加味二至丸颗粒治疗绝经后骨质疏松的疗效观察  

作　　者：张忠良[1] 费霖莉[1] 林俊宏 

机构地区：[1]浙江中医药大学附属金华市中医院,321017

出　　处：《浙江临床医学》2023年第9期1316-1318,共3页Zhejiang Clinical Medical Journal

摘　　要：目的观察加味二至丸颗粒治疗绝经后骨质疏松症的疗效及对E2和OPG水平的影响。方法选择符合标准的绝经后骨质疏松症患者60例,根据数字随机表法分为观察组和对照组,每组各30例。对照组采用口服碳酸钙咀嚼片、阿法骨化醇软胶囊抗骨质疏松治疗,观察组在对照组基础上加用加味二至丸颗粒冲服,共治疗12周。分别于治疗前及随访24周时测定患者骨密度及骨代谢指标,并进行症候量化评分,于治疗前、治疗12周及随访24周时测定患者E2及OPG水平。结果60例患者均随访至24周。两组患者骨密度及25(OH)D均高于治疗前,BGP及β-CTX均低于治疗前,差异有统计学意义(P<0.05);同时随访至24周时,观察组骨密度高于对照组,观察组BGP及β-CTX均低于对照组,差异有统计学意义(P<0.05)。随访24周,观察组症候量化评分低于对照组,差异有统计学意义(P<0.05)。观察组与对照组E2水平比较,差异有统计学意义(F=4.696,P=0.034);不同时间点之间的E2水平存在统计学差异(F=23.103,P<0.001);组间因素与时间因素存在交互效应(F=12.045,P<0.001);治疗12周及随访24周,观察组E2水平高于对照组(P<0.05)。观察组与对照组OPG水平比较,两组间差异有统计学意义(F=19.748,P<0.001);不同时间点之间OPG水平存差异有统计学意义(F=83.587,P<0.001);组间因素与时间因素存在交互效应(F=11.780,P<0.001);治疗12周及随访24周,观察组OPG水平高于对照组(P<0.05)。结论加味二至丸颗粒在西医药物治疗基础上可有效调节绝经后骨质疏松患者骨代谢速率及提高骨密度,升高E2及OPG水平。其治疗机制可能是加味二至丸颗粒通过增加机体E2的分泌,调节RANKL-RANK-OPG轴的表达,降低骨高转换率,从而提高骨密度。Objective To observe the clinical efficacy of Jiawei Erzhiwan Granules in treating postmenopausal osteoporosis,and the effect on estradiol(E2)and Osteoprotegerin(OPG)levels.Methods Sixty patients with postmenopausal osteoporosis who met the criteria were selected and divided into observation group and control group according to the number random table method,with 30 cases in each group.The control group was treated with oral calcium carbonate chewable tablets,alfacalcidol soft capsules for osteoporosis,while the observation group was given Jiawei Erzhiwan Granules in the morning and evening on the basis of the control group.Both groups were treated for 12 weeks and followed up to 24 weeks.Bone mineral density,bone metabolism indexes and quantitative score of symptoms were measured before treatment and 24 weeks of follow-up,and the levels of estradiol and osteoprotegerin were measured before the treatment,12 weeks of treatment,and 24 weeks of follow-up.Results All 60 patients completed follow-up of 24 weeks.The bone mineral density and 25(OH)D of the two groups were higher than those before the treatment,while bone gla protein(BGP)andβ-CTX were lower than those before the treatment,and the differences were statistically significant(P<0.05).At 24 weeks'follow-up,the bone mineral density in the observation group was higher than that in the control group,while BGP andβ-CTX were lower than those in the control group,and the differences were statistically significant(P<0.05).At 24 weeks'follow-up,quantitative score of symptoms in the observation group was lower than that in the control group.The difference of E2 level between the two groups was statistically significant(F=4.696,P=0.034).There were statistical differences in E2 level among different time points(F=23.103,P<0.001).And there was an interactive effect between the group factor and time factor(F=12.045,P<0.001).And the levels of E2 in the observation group were higher than control group at 12 weeks of treatment and 24 weeks follow-up(P<0.05).The difference

关 键 词：骨质疏松 绝经后 二至丸 骨密度 雌二醇 骨保护素 

分 类 号：R681[医药卫生—骨科学]