补肾健骨法预防肾病综合征患者激素性骨质疏松症的作用研究  

Clinical Study of Therapy of Nourishing Kidney and Strengthening Bone in Preventing and Treating Glucocorticoid-induced Osteoporosis of Nephrotic Syndrome Patients

作　　者：鲁欢[1] 涂海涛[2] 罗月中[2] 

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2013年第1期5-8,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(编号:30772863)

摘　　要：【目的】观察补肾健骨法预防激素所致骨质疏松症的效果,为中医药预防及治疗糖皮质激素导致的骨质疏松症提供临床依据和治疗方法。【方法】采用随机、双盲、对照的研究方法,将符合纳入标准的37例肾病综合征患者随机分为2组,治疗组19例,对照组18例。2组均给予常规西药治疗,在此基础上,治疗组给予口服补肾健骨中药胶囊(淫羊藿、续断、补骨脂、熟地黄、丹参、知母等)治疗,对照组给予安慰剂治疗。观察2组在入组时和治疗半年后骨密度、骨痛积分、血清钙浓度的变化。【结果】(1)用药6个月后,治疗组在腰椎、左髋、右髋3个部位的骨密度值无显著改变,与治疗前比较差异均无统计学意义(P>0.05);对照组3个部位的骨密度值均显著下降,与治疗前比较差异均有统计学意义(P<0.05或P<0.01)。治疗后2组比较,对照组3个部位的骨密度值均显著低于治疗组(P<0.05)。(2)治疗后2组的骨痛积分均显著提高,与治疗前比较差异有统计学意义(P<0.05或P<0.01);且治疗后治疗组的骨痛积分水平显著高于对照组(P<0.05)。(3)治疗后2组的血清钙水平均显著提高(P<0.05);但治疗组的血清钙水平低于对照组,2组比较差异有统计学意义(P<0.05)。(4)用药期间2组患者均未出现明显不良反应。【结论】补肾健骨法可显著改善肾病综合征患者使用糖皮质激素所导致的骨质疏松症。Objective To evaluate the clinical effects of therapy of nourishing kidney and strengthening bone on the prevention of glucocorticoid-induced osteoporosis in nephrotic syndrome patients.Methods A randomized,double-blind and control trial was performed in 37 nephrotic syndrome patients which received treatment of glucocorticoid.The patients were divided into 2 groups,19 in the treatment group and 18 in the control group.The treatment group was given capsules including the herbal powder of Herba Epimedii,Radis Dipsaci,Frusctus Psoraleae,Rhizoma Rehmanniae Preparata,Radix Salviae Miltiorrhizae and Rhizoma Anemarrhenae for reinforcing kidney,while patients in the control group received the placebo.After treatment for 6 months,the changes of bone mineral density（BMD）,ostalgia score and serum calcium level were observed.Results After treatment for 6 months,BMD of lumbar vertebrae,left hip and right hip remained unchanged in the treatment group（P〉0.05 compared to that before treatment）,but was decreased in the control group（P〈0.05 or P〈0.01）.The difference of BMD was significant between the two groups after treatment（P〈0.05）.The ostalgia score was increased in both groups（P〈0.05 or P〈0.01 compared to that before treatment）,and the increase in the treatment group was superior to that in control group（P〈0.05）.Serum calcium level was also increased in both groups（P〈0.05 compared to that before treatment）,but the level in the treatment group was lower than that in the control group（P〈0.05）.During the medication,no side effect was found.Conclusion The therapy of nourishing kidney and strengthening bone can greatly relieve the osteoporosis in nephrotic syndrome induced by glucocorticoid.

关 键 词：激素性骨质疏松症 骨密度 补肾健骨法 

分 类 号：R681.1[医药卫生—骨科学]