基于“脾主肉、肾主骨”理论探讨中药对老年骨质疏松患者平衡力的影响  

Discussion on the Effect of Chinese Materia Medica on Balance Capacity of Elderly Patients with Osteoporosis Based on"Spleen Governing Muscle and Kidney Dominating Bone"Theory

作　　者：张遂辉 杨美艳 唐斯伟 王春芸 游焌 谢婧 陈孝红 陈思思 ZHANG Suihui;YANG Meiyan;TANG Siwei;WANG Chunyun;YOU Jun;XIE Jing;CHEN Xiaohong;CHEN Sisi(Department of Geriatrics,the Third People's Hospital of Ganzhou,Ganzhou 341000,China)

机构地区：[1]赣州市第三人民医院老年科,江西赣州341000

出　　处：《中国医学创新》2024年第14期129-133,共5页Medical Innovation of China

基　　金：2021年度江西省中医药管理局科技计划项目(2021B033)。

摘　　要：目的:基于“脾主肉、肾主骨”理论,探讨中药对老年骨质疏松患者平衡力的影响,为老年骨质疏松患者跌倒的预防提供一定的理论参考。方法:将赣州市第三人民医院老年科2021年9月—2022年8月收治的86例老年骨质疏松症患者随机分为观察组(n=44)与对照组(n=42)。对照组患者给予常规西医药物(碳酸钙D3及阿法骨化醇)治疗,观察组患者在对照组基础上加用补肾健骨汤治疗。两组患者治疗前及治疗3个月后均检测骨密度和骨转换标志物,评价疼痛控制情况和平衡能力改善情况。结果:治疗前两组腰椎和左髋关节骨密度、Ⅰ型胶原氨基端延长肽(PⅠNP)、闭眼单脚站立测试(SST)、星形偏移平衡测试(SEBT)、β-胶原降解产物(β-CTX)及视觉模拟评分法(VAS)评分比较,差异均无统计学意义(P>0.05)。治疗3个月后,观察组腰椎和左髋关节骨密度[(0.665±0.091)g/cm2、(0.657±0.094)g/cm2]、PⅠNP[(70.241±15.271)μg/L]及SEBT[(74.524±6.842)%]均明显高于对照组[(0.632±0.052)g/cm2、(0.621±0.069)g/cm2、(62.632±14.986)μg/L及(70.807±6.613)%],观察组SST[(11.232±1.899)s]长于对照组[(10.092±2.071)s],观察组的β-CTX[(0.365±0.113)μg/L]、VAS[(1.521±0.625)分]均明显低于对照组[(0.382±0.126)μg/L、(2.637±0.684)分](P<0.05)。结论:补肾健骨法联合碳酸钙D3及阿法骨化醇治疗可快速提高老年骨质疏松患者的骨密度、PⅠNP,降低β-CTX,缓解疼痛,改善动静态平衡能力。Objective:To discuss the effect of Chinese materia medica on balance capacity of elderly patients with osteoporosis based on"spleen governing muscle and kidney dominating bone"theory,and to provide a theoretical reference for the prevention of falls in elderly patients with osteoporosis.Method:A total of 86 elderly patients with osteoporosis admitted to Department of Geriatrics,the Third People's Hospital of Ganzhou from September 2021 to August 2022 were randomly divided into observation group(n=44)and control group(n=42).Patients in the control group was treated with conventional western medicine(Calcium Carbonate and Vitamin D3 and Alfacalcidol Soft),patients in observation group was treated with Bushen Jiangu Decoction on the basis of control group.Bone density and bone turnover markers were detected before and after 3 months of treatment in both groups,and the pain control and balance improvement were evaluated.Result:Before treatment,there were no significant differences in bone density of lumbar spine and left hip joint,procollagen typeⅠnterminal propeptide(PⅠNP),stork stand test(SST),star excursion balance test(SEBT),β-collagen degradation product(β-CTX)and visual analogue scale(VAS)scores between the two groups(P>0.05).3 months after treatment,bone density of lumbar spine and left hip joint[(0.665±0.091)g/cm2,(0.657±0.094)g/cm2],PⅠNP[(70.241±15.271)μg/L],and SEBT[(74.524±6.842)%]in observation group were significantly higher than those of control group[(0.632±0.052)g/cm2,(0.621±0.069)g/cm2,(62.632±14.986)μg/L and(70.807±6.613)%],SST[(11.232±1.899)s]in observation group was significantly longer than that in control group[(10.092±2.071)s],and theβ-CTX[(0.365±0.113)μg/L]and VAS[(1.521±0.625)scores]in observation group were significantly lower than those in control group[(0.382±0.126)μg/L,Medical Innovation of China Vol.21,No.14 May,2024(2.637±0.684)scores](P<0.05).Conclusion:Tonifying kidney and strengthening bones combined with Calcium Carbonate and Vitamin D3 and Alfacalcidol So

关 键 词：补肾健骨汤 骨质疏松 骨转换 平衡力 跌倒 

分 类 号：R259[医药卫生—中西医结合]