广东省中老年女性骨质疏松症患者骨密度、中医证型及其影响因素调查分析

目的对广东省中老年女性骨质疏松症患者骨密度、中医证型及其影响因素做横断面研究并探讨分析其关系。方法对广东省内各地(广州市、中山市、佛山市、惠州市、台山市等)医院1 453名骨质疏松症患者进行问卷调查,对所收集的资料采用SPSS统计软件进行统计分析,分析骨密度、中医证型及其影响因素(年龄、绝经年龄/年限,既往骨折史,髋部骨密度,治疗时间等)。结果最终筛选出符合标准的样本共373例,年龄介于48～95岁之间,平均年龄73.56±9.32岁,其中脾肾阳虚证130例,占34.85%,肝肾阴虚证161例,占43.16%,气滞血瘀证75例,占20.11%,其他证型7例,占1.88%。各年龄段、不同绝经年龄组间、不同绝经年限组间的患者骨密度比较差异有统计学意义(P<0.05),是否有既往骨折史和父母是否发生过髋骨骨折的骨密度比较有明显差异(P<0.05),脾肾阳虚证的患者髋部骨密度明显高于肝肾阴虚证(P<0.05),治疗时间大于6个月的患者活动度改善情况和一般情况优于治疗时间少于6个月的(P<0.05),脾肾阳虚证、肝肾阴虚证的患者接受治疗半年以上的治疗效果明显优于不超过半年的,结果具有统计学意义(P<0.05)。结论广东省中老年女性骨质疏松症各年龄段的骨密度有一定的差异性,绝经年龄、绝经年限、既往骨折史、父母髋骨骨折史与骨密度有一定相关性,不同中医证型的患者接受治疗的时间不同其效果亦有差别。

The investigation and analysis of BMD, TCM syndromes and the influential factors in middle-aged and elderly women with osteoporosis in Guangdong

Objective To investigate the relationship among bone mineral density (BMD), TCM syndromes, and the influential factors in middle-aged and elderly women with osteoporosis in Guangdong province. Methods A total of 1453 osteoporosis patients were inquired with age, menopause age, menopausal period, history of fracture, BMD of hip and lumbar vertebrae, et al. The data were analyzed using software SPSS 20.0 editions. Results A total of 373 samples were obtained, aging from 48 to 95 years old, with the average of 73.56±9.32 years old. Among those, 130 cases were with spleen and kidney yang deficiency syndrome (34.85%), 161 cases with Yin deficiency of liver and kidney syndrome (43.16%), 75 cases with Qi stagnation and blood stasis syndrome (20.11%), and 7 cases with other syndromes (1.88%). BMD was significantly different among difference age groups, menopause age groups, and menopausal period groups (P<0.05). BMD was significantly different between the patients having and having not the history of fracture, and between having and having not parental fractures (P<0.05). BMD of patient with spleen and kidney Yang deficiency syndrome was higher than that of patients with Yin deficiency of liver and kidney syndrome (P<0.05). The patients who had been treated for more than 6 months were better than those treated less than 6 months in terms of improvement of joint movement. The efficacy was better in patients with Yin deficiency of liver and kidney syndrome or spleen and kidney Yang deficiency syndrome who received treatment for more than half a year. Conclusion There is a certain difference in BMD among middle-aged and elderly women with osteoporosis in Guangdong. Age, menopause age, menopausal period, and patients with fracture history or parent history of fracture are influential factors of BMD. The efficacy is various in patients with different TCM syndrome or with different treatment time.