yiqi cream combined with alendronate has significant clinical effect on relieving the low back pain of the spleen and stomach qi deficiency type of primary osteoporosis (4) in the group of patients with L2-4 and femur neck in two positions. Bone mineral density did not improve significantly after 16 weeks of bone density. The clinical effect of simple use of alendronate on improving the bone density of primary osteoporosis of the spleen and stomach was not obvious. The bone density did not improve after eight weeks of treatment in the treatment group, but the treatment group was treated with the lumbar (L2-4) and the femur after 16 weeks. The bone density of the two parts of the neck was better than that before the treatment. It showed that the combination of Jianpi Yiqi cream and alendronate needed a long time to improve the spleen and stomach qi deficiency osteoporosis, but the treatment group was better than the control group to improve the bone density and bone strength of the patients with spleen and stomach qi deficiency primary osteoporosis. (5) serum calcium and blood. There was no obvious clinical improvement in the treatment group and the treatment group for eight weeks and sixteen weeks after treatment. The curative effect was not obvious. It showed that the Jianpi Yiqi cream side and alendronate sodium did not improve the bone biochemical indexes in a short time. Conclusion: the clinical effect of the combined therapy of Jianpi Yiqi cream and A Lun phosphonate is obviously superior to that of the pair. The overall quality of life in patients with primary osteoporosis, including alleviating pain and improving bone mineral density, is more advantageous than the simple use of alendronate.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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