阿仑膦酸钠联合阿法骨化醇治疗老年骨质疏松症的临床效果评价  

Clinical evaluation of alendronate combined with alfacalcidol in the treatment of senile osteoporosis

作　　者：王丽娜[1] 余霞丽 刘虎 Wang Lina;Yu Xiali;Liu Hu(Graduate School,Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310053,China;Department of Pnarmacy,Zhejiang Provincial Tongde Hospital,Hangzhou,Zhejiang 310012,China;Department of Orthopedic Surgery,Yongkang Orthopedic Hospital,Yongkang,Zhejiang 321300,China)

机构地区：[1]浙江中医药大学研究生院,浙江杭州310053 [2]浙江省立同德医院药学部,浙江杭州310012 [3]浙江省永康市骨科医院骨科,浙江永康321300

出　　处：《中国药物与临床》2023年第9期585-589,共5页Chinese Remedies & Clinics

摘　　要：目的评价阿仑膦酸钠联合阿法骨化醇治疗老年骨质疏松症的临床效果。方法选取2021年1月至2022年6月永康市骨科医院收治的老年骨质疏松症患者120例,根据治疗方式不同分为阿法骨化醇组和联合用药组,每组各60例。阿法骨化醇组采用阿法骨化醇软胶囊治疗,联合用药组则采用阿法骨化醇软胶囊联合阿仑膦酸钠片治疗,1个月为1疗程,2组均治疗6个疗程。比较2组临床疗效,对比治疗前后2组不同部位骨密度、钙磷代谢、骨标志物及氧化应激相关指标变化情况,统计2组服药期间不良反应。结果联合用药组总有效率高于阿法骨化醇组(P<0.05)。2组腰椎(L_(2~4))、股骨颈、股骨粗隆骨密度较治疗前均增高(P<0.05),但联合用药组骨密度增高更明显(P<0.05)。治疗后,联合用药组血钙、血磷水平均高于阿法骨化醇组(P<0.05),血清骨钙素(BGP)、骨碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶5b(TRACP-5b)均低于阿法骨化醇组(P<0.05)。治疗后,联合用药组MDA水平均低于阿法骨化醇组(P<0.05),超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)水平均高于阿法骨化醇组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论阿仑膦酸钠联合阿法骨化醇治疗老年骨质疏松症可提高临床疗效,改善患者骨代谢及氧化应激指标,提升骨密度,效果优于单独使用阿法骨化醇。Objective To evaluate the clinical effect of alendronate combined with alfacalcidol in the treatment of senile osteoporosis.Methods A total of 120 senile osteoporosis patients admitted to Yongkang Orthopedic Hospital from January 2021 to June 2022 were selected and divided into alfacalcidol group and combination therapy group according to different treatment methods,with 60 cases in each group.The alfacalcidol group was treated with alfacalcidol soft capsules,and the combination therapy group was treated with alfacalcidol soft capsules combined with alendronate tablets,with 1 month as a course of treatment,and a total of 6 courses of treatment.The clinical efficacy of the two groups was compared,and the changes of bone mineral density,calcium and phosphorus metabolism,bone markers and oxidative stress related indicators of different parts of the two groups before and after treatment were compared,and the adverse reactions of the two groups during medication were statistically analyzed.Results The total effective rate of the combination therapy group was significantly higher than that of the alfacalcidol group(P<0.05).The bone mineral density of lumbar spine(L_(2~4)),femoral neck and femoral trochanter in both groups were higher than those before treatment(P<0.05),but the bone mineral density increased more significantly in the combination therapy group(P<0.05).After treatment,the levels of S-Ca and S-P in the combination therapy group were significantly higher than those in the alfacalcidol group(P<0.05),and the levels of BGP,BALP and TRACP-5b were significantly lower than those in the alfacalcidol group(P<0.05);the levels of MDA in the combination therapy group were significantly lower than those in the alfacalcidol group(P<0.05),and the levels of SOD and GSH-PX were significantly higher than those in the alfacalcidol group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Alendronate combined with alfacalcidol in the treatment of senile o

关 键 词：骨质疏松 老年人 阿屈膦酸盐 阿法骨化醇 骨密度 骨标志物 氧化应激 

分 类 号：R580[医药卫生—内分泌]