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目的:探讨补肾健脾化瘀法对原发性骨质疏松症(POP)的疗效及对骨代谢指标的影响。方法:将70例2010年1月—2014年12月收治的患者随机分为对照组和治疗组,每组35例。对照组采用碳酸钙D3片口服,治疗组在对照组基础上联合口服中医补肾健脾化瘀药方(黄芪,生地,淫羊藿,鹿角胶,龟胶,补骨脂,山药,水蛭等)。3个月为1个疗程,2个疗程后观察两组患者骨痛、功能改善、骨密度、骨代谢指标及不良反应情况。结果:治疗6个月后,治疗组及对照组患者的骨痛评分、Oswestry功能障碍指数、腰椎L2-4及髋部的骨密度值较治疗前均显著减小(P<0.01,P<0.05),且治疗组患者疗效明显优于对照组,差异有统计学意义(P<0.05)。治疗组治疗后血清BALP及TRACP-5b较治疗前及对照组明显下降(P<0.05),血清CT水平较治疗前及对照组显著增高(P<0.05),血清Ca、P及BGP含量较治疗前及对照组无明显统计学差异(P>0.05),而对照组治疗前后各项骨代谢指标变化均无统计学意义(P>0.05)。治疗期间两组患者不良反应发生率无明显统计学差异(P>0.05)。结论:补肾健脾化瘀法联合碳酸钙D3能有效改善骨痛、患者功能及骨代谢,升高骨密度且不良反应少,值得临床推广。
Objective: To investigate the effect of Bushen Jianpi Huayu method on primary osteoporosis (POP) and its effect on bone metabolism. Methods: Seventy patients who were treated from January 2010 to December 2014 were randomly divided into control group and treatment group, 35 cases in each group. In the control group, calcium carbonate D3 tablets were taken orally. In the treatment group, the rats were treated with the combination of tonifying kidney and invigorating the spleen and removing blood stasis prescriptions (Astragalus, habitat, epimedium, antler gum, turtle gum, psoralen, yam, leeches) on the basis of the control group. 3 months for a course of treatment, after 2 courses of treatment were observed in two groups of patients with bone pain, functional improvement, bone mineral density, bone metabolism and adverse reactions. Results: After 6 months of treatment, the bone pain scores, Oswestry disability index, lumbar L2-4 and hip BMD of the treatment group and the control group were significantly lower than those before treatment (P <0.01, P <0.05 ), And the treatment group was significantly better than the control group, the difference was statistically significant (P <0.05). After treatment, serum BALP and TRACP-5b levels were significantly decreased (P <0.05), serum CT levels were significantly higher than before treatment and control group (P <0.05), and serum Ca, P and BGP levels were significantly lower than those before treatment There was no significant difference between the two groups before and after treatment (P> 0.05), but there was no significant difference in the indexes of bone metabolism before and after treatment in the control group (P> 0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P> 0.05). Conclusion: Bushen Jianpi Huayu method combined with calcium carbonate D3 can effectively improve bone pain, patient function and bone metabolism, increase bone density and fewer adverse reactions, which is worthy of clinical promotion.