中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2014年
9期
21-24
,共4页
李明%徐明雄%冯左基%胡建强%郝涛%贾舜%祝海滨%夏文波%东光彬
李明%徐明雄%馮左基%鬍建彊%郝濤%賈舜%祝海濱%夏文波%東光彬
리명%서명웅%풍좌기%호건강%학도%가순%축해빈%하문파%동광빈
骨质疏松,绝经后%壮骨方%骨密度%雌二醇%治疗,临床研究性
骨質疏鬆,絕經後%壯骨方%骨密度%雌二醇%治療,臨床研究性
골질소송,절경후%장골방%골밀도%자이순%치료,림상연구성
Osteoporosis,postmenopausal%ZHUANGGU decoction%Bone density%Estradiol%Therapies,investigational
目的:探讨自拟壮骨方治疗绝经后骨质疏松症的疗效及作用机制。方法:将纳入研究的240例绝经后骨质疏松症患者随机分为2组,每组120例。治疗组采用口服自拟壮骨方治疗,对照组采用口服尼尔雌醇片治疗。比较2组患者的骨密度及血清中钙、磷、碱性磷酸酶、雌二醇的水平,同时比较2组患者治疗后的疼痛改善情况。结果:①骨密度。治疗前2组患者腰椎和股骨颈骨密度比较,组间差异均无统计学意义[(0.73±0.26)g·cm-2,(0.71±0.29)g·cm-2,t=3.296,P=0.110;(0.84±0.03)g· cm-2,(0.85±0.02)g·cm-2,t=3.114,P=0.201]。治疗组治疗前后腰椎骨密度的差值大于对照组[(0.20±0.15)g·cm-2,(0.18±0.12)g·cm-2,t=4.012,P=0.021];2组患者股骨颈骨密度的差值比较,差异无统计学意义[(0.60±0.24)g·cm-2,(0.16±0.14)g·cm-2,t=1.062,P=0.080]。②血生化指标。治疗前2组患者血清中钙、磷、碱性磷酸酶、雌二醇浓度比较,组间差异均无统计学意义[(2.24±0.16)mmol·L-1,(2.22±0.14)mmol·L-1,t =5.659,P=0.431;(1.19±0.21)mmol·L-1,(1.18±0.22)mmol·L-1,t =3.314,P=0.158;(109.50±13.41)U·L-1,(108.71±20.42)U·L-1,t =1.354,P=0.762;(40.86±18.26)pmol·L-1,(41.14±19.04)pmol·L-1,t=1.918,P=0.656]。治疗组血清中钙和磷浓度治疗前后的差值均大于对照组[(1.61±0.46)mmol·L-1,(0.31±0.25)mmol·L-1,t =5.618,P=0.000;(0.60±0.24)mmol·L-1,(0.30±0.14) mmol·L-1,t=7.012,P=0.000];碱性磷酸酶和雌二醇浓度治疗前后的差值与对照组比较,差异均无统计学意义[(20.21±12.16)U·L-1,(16.11±10.12)U·L-1,t=1.368,P=0.612;(19.26±10.23)pmol·L-1,(16.76±9.67)pmol·L-1,t=1.386, P=0.748]。③疼痛改善情况。治疗组显效74例、有效35例、无效11例,对照组显效71例、有效34例、无效15例。治疗结束后2组患者疼痛改善情况比较,差异无统计学意义(Z=-0.547,P=0.584)。结论:自拟壮骨方具有类雌激素样作用,可通过提高雌激素水平,改善骨代谢,增加骨密度,减轻绝经后骨质疏松症患者的疼痛症状。
目的:探討自擬壯骨方治療絕經後骨質疏鬆癥的療效及作用機製。方法:將納入研究的240例絕經後骨質疏鬆癥患者隨機分為2組,每組120例。治療組採用口服自擬壯骨方治療,對照組採用口服尼爾雌醇片治療。比較2組患者的骨密度及血清中鈣、燐、堿性燐痠酶、雌二醇的水平,同時比較2組患者治療後的疼痛改善情況。結果:①骨密度。治療前2組患者腰椎和股骨頸骨密度比較,組間差異均無統計學意義[(0.73±0.26)g·cm-2,(0.71±0.29)g·cm-2,t=3.296,P=0.110;(0.84±0.03)g· cm-2,(0.85±0.02)g·cm-2,t=3.114,P=0.201]。治療組治療前後腰椎骨密度的差值大于對照組[(0.20±0.15)g·cm-2,(0.18±0.12)g·cm-2,t=4.012,P=0.021];2組患者股骨頸骨密度的差值比較,差異無統計學意義[(0.60±0.24)g·cm-2,(0.16±0.14)g·cm-2,t=1.062,P=0.080]。②血生化指標。治療前2組患者血清中鈣、燐、堿性燐痠酶、雌二醇濃度比較,組間差異均無統計學意義[(2.24±0.16)mmol·L-1,(2.22±0.14)mmol·L-1,t =5.659,P=0.431;(1.19±0.21)mmol·L-1,(1.18±0.22)mmol·L-1,t =3.314,P=0.158;(109.50±13.41)U·L-1,(108.71±20.42)U·L-1,t =1.354,P=0.762;(40.86±18.26)pmol·L-1,(41.14±19.04)pmol·L-1,t=1.918,P=0.656]。