CAJ | 학술논문

目的：观察六味地黄丸加味治疗肝肾阴虚证绝经后骨质疏松症的临床疗效。方法选择中医辨证为肝肾阴虚证的绝经后骨质疏松症患者120例，按随机数字表法分为 A、B、C 三组。A 组：给予六味地黄丸加味药物制成的蜜丸，每天2粒，连续服用6个月；B 组：给予唑来膦酸注射液5 mg 静脉滴注；C 组：同时给予中药蜜丸和唑来膦酸治疗；三组均同时服用碳酸钙 D3片；三组病例均观察、随访12个月，比较三组临床疗效。结果A、C 组治疗后3个月雌二醇水平与治疗前比较，差异有统计学意义（t ＝2．54，P ＝0．05，t ＝2．07， P ＝0．06）。A 组治疗后3个月、6个月 VAS 评分分别为（3．75±1．32）分、（2．06±1．53）分，与治疗前差异均有统计学意义（t ＝10．18，P ＝0．00，t ＝9．26，P ＝0．00）。A 组治疗后3个月、6个月 SF-36评分分别为（90．82±12．38）分、（105．82±9．06）分，与治疗前比较，差异均有统计学意义（t ＝8．40，P ＝0．00，t ＝5．21，P ＝0．00）。A 组治疗后6个月腰1～4骨密度为（0．85±0．07）g／m2，与治疗前[（0．76±0．07）g／m2]比较，差异有统计学意义（t ＝7．56，P ＝0．00）；A 组治疗后6个月 Wards 区骨密度与治疗前比较，差异有统计学意义（t ＝8．07，P ＝0．00）。C 组治疗后6个月腰1～4骨密度为（0．91±0．07）g／m2，与 B 组[（0．88±0．05）g／m2]比较，差异有统计学意义（t ＝27．19，P ＝0．00）；C 组治疗后6个月 Wards 区骨密度为（0．62±0．04）g／m2，与 B 组比较，差异有统计学意义（t ＝26．22，P ＝0．00）。A 组治疗后6个月中医证候积分为（5．42±2．13）分，与 B 组[（10．75±4．08）分]比较，差异有统计学意义（t ＝13．29，P ＝0．00）。结论六味地黄丸加味能提高骨密度，减轻绝经后骨质疏松症患者骨痛，改善其生活质量，且无明显不良反应，其与唑来膦酸合用可增强疗效。目的：觀察六味地黃汍加味治療肝腎陰虛證絕經後骨質疏鬆癥的臨床療效。方法選擇中醫辨證為肝腎陰虛證的絕經後骨質疏鬆癥患者120例，按隨機數字錶法分為 A、B、C 三組。A 組：給予六味地黃汍加味藥物製成的蜜汍，每天2粒，連續服用6箇月；B 組：給予唑來膦痠註射液5 mg 靜脈滴註；C 組：同時給予中藥蜜汍和唑來膦痠治療；三組均同時服用碳痠鈣 D3片；三組病例均觀察、隨訪12箇月，比較三組臨床療效。結果A、C 組治療後3箇月雌二醇水平與治療前比較，差異有統計學意義（t ＝2．54，P ＝0．05，t ＝2．07， P ＝0．06）。A 組治療後3箇月、6箇月 VAS 評分分彆為（3．75±1．32）分、（2．06±1．53）分，與治療前差異均有統計學意義（t ＝10．18，P ＝0．00，t ＝9．26，P ＝0．00）。A 組治療後3箇月、6箇月 SF-36評分分彆為（90．82±12．38）分、（105．82±9．06）分，與治療前比較，差異均有統計學意義（t ＝8．40，P ＝0．00，t ＝5．21，P ＝0．00）。A 組治療後6箇月腰1～4骨密度為（0．85±0．07）g／m2，與治療前[（0．76±0．07）g／m2]比較，差異有統計學意義（t ＝7．56，P ＝0．00）；A 組治療後6箇月 Wards 區骨密度與治療前比較，差異有統計學意義（t ＝8．07，P ＝0．00）。C 組治療後6箇月腰1～4骨密度為（0．91±0．07）g／m2，與 B 組[（0．88±0．05）g／m2]比較，差異有統計學意義（t ＝27．19，P ＝0．00）；C 組治療後6箇月 Wards 區骨密度為（0．62±0．04）g／m2，與 B 組比較，差異有統計學意義（t ＝26．22，P ＝0．00）。A 組治療後6箇月中醫證候積分為（5．42±2．13）分，與 B 組[（10．75±4．08）分]比較，差異有統計學意義（t ＝13．29，P ＝0．00）。結論六味地黃汍加味能提高骨密度，減輕絕經後骨質疏鬆癥患者骨痛，改善其生活質量，且無明顯不良反應，其與唑來膦痠閤用可增彊療效。
목적：관찰륙미지황환가미치료간신음허증절경후골질소송증적림상료효。방법선택중의변증위간신음허증적절경후골질소송증환자120례，안수궤수자표법분위 A、B、C 삼조。A 조：급여륙미지황환가미약물제성적밀환，매천2립，련속복용6개월；B 조：급여서래련산주사액5 mg 정맥적주；C 조：동시급여중약밀환화서래련산치료；삼조균동시복용탄산개 D3편；삼조병례균관찰、수방12개월，비교삼조림상료효。결과A、C 조치료후3개월자이순수평여치료전비교，차이유통계학의의（t ＝2．54，P ＝0．05，t ＝2．07， P ＝0．06）。A 조치료후3개월、6개월 VAS 평분분별위（3．75±1．32）분、（2．06±1．53）분，여치료전차이균유통계학의의（t ＝10．18，P ＝0．00，t ＝9．26，P ＝0．00）。A 조치료후3개월、6개월 SF-36평분분별위（90．82±12．38）분、（105．82±9．06）분，여치료전비교，차이균유통계학의의（t ＝8．40，P ＝0．00，t ＝5．21，P ＝0．00）。A 조치료후6개월요1～4골밀도위（0．85±0．07）g／m2，여치료전[（0．76±0．07）g／m2]비교，차이유통계학의의（t ＝7．56，P ＝0．00）；A 조치료후6개월 Wards 구골밀도여치료전비교，차이유통계학의의（t ＝8．07，P ＝0．00）。C 조치료후6개월요1～4골밀도위（0．91±0．07）g／m2，여 B 조[（0．88±0．05）g／m2]비교，차이유통계학의의（t ＝27．19，P ＝0．00）；C 조치료후6개월 Wards 구골밀도위（0．62±0．04）g／m2，여 B 조비교，차이유통계학의의（t ＝26．22，P ＝0．00）。A 조치료후6개월중의증후적분위（5．42±2．13）분，여 B 조[（10．75±4．08）분]비교，차이유통계학의의（t ＝13．29，P ＝0．00）。결론륙미지황환가미능제고골밀도，감경절경후골질소송증환자골통，개선기생활질량，차무명현불량반응，기여서래련산합용가증강료효。
