二磷酸盐联合活性维生素D治疗膝骨关节炎合并骨质疏松的临床研究  

A clinic study on diphosphate combined with active vitamin D in the treatment of knee osteoarthritis with osteoporosis

作　　者：段敬瑞 蔡雨卫 薛艳 张健 顾新丰[2,3] 曹月龙 郑昱新[2,3] DUAN Jingrui;CAI Yuwei;XUE Yan;ZHANG Jian;GU Xinfeng;CAO Yuelong;ZHENG Yuxin(Department of Orthopedics,the First People's Hospital of Pingdingshan,Pingdingshan 467000,Henan Province,China;Department of Orthopedics,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Institute of Traumatology&Orthopedics,Shanghai Academy of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]平顶山市第一人民医院骨科二病区,河南平顶山467000 [2]上海中医药大学附属曙光医院骨关节科,上海201203 [3]上海市中医药研究院骨伤科研究所,上海201203

出　　处：《世界临床药物》2022年第9期1138-1142,共5页World Clinical Drug

基　　金：上海中医药大学高峰高原建设中医骨伤团队、上海市重中之重临床重点学科建设项目(2017ZZ02024)。

摘　　要：目的 观察二磷酸盐联合活性维生素D治疗膝骨关节炎(knee osteoarthritis,KOA)合并骨质疏松(osteoporosis,OP)的临床效果。方法 选取2015年3月至2017年2月上海中医药大学附属曙光医院骨关节科门诊患KOA合并OP患者98例,随机分为观察组及对照组,每组49例。观察组采用二磷酸盐联合活性维生素D口服治疗,对照组采用硫酸氨基葡萄糖胶囊联合活性维生素D口服治疗,疗程均为3个月。测定入组患者右侧股骨颈骨密度(bone mineral density,BMD)、视觉模拟评分法(visual analogue scale,VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster university of orthopedic index,WOMAC),评价治疗前后OP和膝关节疼痛程度。结果 治疗3个月后,两组BMD均升高,且组间比较差异有统计学意义(P <0.05)。治疗2个月后,两组组间VAS评分、WOMAC降低,WOMAC组间差异有统计学意义(P <0.05);治疗3个月后,两组膝关节VAS评分和WOMAC较治疗前均降低,且组间比较差异均有统计学意义(P <0.05)。结论 二磷酸盐联合活性维生素D对于改善KOA合并OP疗效良好,值得临床进一步推广。Objective To observe the clinical effects of diphosphate combined with active vitamin D in the treatment of knee osteoarthritis(KOA) with osteoporosis(OP).Methods A total of 98 patients with KOA and OP in the department of osteoarthritis,Shuguang hospital affiliated to Shanghai university of traditional Chinese medicine from March 2015 to February 2017 were selected,and randomly divided into observation group and control group,with 49 cases in each group.The observation group was treated with diphosphate combined with active vitamin D orally,and the control group was treated with glucosamine sulfate capsules combined with active vitamin D orally.The course of treatment was 3 months.The bone mineral density(BMD),visual analog scale(VAS) scores,Western Ontario and McMaster University of Orthopedic Index(WOMAC) of the femoral neck were measured to evaluate the degree of OP and knee pain before and after treatment.Results After 3 months of treatment,BMD increased in both groups,and the difference between the two groups was statistically significant(P<0.05).After 2 months of treatment,the VAS and WOMAC scores decreased between the two groups,and the difference in WOMAC scores between the two groups were statistically significant(P<0.05).After 3 months of treatment,the knee VAS scores and WOMAC of the two groups were lower than those before treatment,and the differences between the groups were statistically significant(P<0.05).Conclusion Diphosphate combined with active vitamin D has a good effect on improving KOA combined with OP,which is worthy of further clinical promotion.

关 键 词：二磷酸盐 活性维生素D 膝骨关节炎 骨质疏松 

分 类 号：R979.9[医药卫生—药品] R580[医药卫生—药学] R684.3