参苓白术散治疗脾虚型HIV感染患者骨质疏松的临床疗效研究  

Clinical efficacy of Shenling Baizhu Powder on treating osteoporosis in patients with spleen deficiency type human immunodeficiency virus infection

作　　者：刘晓阳 任鹏 张峰 鲍锐 LIU Xiaoyang;REN Peng;ZHANG Feng;BAO Rui(Department of Orthopedics,Guiyang Public Health Treatment Center,Guiyang 550000,Guizhou,China)

机构地区：[1]贵阳市公共卫生救治中心骨外科,贵阳550000

出　　处：《中国性科学》2024年第8期131-135,共5页Chinese Journal of Human Sexuality

基　　金：贵阳市卫生健康局科学技术计划项目([2021]筑卫健科技合同字第28号)。

摘　　要：目的观察参苓白术散治疗脾虚型人类免疫缺陷病毒(HIV)感染患者骨质疏松的临床效果。方法选取贵阳市公共卫生救治中心感染科门诊收治的脾虚型HIV感染骨质疏松患者80例,随机分为对照组(给予阿仑膦酸钠,n=40)和实验组(给予阿仑膦酸钠+参苓白术散,n=40)。分析两组临床疗效、中医证候积分、骨密度(BMD)、骨代谢指标[甲状旁腺激素(PTH)、骨钙素(OC)、碱性磷酸酶(ALP)、骨特异性碱性磷酸酶(BALP)]、静息和活动视觉模拟评分法(VAS)评分、Klotho-成纤维细胞生长因子23(FGF23)轴指标。结果实验组总有效率高于对照组(P<0.05);治疗4周、16周,实验组中医证候积分低于对照组(P<0.05);治疗16周实验组两组L_(1~4)、Ward三角、股骨颈、总髋部BMD高于对照组(P<0.05);治疗4周、16周实验组OC水平高于对照组,ALP、BALP、PTH、Klotho蛋白、FGF23水平低于对照组(P<0.05);治疗4周、16周实验组静息和活动VAS评分低于对照组(P<0.05)。结论参苓白术散治疗脾虚型HIV感染患者骨质疏松疗效确切,可改善BMD、骨代谢情况,并能减轻疼痛程度,可能与抑制Klotho-FGF23轴有关。Objective To observe the clinical effect of Shenling Baizhu Powder on treating osteoporosis in patients with spleen deficiency type human immunodeficiency virus(HIV)infection.Methods A total of 80 patients with HIV infected osteoporosis and spleen deficiency treated in Infection Department of Guiyang Public Health Treatment Center were randomly divided into control group(given alendronate sodium,n=40)and experimental group(given alendronate sodium+Shenling Baizhu Powder,n=40).Clinical efficacy,traditional Chinese medicine(TCM)syndrome score,bone mineral density(BMD),bone metabolism indexes[parathyroid hormone(PTH),osteocalcin(OC),alkaline phosphatase(ALP),bone specific alkaline phosphatase(BALP)],resting and active visual analogue scale(VAS),and Klotho-fibroblast growth factor 23(FGF23)were analyzed.Results The total effective rate of the experimental group was higher than that of the control group(P<0.05).After 4 weeks and 16 weeks of treatment,TCM syndrome scores of the experimental group were lower than those of the control group(P<0.05).After 16 weeks of treatment,the BMD of L_(1-4),Ward triangle,femoral neck and total hip in the experimental group were higher than those in the control group(P<0.05).After 4 and 16 weeks of treatment,the level of OC in the experimental group were higher than those in the control group,and the levels of ALP,BALP,PTH,Klotho protein and FGF23 were lower than those in the control group(P<0.05).After 4 and 16 weeks of treatment,the scores of resting VAS and active VAS in the experimental group were lower than those in the control group(P<0.05).Conclusions Shenling Baizhu Powder is effective in treating osteoporosis in patients with spleen deficiency type HIV.It can improve the BMD and bone metabolism condition,and reduce the degree of pain,which may be related to the inhibition of Klotho-FGF23 axis.

关 键 词：参苓白术散 脾虚型 人类免疫缺陷病毒感染 骨质疏松 骨代谢 骨密度 

分 类 号：R275[医药卫生—中医皮科]