治療組血清中鈣和燐濃度治療前後的差值均大于對照組[(1.61±0.46)mmol·L-1,(0.31±0.25)mmol·L-1,t =5.618,P=0.000;(0.60±0.24)mmol·L-1,(0.30±0.14) mmol·L-1,t=7.012,P=0.000];堿性燐痠酶和雌二醇濃度治療前後的差值與對照組比較,差異均無統計學意義[(20.21±12.16)U·L-1,(16.11±10.12)U·L-1,t=1.368,P=0.612;(19.26±10.23)pmol·L-1,(16.76±9.67)pmol·L-1,t=1.386, P=0.748]。③疼痛改善情況。治療組顯效74例、有效35例、無效11例,對照組顯效71例、有效34例、無效15例。治療結束後2組患者疼痛改善情況比較,差異無統計學意義(Z=-0.547,P=0.584)。結論:自擬壯骨方具有類雌激素樣作用,可通過提高雌激素水平,改善骨代謝,增加骨密度,減輕絕經後骨質疏鬆癥患者的疼痛癥狀。
목적:탐토자의장골방치료절경후골질소송증적료효급작용궤제。방법:장납입연구적240례절경후골질소송증환자수궤분위2조,매조120례。치료조채용구복자의장골방치료,대조조채용구복니이자순편치료。비교2조환자적골밀도급혈청중개、린、감성린산매、자이순적수평,동시비교2조환자치료후적동통개선정황。결과:①골밀도。치료전2조환자요추화고골경골밀도비교,조간차이균무통계학의의[(0.73±0.26)g·cm-2,(0.71±0.29)g·cm-2,t=3.296,P=0.110;(0.84±0.03)g· cm-2,(0.85±0.02)g·cm-2,t=3.114,P=0.201]。치료조치료전후요추골밀도적차치대우대조조[(0.20±0.15)g·cm-2,(0.18±0.12)g·cm-2,t=4.012,P=0.021];2조환자고골경골밀도적차치비교,차이무통계학의의[(0.60±0.24)g·cm-2,(0.16±0.14)g·cm-2,t=1.062,P=0.080]。②혈생화지표。치료전2조환자혈청중개、린、감성린산매、자이순농도비교,조간차이균무통계학의의[(2.24±0.16)mmol·L-1,(2.22±0.14)mmol·L-1,t =5.659,P=0.431;(1.19±0.21)mmol·L-1,(1.18±0.22)mmol·L-1,t =3.314,P=0.158;(109.50±13.41)U·L-1,(108.71±20.42)U·L-1,t =1.354,P=0.762;(40.86±18.26)pmol·L-1,(41.14±19.04)pmol·L-1,t=1.918,P=0.656]。치료조혈청중개화린농도치료전후적차치균대우대조조[(1.61±0.46)mmol·L-1,(0.31±0.25)mmol·L-1,t =5.618,P=0.000;(0.60±0.24)mmol·L-1,(0.30±0.14) mmol·L-1,t=7.012,P=0.000];감성린산매화자이순농도치료전후적차치여대조조비교,차이균무통계학의의[(20.21±12.16)U·L-1,(16.11±10.12)U·L-1,t=1.368,P=0.612;(19.26±10.23)pmol·L-1,(16.76±9.67)pmol·L-1,t=1.386, P=0.748]。③동통개선정황。치료조현효74례、유효35례、무효11례,대조조현효71례、유효34례、무효15례。치료결속후2조환자동통개선정황비교,차이무통계학의의(Z=-0.547,P=0.584)。결론:자의장골방구유류자격소양작용,가통과제고자격소수평,개선골대사,증가골밀도,감경절경후골질소송증환자적동통증상。
Objective:To study the curative effect and mechanism of action of self-made ZHUANGGU decoction in treatment of postm-enopausal osteoporosis(PMO).Methods:Two hundred and forty patients with PMO were randomly divided into 2 groups,1 20 cases in each group.The patients in the treatment group was treated with oral application of self-made ZHUANGGU decoction,while others