补肾活血汤加减联合雷火灸治疗肾虚血瘀型骨质疏松症疗效观察  

Effect of Modified Bushen Huoxue Decoction(补肾活血汤)Combined with Thunder Fire Moxibustion on Osteoporosis of Kidney Deficiency and Blood Stasis Type

作　　者：马佳星 孙晓红[2] 庄琪 李红[2] 钱科威[2] MA Jiaxing;SUN Xiaohong;ZHUANG Qi;LI Hong;QIAN Kewei(Department of Rheumatology and Immunology,Zhangjiagang Hospital of Traditional Chinese Medicine,Suzhou 215600,China;Department of Endocrinology,Zhangjiagang Hospital of Traditional Chinese Medicine,Suzhou 215600,China)

机构地区：[1]张家港市中医医院/南京中医药大学附属张家港医院风湿免疫科,江苏苏州215600 [2]张家港市中医医院/南京中医药大学附属张家港医院内分泌科,江苏苏州215600

出　　处：《山东中医杂志》2025年第2期164-169,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：苏州市科技计划项目(编号:SKYD2023057)。

摘　　要：目的:观察补肾活血汤加减联合雷火灸疗法对肾虚血瘀型骨质疏松症(OP)的治疗效果,为OP的中医临床防治提供参考。方法:选取肾虚血瘀型OP患者80例为观察对象,按随机数字表法分为对照组和观察组各40例,对照组接受常规西药治疗,观察组在西药基础上加用补肾活血汤加减联合雷火灸治疗,于治疗8周后评价两组临床疗效。观察患者治疗前后中医证候积分的变化,应用双能X线骨密度仪检测第4~5腰椎及股骨胫骨骨密度(BMD),通过视觉模拟评分法(VAS)、Oswestry功能障碍指数问卷表(ODI)及SF-36生存质量量表观察患者疼痛强度、腰背功能及生活质量的改善情况,酶联免疫吸附测定(ELISA)实验检测血清中骨钙素(BGP)、β-胶原特殊序列(β-CTX)及总Ⅰ型胶原氨基端延长肽(PINP)骨代谢指标的水平。结果:观察组、对照组患者基线期各指标水平比较差异无统计学意义(P>0.05);治疗8周后,两组患者中医证候积分、VAS评分、ODI评分及血清β-CTX的水平较治疗前明显降低(P<0.05),BMD水平、生存质量评分及血清BGP、PINP的水平较前明显提升(P<0.05);治疗后组间比较,观察组患者临床总有效率较对照组高(P<0.05),中医证候积分、VAS评分、ODI评分及血清β-CTX水平明显低于对照组,BMD水平、生存质量评分及血清BGP、PINP水平明显高于对照组(P<0.05)。结论:补肾活血汤加减联合雷火灸用于肾虚血瘀型OP患者具有较好的疗效,能够增加患者骨密度,减轻疼痛,提高生活质量,其机制可能与调节患者体内骨代谢水平相关。Objective:To observe the therapeutic effect of modified Bushen Huoxue Decoction(补肾活血汤)combined with thunder fire moxibustion on osteoporosis(OP)of kidney deficiency and blood stasis type,and to provide references for traditional Chinese medicine(TCM)clinical prevention and treatment of OP.Methods:Eighty OP patients of kidney deficiency and blood stasis type were randomly divided into a control group and an observation group,40 patients in each group,using a random number table.The control group received conventional western medicine,while the observation group received additional Bushen Huoxue Decoction combined with thunder fire moxibustion alongside western medicine.The clinical efficacy of the two groups was evaluated after 8 weeks of treatment.Changes of TCM symptom scores before and after treatment were recorded.Bone mineral density(BMD)of lumbar vertebrae L4 and L5,femur,and tibia were measured using dual-energy X-ray bone densitometer.Pain intensity,lumbar and back function,and quality of life were assessed using visual analogue scale(VAS),Oswestry disability index(ODI)and 36-Item Short Form Survey(SF-36),respectively.Serum levels of boneγ-carboxyglutamate protein(BGP),β-collagen degradation product(β-CTX)and type I procollagen amino terminal elongation peptide(PINP)were measured by enzyme-linked immunosorbent assay(ELISA).Results:There were no statistical differences between the observation group and the control group at baseline(P>0.05).After 8 weeks of treatment,the observation group showed lower TCM symptom scores,VAS and ODI scores,as well as serumβ-CTX levels(P<0.05)compared to before treatment.BMD levels,quality of life score and levels of serum BGP and PINP significantly increased compared to baseline(P<0.05).Compared to the control group,the observation group had a significantly higher total effective rate(P<0.05).Additionally,the observation group exhibited significantly lower TCM symptom scores,VAS and ODI scores,and serumβ-CTX levels,while BMD levels,quality of life scores and le

关 键 词：补肾活血汤 雷火灸 骨质疏松症 肾虚血瘀 骨代谢 

分 类 号：R274[医药卫生—中医骨伤科学]