四物汤加减治疗脑卒中后偏瘫继发骨质疏松症的疗效观察  

Efficacy of Modified Siwu Decoction(四物汤加减)on Osteoporosis Secondary to Hemiplegia after Cerebral Apoplexy

作　　者：杨涛 王静 陈艳妮 张冰洁 刘秀云 YANG Tao;WANG Jing;CHEN Yanni;ZHANG Bingjie;LIU Xiuyun(Zhangjiakou First Hospital,Zhangjiakou Hebei 075000,China)

机构地区：[1]张家口市第一医院,河北张家口075000

出　　处：《中医药导报》2023年第8期58-61,75,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：河北省中医药管理局科研计划项目(2022528)。

摘　　要：目的:观察四物汤加减治疗脑卒中(CVA)后偏瘫继发骨质疏松症(OP)的疗效。方法:选取100例CVA后偏瘫继发OP患者,按照随机数字表法分为对照组(n=57,常规治疗)和治疗组(n=43,常规治疗+四物汤加减),4周为1个疗程,治疗2个疗程。比较两组患者临床疗效、中医证候积分、骨密度(BMD)、骨生化指标、骨代谢指标及治疗安全性。结果:治疗组总有效率为86.05%(37/43),对照组总有效率为68.42%(39/57),治疗组疗效优于对照组(P<0.05)。两组患者治疗后中医证候积分均较治疗前降低(P<0.05),且治疗组患者治疗后中医证候积分低于对照组(P<0.05);两组患者治疗后上肢、下肢BMD水平均较治疗前升高(P<0.05),且治疗组患者治疗后上肢、下肢BMD水平均高于对照组(P<0.05);两组患者治疗后25-羟维生素D[25-(OH)D]、血清骨钙素(OC)、Ⅰ型前胶原氨基端延长肽(P1NP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平均较治疗前升高(P<0.05),且治疗组患者治疗后25-(OH)D、OC、P1NP、β-CTX水平均高于对照组(P<0.05)。两组患者治疗后谷丙转氨酶(ALT)、谷草转氨酶(GOT)、血肌酐(SCr)、尿素水平与治疗前比较,差异均无统计学意义(P>0.05),且治疗后两组患者ALT、GOT、SCr、尿素水平比较,差异均无统计学意义(P>0.05)。结论:四物汤加减治疗CVA后偏瘫继发OP患者有较好临床疗效,可以减轻其临床症状,提高其BMD,改善其骨生化、骨代谢水平,且较为安全。Objective:To explore the efficacy of modified Siwu decoction on osteoporosis(OP)secondary to hemiplegia after cerebral apoplexy.Methods:Totally 100 patients with OP secondary to hemiplegia after cerebral apoplexy were selected as the research subjects.According to the random number method,the patients were divided into control group(n=57,conventional treatment)and treatment group(n=43,conventional treatment and modified Siwu decoction).The course of treatment was 4 weeks,with 2 courses of treatment.The clinical treatment effect,traditional Chinese medicine(TCM)scores,bone mineral density(BMD),bone biochemistry,bone metabolism indicators and treatment safety were compared between the two groups.Results:The total effective rate was 86.05%(37/43)in treatment group and 68.42%(39/57)control group.The treatment group showed higher total effective rate than control group(P<0.05).The TCM syndrome scores decreased in two groups after treatment(P<0.05),and the treatment group showed lower TCM syndrome scores than control group(P<0.05).The BMD of upper and lower limbs increased in two groups after treatment(P<0.05),and the treatment group showed higher BMD of upper and lower limbs than control group(P<0.05).The levels of 25-hydroxyvitamin D[25-(OH)D],serum osteocalcin(OC),procollagen type I N-terminal propeptide(P1NP)and C-terminal telopeptide ofβ-I collagen(β-CTX)increased in two groups after treatment(P<0.05),and the treatment group showed higher levels of 25-hydroxyvitamin D[25-(OH)D],serum osteocalcin(OC),procollagen type I N-terminal propeptide(P1NP)and C-terminal telopeptide ofβ-I collagen(β-CTX)than control group(P<0.05).No statistical differences were shown in the levels of alanine aminotransferase(ALT),glutamic oxalacetic transaminase(GOT),serum creatinine(SCr)and urea between before and after treatment in two groups(P>0.05).Conclusion:Modified Siwu decoction shows good clinical efficacy on OP secondary to hemiplegia after cerebral apoplexy.It can relieve the clinical syndromes,enhance the BMD,and improve the b

关 键 词：骨质疏松症 脑卒中 偏瘫 四物汤 骨生化 骨代谢 

分 类 号：R255.2[医药卫生—中医内科学]