益骨汤加减治疗老年骨质疏松症的多中心随机对照临床研究  

YiGu Recipe in Treatment for Senile Osteoporosis:A Multicenter,Randomized Placebo-control Clinical Study

作　　者：徐铮青[1] 姚新苗[1] 何帮剑[1] 吕一[1] 童培建[2] 史晓琳[3] 季四青[1] 全仁夫 

机构地区：[1]浙江中医药大学附属第三医院,杭州310005 [2]浙江中医药大学附属第一医院 [3]浙江中医药大学附属第二医院 [4]萧山区中医院

出　　处：《浙江中医药大学学报》2016年第4期253-257,共5页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药防治重大疾病攻关计划项目(2012ZGG044);浙江省中医药科技计划(2016ZA103);浙江省中医药科技计划(2016ZA105)~~

摘　　要：[目的]研究益骨汤对老年骨质疏松症的作用和疗效。[方法]将160例符合纳入标准的老年骨质疏松症病人随机分成试验组和对照组,每组80例。试验组采用＂益骨汤加减＋双膦酸盐＋基础治疗（钙剂＋维生素D）＂进行治疗,根据分型随症加减;对照组采用＂双膦酸盐＋基础治疗＂进行治疗。于治疗前、治疗6个月后,分别观察两组患者治疗前后的临床症状,检测腰椎、髋部骨密度以及骨代谢生化指标（B-ALP、TRAP5b水平）,并行统计学分析。[结果]治疗6个月后,试验组患者的症状改善优于对照组;两组患者的股骨颈骨密度治疗前后无明显变化（P〉0.05）,而对照组和试验组患者的腰椎L2-L4骨密度均有增加,但试验组增加的程度更大（P〈0.05）。治疗6个月后,对照组和试验组患者的B-ALP水平均升高,试验组升高的幅度更大（P〈0.01）;对照组及试验组在治疗后TRAP5b水平均下降,试验组下降的幅度更大（P〈0.01）。[结论]益骨汤随症加减联合西药治疗能较短期内有效提高老年骨质疏松患者的腰椎骨密度,抑制骨吸收,提高骨转换,并明显改善患者症状。[Objective] To study the efficacy of Yi Gu Recipe for senile osteoporosis（SOP）. [Methods] 160 senile osteoporosis people with low bone mineral density（BMD） were randomly divided into the experimental group and the control group, 80 cases in each group. The experimental group were received Yi Gu Recipe＋bisphosphonates＋basical medicine（calcium and vitamin D）, added or subtracted according to the classification; and the control group were received bisphosphonates＋ basical medicine（calcium and vitamin D）. The efficacy of the treatment was evaluated by BMD measurements at spine and hip in the 6 months of the treatment, as well as by the measurements of bone metabolism index（the levels of B-ALP,TRAP5b）. [Results] In 6 months treatment, the patient＇s symptoms of experimental group improved better than that of the other; two groups had no changes in femoral neck bone mineral density（P〈0.05）, lumbar L2-L4 BMD of the control group increased slightly, as increseased significantly in experimental group, the differences between the two groups were significant（P〈0.05）. In 6 months treatment, B-ALP levels of control group and experimental group both increased, the range of the experimental group increased significantly（P〈0.01）; TRAP5 b levels of two groups were both decreased, the experimental group decreased more（P〈0.01）.[Conclusion] Yi Gu Recipe combined with western medicine can effectively improve lumbar bone mineral density in patients with senile osteoporosis,inhibit bone resorption and improve bone transformation, and obviously relieve symptoms of patients.

关 键 词：益骨汤 骨质疏松症 老年 骨痿 骨密度 骨代谢 腰椎 

分 类 号：R681[医药卫生—骨科学]