骨质疏松伴腰椎管狭窄的非手术治疗  

Conservative treatment for osteoporosis with lumbar spinal canal stenosis and neurogenic intermittent claudication

作　　者：林华[1] 韩祖斌[1] 陈新[1] 张咏梅[1] 李卫国[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨病中心,210008

出　　处：《江苏医药》2006年第9期821-823,共3页Jiangsu Medical Journal

基　　金：南京市医学科技重点发展基金(ZKG9913)

摘　　要：目的探讨降钙素和低频脉冲电磁场治疗骨质疏松伴腰椎管狭窄的疗效。方法52例骨质疏松伴腰椎管狭窄间歇性跛行患者随机分成降钙素治疗组(A组)和低频脉冲电磁场治疗组(B组)。A组,鳗鱼降钙素肌注20U/d,第1周每天1次,以后每周2次;B组,低频脉冲电磁治疗每周5次,每次30min,15次后间隔1周再重复。两组患者均补充钙剂600mg/d,3个月后观察包括间歇性跛行评估,腰椎和髋部骨量,跟骨骨超声,腰椎CT和X线片等。结果治疗3个月后,A组患者步行距离、腰腿痛和日常生活指标明显改善(P<0·01),B组患者日常生活质量有所提高(P<0·05)。两组患者骨量、骨超声、腰椎CT和X线片治疗前后比较无明显变化。结论降钙素治疗明显改善骨质疏松伴腰椎管狭窄神经性间歇性跛行患者的临床症状,提高步行能力,减轻腰腿痛;低频脉冲电磁场可减轻腰腿痛症状,但对间歇性跛行的治疗效果不满意。Objective To study the clinical effects of calcitonin and pulsed electromagnetic fields（PEMF） treatment on osteoporosis with lumbar spinal canal stenosis and neurogenic intermittent claudication（NICL）. Methods Fifty-two cases of osteoporosis with lumbar spinal canal stenosis and NICL were randomized into calcitonin treatment group（group A） and PEMF treatment group（group B）. Patients of group A were treated with calcitonin 20 U injected intramuscularly per day in first week, and then calcitonin 20 U twice an week. Patients of group B were treated with PEMF 30 minutes each time and five times an week. All of patients were supplemented with calcium 600 mg per day and the outcomes of walking distance, back and calf pain, bone mineral density（BMD） on lumbar spine and hip, quantity of ultrasound（QUS） on calcaneus,CT and X ray on lumbar spine were followed-up for 3 months after treatment. Results Compared to the basic situation,there was a considerable increase in walking distance,back pain relief anal quality of life improvement in group A, and the quality of life was improved in group B. There was no significant difference in BMD, QUS, CT and X-ray on spine after treatment between the two groups. Conclusion The calcitonin therapy not only provides beneficial effect to the patient with osteoporotic bone pain, but also supplies considerable improvement in the symptoms of lumbar spinal canal stenosis and neurogenic intermittent claudication. The PEMF therapy has poor results for osteoporosis with lumbar spinal canal stenosis and neurogenic intermittent claudication.

关 键 词：骨质疏松 腰椎管狭窄神经性间歇性跛行 非手术治疗 

分 类 号：R681.5[医药卫生—骨科学]