in the control group was treated with nilestriol tablet.Bone mineral density(BMD)and serum level of Ca,P,alkaline phosphatase(ALP)and estradiol (E2)were compared between the 2 groups.Meanwhile,the posttreatment pain degree was compared between the 2 groups.Results:There was no statistical difference in BMD of lumbar spine and femoral neck between the 2 groups before the treatment(0.73+/-0.26 vs 0.71 +/-0.29 g/cm(2),t=3.296,P=0.1 1 0;0.84+/-0.03 vs 0.85 +/-0.02 g/cm(2),t=3.1 1 4,P=0.201 ).After the treatment,the lumbar spine BMD change of treatment group was greater than that of control group(0.20+/-0.1 5 vs 0.1 8+/-0.1 2 g/cm(2),t=4.01 2,P=0.021 ), and there was no statistical difference in the femoral neck BMD change between the 2 groups(0.60+/-0.24 vs 0.1 6+/-0.1 4 g/cm(2), t=1 .062,P=0.080).There was no statistical difference in serum level of Ca,P,ALP an E2 between the 2 groups before the treatment (2.24+/-0.1 6 vs 2.22+/-0.1 4 mmol/L,t=5.659,P=0.431;1 .1 9+/-0.21 vs 1 .1 8+/-0.22 mmol/L,t=3.31 4,P=0.1 58;1 09.50+/-13.41 vs 108.71 +/-20.42 U/L,t=1.354,P=0.762;40.86 +/-18.26 vs 41.14+/-19.04 pmol·L-1,t=1.918,P=0.656).After the treatmeng,the change of serum level of Ca and P of treatment group was greater than that of control group(1 .61 +/-0.46 vs 0.31 +/-0.25 mmol/L,t=5.61 8,P=0.000;0.60+/-0.24 vs 0.30+/-0.1 4 mmol/L,t=7.01 2,P=0.000),while there was no statistical differ-ence in the change of serum level of ALP and E2 between the 2 groups(20.21 +/-1 2.1 6 vs 1 6.1 1 +/-1 0.1 2 U/L,t=1 .368,P=0.61 2;1 9.26+/-1 0.23 vs 1 6.76+/-9.67 pmol/L,t=1 .386,P=0.748).Seventy-four patients obtained an excellent result,35 good and 1 1 poor in the treatment group;while 71 patients obtained an excellent result,34 good and 1 5 poor in the control group.There was no statistical difference in the degree of pain relief between 2 groups after the treatment(Z=-0.547,P=0.584).Conclusion:Self-made ZHUANGGU decoction has estrogen-like effects,so it can effectively reduce the pain symptoms of the patients with PMO through increasing estrogen levels and improving bone metabolism and increasing BMD.