健脾补肾方对脾肾阳虚型亚临床甲减伴骨质疏松患者的临床疗效  

The clinical observation of Jianpibushen formula in subclinical hypothyroidism associated with osteoporosis patients of spleen kidney yang deficiency

作　　者：章联欢[1] 赵萍[2] 章宁杰[3] 童培建[4] ZHANG Lian-huan;ZHAO Ping;ZHANG Ning-jie(Department of Endocrinology,Shaoxing Hospital of Traditional Chinese Medicine,Shaoxing ,Zhejiang 312000,China)

机构地区：[1]绍兴市中医院内分泌科,浙江绍兴312000 [2]绍兴市中医院甲状腺外科 [3]绍兴市中医院手足外科 [4]浙江省骨伤科研究所浙江省中医院骨科,浙江杭州310006

出　　处：《中华全科医学》2019年第2期288-290,324,共4页Chinese Journal of General Practice

基　　金：浙江省科技计划项目(2014C03035)

摘　　要：目的观察健脾补肾方对亚临床甲减伴骨质疏松(脾肾阳虚型)患者的临床疗效和不良反应等。方法将2015年1月—2017年1月于绍兴市中医院就诊的120例脾肾阳虚型亚临床甲减伴骨质疏松患者按照随机数字表均分为2组。对照组予改善甲状腺功能和抗骨质疏松等对症治疗,研究组在对照组基础上加用健脾补肾方。治疗1年后,观察2组甲状腺功能、骨代谢、细胞因子、骨密度、证候积分、疗效和不良反应等。结果治疗后研究组TSH[(3.01±0.42)m U/L]、PTH[(18.75±4.39) ng/L]、骨代谢[BGP(12.92±4.39) ng/m L、PINP(240.79±9.38)μg/L、CTX(0.23±0.01) mmol/L)]、细胞因子[IL-10(2.63±1.07) pg/m L、IL-6(85.71±9.25) pg/m L]、治疗前后症状积分差[(21.45±4.33)分]、疗效(84.0%)改善优于对照组,差异具有统计学意义(均P<0.05)。结论甲状腺功能是影响骨代谢的重要因素,亚临床甲减可引起骨量丢失,降低骨密度。健脾补肾方协助西医治疗可改善亚临床甲减伴骨质疏松(脾肾阳虚型)患者甲状腺功能、抑制骨吸收、促进骨形成、提高骨密度,改善临床症状,提高疗效。Objective To observe the clinical observation of Jianpibushen formula in subclinical hypothyroidism(SCH)associated with osteoporosis(OP) patients of spleen kidney yang deficiency.Methods From January 2015 to January2017,120 SCH with OP patients were randomly divided into the research group and the control group according to the random number table.The control group were given the conventional radiation of improving the thyroid gland and osteoporosis treatment.While the research group were given Jianpibushen formula on the basis of the control group.After one year treatment,thyroid function,bone metabolism,cytokine,bone mineral density(BMD),symptom score,curative effect and adverse reaction were compared between the two groups.Results After treatment,TSH [(3.01 ± 0.42)m U/L],PTH:[(18.75 ± 4.39) ng/L],bone metabolism [BGP:(12.92 ± 4.39) ng/m L,PINP:(240.79 ± 9.38)μg/L,CTX(0.23 ± 0.01) mmol/L],cytokine [IL-10:(2.63 ± 1.07) pg/m L,IL-6:(85.71 ± 9.25) pg/m L],symptom score[(21.45 ± 4.33) scores],and curative effect(84.0%) in the research group were significantly better than those in the control group.The differences were statistically significant(all P < 0.05).Conclusion Thyroid function was an important factor on affecting bone metabolism.SCH can cause bone loss and reduce the BMD.Combing the Jianpibushen formula with the conventional treatment of SCH with OP patients of spleen kidney yang deficiency had satisfaction curative effect.It can significantly improve the thyroid function,promoting the bone formation,decreasing the bone resorption,increasing the BMD,and improving clinical symptoms and curative effect.

关 键 词：脾肾阳虚型 骨质疏松症 亚临床甲减 临床观察 

分 类 号：R581.2[医药卫生—内分泌] R681[医药卫生—内科学]