温阳益气法中药联合阿仑膦酸钠维D3治疗老年骨质疏松症的疗效及对骨代谢和血清炎症因子的影响研究  

Therapeutic Efficacy of Wenyang Yiqi Therapy Combined with Alendronate Sodium Vitamin D3 for Osteoporosis in the Elderly and Its Effect on Bone Metabolism and Serum Inflammatory Factors

作　　者：王正凯 张根 刘振峰 杨澔侠 何剑全 WANG Zhengkai;ZHANG Gen;LIU Zhenfeng;YANG Haoxia;HE Jianquan(Dept.of Orthopedics and Traumatology of Traditional Chinese Medicine,Wuxi Ninth People's Hospital,Wuxi 214062 Jiangsu,China)

机构地区：[1]无锡市第九人民医院中医骨伤科,江苏无锡214062

出　　处：《广州中医药大学学报》2025年第3期614-620,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(编号:82004433);无锡市中医药管理局中医药科技项目(编号:ZYKJ201911)。

摘　　要：【目的】观察温阳益气法中药联合阿仑膦酸钠维D3治疗老年骨质疏松症(OP)脾肾阳虚证患者的疗效及对骨代谢和血清炎症因子的影响。【方法】将2021年10月至2023年10月在无锡市第九人民医院中医骨伤科就诊的110例老年OP脾肾阳虚证患者随机分为试验组和对照组,每组各55例。对照组给予阿仑膦酸钠维D3治疗,试验组在对照组的基础上给予温阳益气法中药(包括淫羊藿、黄芪、牡蛎、当归、川牛膝、补骨脂、桑寄生等)治疗,疗程为3个月。观察2组患者治疗前后中医证候积分、骨密度(BMD)、疼痛视觉模拟量表(VAS)评分、骨代谢指标[β胶原降解产物(β-CTX)、总I型原胶原氨基端延长肽(PINP)、骨钙素(BGP)]以及血清炎症因子指标[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]的变化情况,并评价2组患者的临床疗效。【结果】(1)疗效方面,治疗3个月后,试验组的总有效率为94.55%(52/55),对照组为74.55%(41/55),组间比较(χ^(2)检验),试验组的疗效明显优于对照组(P<0.01)。(2)中医证候积分方面,治疗后,2组患者的腰膝酸软、畏寒肢冷、神疲倦怠、夜尿频多等中医证候积分均较治疗前降低(P<0.05),且试验组的降低幅度均明显优于对照组(P<0.01)。(3)BMD和疼痛VAS评分方面,治疗后,2组患者的BMD均较治疗前升高(P<0.05),疼痛VAS评分均较治疗前降低(P<0.05),且试验组对BMD的升高幅度及对疼痛VAS评分的降低幅度均明显优于对照组(P<0.01)。(4)骨代谢指标方面,治疗后,2组患者的血清β-CTX、PINP水平均较治疗前降低(P<0.05),血清BGP水平均较治疗前升高(P<0.05),且试验组对血清β-CTX、PINP水平的降低幅度及对血清BGP水平的升高幅度均明显优于对照组(P<0.01)。(5)血清炎症因子方面,治疗后,2组患者的血清IL-6、TNF-α水平均较治疗前降低(P<0.05),且试验组的降低幅度均明显优于对照组(P<0.01)。【结论】温阳益气法中药联合阿仑�Objective To investigate the therapeutic efficacy of Wenyang Yiqi Therapy,the method of warming yang and replenishing qi in traditional Chinese medicine(TCM),combined with Alendronate Sodium Vitamin D3 in the treatment of elderly patients with osteoporosis(OP)of the spleen-kidney yang deficiency syndrome,and to observe its effect on bone metabolism and serum inflammatory factors.Methods A total of 110 cases of elderly patients with OP of spleen-kidney yang deficiency syndrome who admitted to the Department of Orthopedics and Traumatology of Traditional Chinese Medicine of Wuxi Ninth People s Hospital from October 2021 to October 2023 were randomly divided into a trial group and a control group,with 55 patients in each group.The two groups were treated with Alendronate Sodium Vitamin D3,and additionally the trial group was Therapy by using Chinese herbal medicines of Epimedii Folium,Astragali Radix,Ostreae Concha,Angelicae Sinensis Radix,Cyathulae Radix,Psoraleae Fructus,Taxilli Herba,etc.The course of treatment for the two groups covered three months.Before and after treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,bone mineral density(BMD),Visual Analogue Scale(VAS)score of pain,bone metabolism indicators ofβ-C-terminal telopeptide of type 1 collagen(β-CTX),total procollagen type 1 N-terminal propeptide(PINP)and bone gla-protein(BGP),and serum inflammatory factor indicators of [interleukin 6(IL-6)and tumor necrosis factorα(TNF-α)].After treatment,the clinical efficacy of the two groups of patients was evaluated.Results(1)After three months of treatment,the total effective rate of the trial group was 94.55%(52/55)and that of the control group was 74.55%(41/55),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the trial group was significantly superior to that of the control group(P<0.01).(2)After treatment,the scores of TCM symptoms of soreness and weakness in the waist and knee,aversion of cold with cold limbs,fatigue

关 键 词：温阳益气法 阿仑膦酸钠维D3 老年骨质疏松症 脾肾阳虚 骨代谢 骨密度 炎症反应 

分 类 号：R274.9[医药卫生—中西医结合]