抗骨质疏松治疗对腰椎间盘突出症防治作用的研究  

A study of the effect of anti-osteoporosis therapy on prevention and treatment of the lumbar disc herniation

作　　者：吴炜戎[1] 蒋春梅[1] 谢启新 蔡晓燕[1] 娄爱菊[1] 

机构地区：[1]广州医学院荔湾医院风湿科,广州510170

出　　处：《中国骨质疏松杂志》2015年第7期866-869,887,共5页Chinese Journal of Osteoporosis

摘　　要：目的研究抗骨质疏松（OP）药物对腰椎间盘突出症（LDH）是否有预防和治疗作用。方法选取2011年4月～2012年4月在我院诊断不合并腰椎间盘突出症的骨质疏松症50岁以上患者119例,根据不同治疗方案分为3个治疗组A、B、C及对照组A,合并腰椎间盘突出症的骨质疏松患者共76例,根据不同治疗方案分为3个治疗组D、E、F及对照组B。治疗组A、D予以钙剂、阿法骨化醇胶丸、阿仑膦酸钠片口服;治疗组B、E予以钙剂、阿法骨化醇胶丸口服、唑来膦酸注射液静脉滴注;治疗组C、F接受口服钙剂和阿法骨化醇胶丸。对照组A、B为不愿进行药物治疗的病例。观察应用抗骨质疏松药2年对腰椎间盘突出症防治的效果。结果予不同治疗方案后,治疗组A、治疗组B腰椎间盘突出症的发病率低于治疗组C及对照组A（P〈0.05）。合并腰椎间盘突出症的骨质疏松治疗组D、E、F病例下腰痛评分升高、疼痛发作频率下降（P〈0.05）。治疗组D、治疗组E治疗后CT表现较治疗前基本无变化（P〉0.05）;治疗组F及对照组CT影像表现较观察起点有加重（P〈0.05）,治疗组D与治疗组E之间、治疗组F与对照组B之间CT表现比较无统计学意义（P〉0.05）。结论标准抗骨质疏松治疗方案能有效防治腰椎间盘突出症。Objective To study the effect of anti-osteoporosis medicine on the prevention and treatment of lumbar disc herniation（ LDH） in patients combined with osteoporosis（ OP）. Methods One hundred and nineteen patients with OP without LDH were randomly divided into 4 groups： the treatment group A,B,and C and the control group A. Seventy-six patients with OP were randomly divided into the treatment group D,E,and F and the control group B. The treatment group A and D were treated with calcium,oral alfacalcidol,and alendronate. The treatment group B and E were treated with calcium,alfacalcidol,and injection of zoledronic acid. The treatment group C and F were treated with calcium and alfacalcidol. The control group A and B were patients who did not will to accept treatment. The efficacy of the anti-OP medicines was observed in 2 years. Re sults The incidence of LDH in the treatment group A and B was significantly lower than that in the treatment group C and the control group A（ P〈0. 05）.After treatment,the lower back pain score in the treatment group D,E,and F increased significantly,and the attack frequency of LDH decreased significantly（ P〈0. 05）. In the CT scans of the treatment group D and E,there was no significant difference between pre-treatment and after treatment（ P〉0. 05）. The CT images of the treatment group F and the control B were more severe than those in the beginning of the study（ P〈0. 05）. And there was no significant difference between the treatment group D and E,and the treatment group F and the control B（ P〉0. 05）. Conclusion The standardized anti- osteoporosis treatment can effectively prevent and treat LDH combined with OP.

关 键 词：骨质疏松 腰椎间盘突出症 防治 

分 类 号：R681[医药卫生—骨科学]