补肾健脾化瘀法治疗原发性骨质疏松症的疗效及对骨代谢指标的影响  

Effect of Method of Tonifying Kidney and Spleen and Removing Blood Stasis on Patients with Primary Osteoporosis Postmenopausal and the Influence on Indicators of Bone Metabolism

作　　者：吕金柱[1] 罗建民[1] 顾硕[1] 朱求亮[1] 

机构地区：[1]安吉县人民医院骨科,浙江安吉313300

出　　处：《中华中医药学刊》2017年第5期1278-1281,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省科技厅项目(2015c33263)

摘　　要：目的:探讨补肾健脾化瘀法对原发性骨质疏松症(POP)的疗效及对骨代谢指标的影响。方法:将70例2010年1月—2014年12月收治的患者随机分为对照组和治疗组,每组35例。对照组采用碳酸钙D3片口服,治疗组在对照组基础上联合口服中医补肾健脾化瘀药方(黄芪,生地,淫羊藿,鹿角胶,龟胶,补骨脂,山药,水蛭等)。3个月为1个疗程,2个疗程后观察两组患者骨痛、功能改善、骨密度、骨代谢指标及不良反应情况。结果:治疗6个月后,治疗组及对照组患者的骨痛评分、Oswestry功能障碍指数、腰椎L2-4及髋部的骨密度值较治疗前均显著减小(P<0.01,P<0.05),且治疗组患者疗效明显优于对照组,差异有统计学意义(P<0.05)。治疗组治疗后血清BALP及TRACP-5b较治疗前及对照组明显下降(P<0.05),血清CT水平较治疗前及对照组显著增高(P<0.05),血清Ca、P及BGP含量较治疗前及对照组无明显统计学差异(P>0.05),而对照组治疗前后各项骨代谢指标变化均无统计学意义(P>0.05)。治疗期间两组患者不良反应发生率无明显统计学差异(P>0.05)。结论:补肾健脾化瘀法联合碳酸钙D3能有效改善骨痛、患者功能及骨代谢,升高骨密度且不良反应少,值得临床推广。Objective ： To evaluate the effect of the method of tonifying the kidney and spleen and removing the blood stasis on patients with primary osteoporosis postmenopausal （POP） and the influence on the indicators of bone metabolism. Method： Seventy patients from January 2010 to December 2014 were randomly divided into control group and treatment group, 35 cases in each group. The control group was given calcium carbonate vitamin D3 , while the treatment group was treated with the prescriptions for tonifying the kidney and spleen and removing the blood stasis （ composed of Huangqi, Shengdi, Renyanghuo, Lujiaojiao, Guijiao, Buguzhi, Shanyao, Shuizhi and so on） on the basis of control group. Three months was for a course of treatment. The pain score, Oswestry disablity index （ ODI）, bone mineral densi- ty （BMD） and the indicators of bone metabolism were analyzed and compared after two courses of the treatment. Result： Six months after the treatment, the pain score, ODI and BMD were significantly decreased in the treatment and control group （P 〈0. 01, P 〈0. 05）, and the curative effect of the treatment group was superior to that of the control group （P 〈0. 05）. In the treatment group, the serum concentrations of BALP and TRACP -5b were lower after treatment than those pre - treatment and those of the control group （ P 〈 0. 05 ）, while the CT was higher （ P 〈 0. 05 ） and the Ca, P, BGP shows no statistical differences （ P 〉 0. 05 ） after treatment. However, there was no obvious change in indicators of bone metabolism of the control group before and after treatment （P 〉 0.05 ）. The rate of adverse reaction showed no sig- nificant difference between two groups （ P 〉 0. 05 ）. Conclusion ： The method of tonifying the kidney and spleen and remo- ving the blood stasis combined with calcium carbonate vitamin D3 in treatment of patients of POP can be effective in im- proving the symptom of pain, function and bone metabolism, and increasing the BMD with less adver

关 键 词：补肾健脾 化瘀 原发性骨质疏松症 骨代谢 

分 类 号：R274.9[医药卫生—中西医结合]