Objective To study the clinical effects of addition treatment of liver-kidney yin deficiency and postmenopausal osteoporosis with Liuwei Dihuang pill.Methods 120 patients suffering from postmenopausal osteopo-rosis who were determined to be subject to liver -kidney Yin deficiency by doctors of traditional Chinese medicine when they received treatment at the outpatient clinic of traditional Chinese medicine department of our hospital in the period from February 2010 to june 2013 were divided into three groups:group A,B and C,with the random number table.For group A:provided the honeyed pills made up by supplemented six -ingredient rehmannia pill,and taken two pills per day continuously for six months;For group B:provided 5mg of zoledronic acid injection for intravenous drip infusion;For group C:provided traditional Chinese medicine honeyed pills and zoledronic acid for treatment at the same time;all of the three groups take Calcium carbonate D3 at the same time;The three groups of cases until the 12th month were observed and followed -up.The clinical efficacy of three groups were compared.Results A,C group 3 months after treatment with estradiol levels compared with before treatment,the difference was statistically significant (t =2.54,P =0.05,t =2.07,P =0.06).A group 3 months after treatment,the VAS scores at 6 months respectively (3.75 ±1.32),(2.06 ±1.53)points before treatment,and the differences were statistically significant(t =10.18, P =0.00,t =9.26,P =0.00).A group 3 months after treatment,the SF -36 scores at 6 months were (90.82 ± 12.38),(105.82 ±9.06)% respectively,compared with that before treatment,the differences were statistically significant(t =8.40,P =0.00,t =5.21,P =0.00).A group 6 months after treatment of lumbar 1 -4 bone density-were (0.85 ±0.07)g/m2 ,and before treatment[(0.76 ±0.07)g/m2 ]comparison,the difference was statistically significant(t =7.56,P =0.00);A group 6 months after treatment of Wards bone density compared with before treatment,the difference was statistically significant(t =8.07,P =0.00).C group 6 months after treatment of lumbar 1 -4 bone density(0.91 ±0.07)g/m2 ,and B Group[(0.88 ±0.05)g/m2 ]comparison,the difference was statistical-ly significant(t =27.19,P =0.00);C group after treatment,the bone mineral density of Wards area for 6 months were (0.62 ±0.04)g/m2 .The difference was statistically significant (t =26.22,P =0.00),compared with the B group. The TCMsyndromes of TCMin the 6 months after treatment in A group were (5.42 ±2.13),and the difference was statistically significant (t =13.29,P =0.00),compared with the B Group (10.75 ±4.08).(t =13.29,P =0.00). Compared with B group,the difference was statistically significant(t =26.22,P =0.00).A group after the treatment of TCMsyndrome score was 6 months(5.42 ±2.13),and B Group[(10.75 ±4.08)],the difference was statistically significant(t =13.29,P =0.00).Conclusion The addition of Liuwei Dihuang pill can improve BMD,alleviate the ostealgia and improve life quality of patients suffering from postmenopausal osteoporosis,and has no obvious adverse effects.It can enhance curative effects through using with diphosphonate.