机构地区:[1]南京中医药大学附属医院,江苏省南京市210029 [2]南京医科大学第一附属医院 [3]南京中医药大学
出 处:《中国康复医学杂志》2025年第2期231-236,247,共7页Chinese Journal of Rehabilitation Medicine
基 金:江苏省中医药科技发展计划重点项目(ZD202313);南京中医药大学自然基金项目(XZR2021006);南京市中医药科技专项(ZYYB202220);江苏省中管局江苏省中医药科技发展计划项目(MS2022021)。
摘 要:目的:观察雷火灸联合脉冲电磁场(pulsed electromagnetic fields,PEMFs)对原发性骨质疏松症患者骨代谢和运动功能的影响。方法:本研究入组原发性骨质疏松症患者90例,采用信封法分为PEMFs组、雷火灸组和PEMFs+雷火灸组,每组30例。PEMFs治疗频率为16Hz,强度为20mT;雷火灸选取双侧肝俞、肾俞部位施灸。治疗时间均为30min,每周3次,连续3个月。在治疗前、治疗3个月及入组6个月随访时评估计时起立-走(TUG)、血清I型前胶原氨基末端肽(PINP)和血清Ⅰ型胶原交联C-末端肽(CTX-I),并在入组6个月随访时进行骨密度(BMD)检测。结果:(1)组间比较:与PEMFs组比较,PEMFs+雷火灸组治疗3个月降低TUG用时和血清CTX-Ⅰ水平显著(P<0.05),血清PINP水平降低更显著(P<0.01)。入组6个月随访时,PEMFs+雷火灸组降低TUG用时较PEMFs组显著(P<0.01)。与雷火灸组比较,PEMFs+雷火灸组治疗3个月降低血清CTX-Ⅰ水平显著(P<0.05)。(2)组内比较:治疗3个月与治疗前比较,PEMFs组降低TUG用时和血清CTX-Ⅰ水平显著(P<0.05);雷火灸组和PEMFs+雷火灸组TUG用时和血清PINP与CTX-Ⅰ水平显著降低(P<0.01)。入组6个月随访时与治疗前比较,PEMFs组降低TUG用时显著(P<0.05);PEMFs+雷火灸组TUG用时和血清PINP水平显著降低(P<0.01)。三组患者腰总和髋总BMD在入组6个月随访和治疗前比较均无显著差异(P>0.05)。结论:雷火灸联合PFMFs可提高原发性骨质疏松症患者运动功能、改善骨代谢指标;骨密度值呈好转趋势。Objective:To investigate the effect of thunder-fire moxibustion combined with pulsed electromagnetic fields(PEMFs)on bone metabolism and motor function in individuals with primary osteoporosis.Method:Ninety patients with primary osteoporosis were randomly assigned to three groups using the envelope method:PEMFs group(n=30),thunder-fire moxibustion group(n=30),and PEMFs+thunder-fire moxibustion group(n=30).The PEMFs treatment frequency was 16Hz with an intensity of 20mT,while thunder-fire moxibustion was applied at bilateral Ganshu(BL18)and Shenshu(BL23).Each treatment session lasted 30 minutes,conducted three times a week for three consecutive months.The timed up-and-go(TUG)test,serum typeⅠprocollagen amino-terminal peptide(PINP)and type I collagen carboxy-terminal peptide(CTX-I)were assessed before treatment,after 3-month treatment,and at 6-month follow-up.Bone mineral density(BMD)was measured at 6-month follow-up.Result:①Inter-group comparison:after 3-month treatment,the PEMFs+Thunder-Fire Moxibustion group showed a significant reduction in TUG time and serum CTX-I levels compared to the PEMFs group(P<0.05),and a more significant reduction in serum PINP levels(P<0.01).At the 6-month follow-up,the TUG time in PEMFs+thunder-fire moxibustion group was significantly lower than PEMFs group(P<0.01).Compared to the thunder-fire moxibustion group,the PEMFs+thunder-fire moxibustion group serum level of CTX-Ⅰof decreased significantly after 3-month treatment(P<0.05).②Intra-group comparison:After three months of treatment compared to baseline,the PEMFs group showed a significant reduction in TUG time and serum CTX-I levels(P<0.05),while both the Thunder-Fire Moxibustion group and the PEMFs+Thunder-Fire Moxibustion group showed significant reductions in TUG time and serum PINP and CTX-I levels(P<0.01).Comparison between 6-month follow-up and before treatment,the TUG time of PEMFs group decreased significantly(P<0.05).The TUG time and the serum level of PINP in PEMFs+thunder-fire moxibustion group significantly decr
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