补肾健脾通络方联合五行健骨操治疗老年骨质疏松症患者的临床效果  

Clinical effect of Bushen Jianpi Tongluo decoction combined with Wuxing Jiangu exercise in the treatment of elderly patients with osteoporosis

作　　者：张彦芬 冀花 ZHANG Yanfen;JI Hua(Department of Integrated Traditional Chinese and Western Medicine,Shangluo Central Hospital,Shangluo,Shaanxi 726000,China)

机构地区：[1]陕西省商洛市中心医院中西医结合科,陕西商洛726000

出　　处：《检验医学与临床》2025年第3期345-349,355,共6页Laboratory Medicine and Clinic

基　　金：陕西省中医药管理局课题计划项目(SZY-KJCYC-2023-100)。

摘　　要：目的探究补肾健脾通络方联合五行健骨操治疗老年骨质疏松症(OP)患者的临床效果。方法选取2021年4月至2023年1月于商洛市中心医院就诊的106例老年OP患者作为研究对象,按照随机数字表法分为对照组(53例)和观察组(53例)。两组均采用常规治疗,对照组采用五行健骨操治疗,观察组采用补肾健脾通络方联合五行健骨操治疗,两组均4周为1个疗程,共治疗3个疗程。比较两组治疗前后中医证候积分、骨密度、骨生化指标[25羟维生素D、Ⅰ型胶原氨基酸延长肽(PⅠNP)、骨碱性磷酸酶(BALP)]及细胞因子[白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α]的差异,分析治疗后并发症发生情况。结果治疗3个疗程后,两组主、次症积分均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗3个疗程后,两组骨密度均高于治疗前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。两组治疗后骨密度评分T值虽均降低,但与治疗前比较,差异均无统计学意义(P>0.05)。治疗3个疗程后,两组血清PⅠNP水平均低于治疗前,且观察组均低于对照组,两组血清25羟维生素D、BALP水平均高于治疗前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。治疗3个疗程后,两组IL-6、TNF-α水平均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗后8周、16周内,两组并发症总发生率比较,差异均无统计学意义(P>0.05)。结论补肾健脾通络方联合五行健骨操治疗老年OP患者,通过改善机体维生素D吸收,加速PⅠNP合成Ⅰ型胶原,下调BALP水平,抑制IL-6、TNF-α水平,提高骨密度,改善临床症状,且远期并发症发生率较低。Objective To explore the clinical effect of Bushen Jianpi Tongluo decoction combined with Wuxing Jiangu exercise in the treatment of elderly patients with osteoporosis.Methods A total of 106 elderly OP patients who were treated in Shangluo Central Hospital from April 2021 to January 2023 were selected as the research objects.According to the random number table method,they were divided into the control group(53 cases)and the observation group(53 cases).The control group was treated with Wuxing Jiangu exercise,and the observation group was treated with Bushen Jianpi Tongluo decoction combined with five elements Jianguo exercise.Both groups were treated for 4 weeks as a course of treatment,and a total of 3 courses of treatment were required.The differences in TCM syndrome score,bone mineral density,bone biochemical indexes[25-hydroxyvitamin D,type Ⅰ collagen amino acid prolonged peptide(PⅠNP),bone alkaline phosphatase(BALP)]and cytokines[interleukin(IL)-6,tumor necrosis factor(TNF)-α]before and after treatment were compared between the two groups,and the complications after treatment were analyzed.Results After 3 courses of treatment,the scores of primary and secondary symptoms in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 3 courses of treatment,the bone mineral density of the two groups was higher than that before treatment,and that of the observation group was higher than that of the control group,the differences were statistically significant(P<0.05).The T value of bone mineral density score was decreased in both groups after treatment,and there was no significant difference when compared with that before treatment(P>0.05).After 3 courses of treatment,the serum levels of PⅠNP in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).The serum levels of 25-hydroxyvitamin

关 键 词：补肾健脾通络方 五行健骨操 骨质疏松症 中医证候积分 血清护骨素 骨碱性磷酸酶 

分 类 号：R681[医药卫生—骨科学] R259.2[医药卫生—外科学]