穴位贴敷疗法对绝经后骨质疏松患者血清OPG、RANKL和髋部骨密度的影响  

The effect of acupoint application on serum OPG,RANKL,and BMD of total hip in postmenopausal osteoporosis women

作　　者：马俊义[1] 施振宇[2] 史晓林[3] 

机构地区：[1]浙江中医药大学附属第三医院,浙江杭州310005 [2]浙江中医药大学,浙江杭州310053 [3]浙江中医药大学附属第二医院,浙江杭州310005

出　　处：《中国骨质疏松杂志》2017年第7期921-925,共5页Chinese Journal of Osteoporosis

基　　金：2013年浙江省中医药科技计划项目(2013ZB071)

摘　　要：目的观察穴位贴敷疗法对绝经后骨质疏松患者骨代谢、髋部骨密度的影响,以评价其有效性和安全性。方法将符合要求的80例绝经后骨质疏松患者随机分为试验组及对照组,各40例。以6个月为一个疗程,共两个疗程。试验组予以外用中药穴位贴敷,内服钙尔奇D片和福善美片治疗,对照组仅予内服钙尔奇D片和福善美片治疗,疗程为12个月。比较2组治疗前、治疗后第6个月及第12个月血骨保护素(osteoprotegerin,OPG)、核因子-κB受体激活配体(receptor activator of nuclear factor-κB ligand,RANKL)含量、髋部骨密度(bone mineral density,BMD)及记录骨折发生情况,所得数据进行统计学分析。结果80例中75例获得完整随访,其中治疗组37例,对照组38例。(1)比较治疗前2组患者血OPG含量(t=1.43,P=0.157)、RANKL含量(t=-1.84,P=0.07),差异无统计学意义;试验组治疗6个月后血OPG含量(t=15.79,P<0.01)与治疗12个月后血OPG含量(t=21.68,P<0.01)均大于对照组;试验组治疗6个月后血RANKL含量测定(t=-0.35,P=0.726)与治疗12个月后血RANKL含量测定(t=-1.15,P=0.253)与对照组相比,差异无统计学意义。(2)治疗前2组患者髋部BMD比较,差异无统计学意义(t=0.26,P=0.791);治疗6个月后,2组患者的髋部BMD均增大,试验组BMD与对照组相比,差异无统计学意义(t=1.06,P=0.292);治疗12个月后,2组患者的髋部BMD仍继续增大,试验组BMD增加值大于对照组(t=2.22,P=0.029)。(3)试验中对照组共累计出现2例患者出现髋部骨折,而试验组只出现1例,经卡方检验,卡方值为0.320,P=0.572,差异无统计学意义,但骨折发生率的比较中,对照组(5.26%)略高于试验组(2.70%)。结论应用穴位贴敷疗法,能有效缓解疼痛、肌痉挛等症状;穴位贴敷使中药在局部发挥作用,加速髋部骨密度增加;提升OPG的血清含量,促进骨骼成骨作用,提高髋部骨量,从而达到防治骨质疏松性髋部骨折的目的。Objective To observe the effect of acupoint application on bone metabolism and bone mineral density in postmenopausal osteoporosis patients,and to evaluate its effectiveness and safety.Methods Eighty postmenopausal osteoporosis patients were rand omly divided into experimental group and control group,with 40 cases in each group.Six-month was a treatment course,and two consecutive courses were conducted.The patients in the experimental group were treated with external application of Chinese medicine acupoints,combined with oral administration of calcium D and alendronate.The patients in the control group received oral administration of calcium D and alendronate only for consecutive 12 months.The levels of osteoprotegerin（OPG）,nuclear factor-activated receptor ligand（RANKL）,hip BMD and recorded fractures were compared between the two groups before and after 6 months,12-month of the treatment,respectively.The data were statistically analyzed.Results 75 cases of 80 cases were followed up,including 37 cases in the treatment group and 38 cases in the control group.There was no significant difference in the levels of serum OPG（t=1.43,P=0.157） and serum RANKL（t=-1.84,P=0.07） between the two groups before the treatment.The levels of serum OPG after 6 months（t=15.79,P0.01） and after 12 months（t=21.68,P0.01） in the experimental group was significantly higher than that in the control group（P0.01）.The levels of RANKL after 6 months（t=-0.35,P=0.726） and after 12 months（t=-1.15,P=0.253） in the experimental group was not statistically different compared with the control group.There was no significant difference in hip BMD between the two groups before and after treatment（t=0.26,P=0.791）.After 6 months of the treatment,the BMD of the hip increased in the both groups,but was not different between the two groups（t=1.06,P=0.292）.After 12 months of the treatment,the BMD of the hip in the two groups continued to increase,and the BMD in the experimental group was higher than that in the contr

关 键 词：绝经后骨质疏松 髋部骨折 骨密度 骨代谢 

分 类 号：R274.1[医药卫生—中医骨伤科学]