自拟益肾健脾化瘀方治疗绝经后脾肾阳虚型骨质疏松症的临床研究

发布时间：2018-11-03 17:10

【摘要】：目的探讨自拟益肾健脾化瘀方治疗绝经后脾肾阳虚型骨质疏松症的临床疗效。方法选取2016年1月-2017年1月我院收治的120例绝经后骨质疏松症患者,将其按照随机数字法随机分为观察组和对照组,每组60例,2组均给予碳酸钙D3片,在此基础上,对照组给予仙灵骨葆胶囊,观察组给予自拟益肾健脾化瘀方剂,2组均治疗3月。结果治疗后2组腰背疼痛、腰膝酸软、夜尿增加、畏寒肢冷、神疲倦怠及总评分均显著下降(P0.01),但观察组下降更为明显(P0.01);治疗后观察组总有效率为93.33%,显著高于对照组(80.00%,P0.01);2组腰椎L2~L4、股骨颈、股骨大转子、Ward's三角骨密度均较治疗前显著增加(P0.01),但观察组增加更为明显(P0.01);2组骨特异性碱性磷酸酶(B-ALP)、抗酒石酸酸性磷酸酶(TRACP)均较治疗前显著下降(P0.01),观察组下降更为明显(P0.01);2组雌二醇(E2)、胰岛素生长因子(IGF-1)均较治疗前显著上升(P0.01),观察组上升更为明显(P0.01);2组患者不良反应发生率比较差异无统计学意义(P0.05)。结论采用自拟益肾健脾化瘀方可以显著改善绝经后脾肾阳虚型骨质疏松症的临床症状,同时可改善患者骨代谢和骨密度,其作用机制可能与提高雌激素和IGF-1水平有关。
[Abstract]:Objective to investigate the clinical effect of Yishen Jianpi Huayu recipe in treating postmenopausal osteoporosis with deficiency of spleen and kidney yang. Methods 120 postmenopausal osteoporosis patients admitted to our hospital from January 2016 to January 2017 were randomly divided into observation group (n = 60) and control group (n = 60). The control group was treated with Xianling Gu Bao capsule, the observation group with self-made prescription of tonifying kidney and spleen and removing blood stasis, and the two groups were treated for 3 months. Results after treatment, the pain of the back of the waist, the weakness of the waist and knee, the increase of nocturnal urine, the chills of the cold limbs, the burnout of the cold limbs and the total score of the two groups were significantly decreased (P0.01), but the decrease was more obvious in the observation group (P0.01). The total effective rate of the observation group was 93.33, which was significantly higher than that of the control group (80.00g / P0.01). The bone mineral density of L2P L4, femoral neck, greater trochanter of femur and Ward's triangle in both groups were significantly higher than those before treatment (P0.01), but the increase in observation group was more obvious (P0.01). Bone specific alkaline phosphatase (B-ALP) and tartrate-resistant acid phosphatase (TRACP) were significantly decreased in both groups (P0.01), especially in the observation group (P0.01). The levels of estradiol (E2) and insulin growth factor (IGF-1) in both groups were significantly higher than those before treatment (P0.01), especially in the observation group (P0.01). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion the self-made prescription of tonifying spleen and removing blood stasis can significantly improve the clinical symptoms of osteoporosis with deficiency of spleen and kidney yang after menopause, as well as improve bone metabolism and bone mineral density. The mechanism may be related to the increase of estrogen and IGF-1 levels.
【作者单位】：江西省妇幼保健院妇科;江西省妇幼保健院病理科;
【基金】：江西省卫计委科技计划课题(20165443)
【分类号】：R259

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