温肾益髓汤治疗肾阳虚证骨质疏松症的临床疗效观察  

Clinical efficacy observation of Wenshen Yisui Decoction(温肾益髓汤)in treating osteoporosis with kidney yang deficiency syndrome

作　　者：胡继辉 杨智军 崔裕博 杨文龙 李典 邓志军 赵斌 杨凤云[2] HU Ji-hui;YANG Zhi-jun;CUI Yu-bo;YANG Wen-long;LI Dian;DENG Zhi-jun;ZHAO Bin;YANG Feng-yun(Jiangxi University of Chinese Medicine,Nanchang 330004,China;Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China)

机构地区：[1]江西中医药大学,江西南昌330004 [2]江西中医药大学附属医院,江西南昌330006

出　　处：《时珍国医国药》2025年第6期1112-1116,共5页Lishizhen Medicine and Materia Medica Research

基　　金：杨凤云全国名老中医专家传承工作室建设项目(国中医药人教函[2022]75号);江西省临床医学研究中心建设项目(20212BCG74004);江西省自然科学基金项目(20232BAB216116);江西省大学生创新创业训练项目(S202310412058,S202410412075,202410412030)。

摘　　要：目的探究温肾益髓汤治疗肾阳虚证骨质疏松症(OP)的临床疗效及作用机制。方法采用随机对照的临床设计方案,选取120例肾阳虚证OP患者,按随机数字表法分为对照组及观察组。对照组予醋酸钙胶囊,并加以阿仑磷酸钠片,观察组在对照组的基础上加服温肾益髓汤。治疗3个月后,根据骨密度、骨代谢指标、Oswestry功能障碍指数(ODI)评分、VAS疼痛评分、疗效评定、中医证候积分评价两组患者的临床疗效。结果治疗3个月后,两组患者的骨密度均有效提升,观察组较对照组作用更加明显(P<0.05);其次,两组患者骨转化指标Ⅰ型胶原氨基端前肽、Ⅰ型胶原交联羧基端肽和骨钙素均降低,且观察组治疗效果优于对照组(P<0.05);同时,ODI评分、VAS评分、中医证候积分均比治疗前降低,且观察组评分降幅大于对照组(P<0.05);此外,两组患者疗效具有差异性,观察组较对照组更好(P<0.05)。结论温肾益髓汤可改善肾阳虚证OP患者的骨密度,降低骨转化率,提高临床疗效。Objective To investigate the clinical efficacy and mechanism of Wenshen Yisui Decoction(温肾益髓,WSYSD)in treating osteoporosis(OP)with kidney yang deficiency syndrome.Methods A randomized controlled clinical trial was conducted on 120 OP patients with kidney yang deficiency syndrome.Participants were divided into the control and observation groups using a random number table.The control group received Calcium Acetate Capsules and Alendronate Sodium Tablets,while the observation group received additional WSYSD alongside the control treatment.After 3 months of treatment,clinical efficacy of the two groups was evaluated based on bone mineral density(BMD),bone metabolism markers,Oswestry Disability Index(ODI)scores,Visual Analog Scale(VAS)pain scores,overall efficacy assessment,and traditional Chinese medicine(TCM)syndrome scores.Results After 3 months,BMD were significantly improved in both groups,with greater improvement in the observation group(P<0.05).Secondly,bone turnover indexes including the Procollagen Type I N-terminal Propeptide(PINP),C-terminal telopeptide of type I collagen(CTXI),and osteocalcin were decreased in both groups,with superior efficacy in the observation group(P<0.05).ODI scores,VAS pain scores,and TCM syndrome scores were all lower than those before treatment,with significantly greater reductions in the observation group(P<0.05).Additionally,there was a significant difference in therapeutic efficacy between the two groups,with the observation group demonstrating superior outcomes compared to the control group(P<0.05).Conclusion WSYSD improves BMD,reduces bone turnover rate,and enhances clinical outcomes in OP patients with kidney yang deficiency syndrome.

关 键 词：温肾益髓汤 骨质疏松症 肾阳虚证 骨代谢 骨密度 

分 类 号：R274.9[医药卫生—中西医结合]