益肾活血法对原发性骨质疏松症患者骨密度、骨代谢及脆性骨折发生率的影响  

Effects of Kidney-Supplementing Blood-Quickening Therapy on Bone Mineral Density,Bone Metabolism and the Incidence of Fragility Fractures in Primary Osteoporosis

作　　者：孔西建[1] 吴丹[1] 叶进[1] 翟远坤[2] 

机构地区：[1]河南省洛阳正骨医院骨质疏松科 [2]西北工业大学生命学院

出　　处：《中医杂志》2014年第5期391-395,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81073037;31071043);洛阳市应用技术研究与开发资金项目(1101057A)

摘　　要：目的观察益肾活血法治疗原发性骨质疏松症(OP)的临床疗效。方法 240例原发性OP患者随机分为实验组150例和对照组90例,实验组中肾阳虚血瘀证、肾阴虚血瘀证、脾肾亏虚血瘀证各50例,分别服用骨松强骨方、骨松健骨方、骨松益骨方;对照组中肾阳虚血瘀证、肾阴虚血瘀证、脾肾亏虚血瘀证各30例,均服用仙灵骨葆胶囊。两组均治疗12周,随访至48周。检测治疗前后两组患者骨密度、血清骨特异性碱性磷酸酶(BALP)和Ⅰ型胶原交联C端肽(β-CTX)水平,观察治疗前和治疗后48周时脆性骨折发生率的情况。结果实验组肾阳虚血瘀证、脾肾亏虚血瘀证骨密度疗效总有效率分别为83.33%、89.8%,明显高于对照组的50.00%、37.93%(P<0.05)。实验组肾阳虚血瘀证、肾阴虚血瘀证、脾肾亏虚血瘀证治疗后β-CTX水平、脆性骨折发生率较治疗前均明显下降(P<0.05或P<0.01);并且实验组肾阳虚血瘀证、脾肾亏虚血瘀证与同证型对照组治疗后比较,β-CTX、脆性骨折发生率下降更明显(P<0.05或P<0.01)。结论益肾活血法可有效抑制原发性OP患者骨吸收,防止骨密度下降,降低脆性骨折发生率。Objective To observe the therapeutic effect of kidney-supplementing blood-quickening therapy on Primary osteoporosis （OP）. Methods Totally 240 cases of OP were randomized into the test group of 150 cases and control group of 90 cases. There were 50 patients with kidney-yang deficiency blood stasis pattern, 50 patients with kidney-yin deficiency blood stasis pattern and 50 patients with spleen-kidney deficiency blood stasis pattern in the test group, and they were given Gusong Qianggu Formula （ ）, Gusong Jiangu Formula （） and Gusong Yigu Formula （） respectively. There were 30 patients with kidney-yang deficiency blood sta- sis pattern, 30 patients with kidney-yin deficiency blood stasis pattern and 30 patients with spleen-kidney deficiency blood stasis pattern in the control group, and they were given Xianling Gubao Capsules. Both groups were treated for 12 weeks and followed up to the 48th week. The bone mineral density （BMD） and the levels of bone-specific alkaline phosphatase （BALP） and β-CrossLaps of type I collagen containing cross-linked C-telopeptide （β-CTX） were detec- ted in both groups before and after treatment. The incidence of fragility fractures was observed before treatment and on the 48th week after treatment. Results The total efficacy of BMD in the patients with kidney-yang deficiency blood stasis pattern and spleen-kidney deficiency blood stasis pattern in the test group was 83.33% and 89. 8% respective- ly, which was significantly higher than 50. 00% and 37.93% in the control group （P 〈0. 05 ）. The ^-CTX level and incidence of fragility fractures was significantly decreased in the test group after treatment （ P 〈 0.05 or P 〈 0. 01 ）, especially in the patients with kidney-yang deficiency blood stasis pattern and spleen-kidney deficiency blood stasis pattern （P 〈 0. 05 or P 〈 0. 01 ）. Conclusion kidney-supplementing blood-quickening therapy can effectively in- hibit bone resorption, prevent decreased BMD and reduce the incidence of fragility

关 键 词：益肾活血法 骨松强骨方 骨松健骨方 骨松益骨方 原发性骨质疏松症 骨密度 骨折 骨代谢 

分 类 号：R259[医药卫生—中西医结合]