补肾健骨方治疗原发性骨质疏松症50例

目的:探讨补肾健骨方加减治疗原发性骨质疏松症(POP)的疗效及对骨密度、生活质量和骨代谢生化指标作用。方法:100例POP患者随机按诊治顺序分为对照组和观察组各50例。两组均给予非药物指导和碳酸钙D3咀嚼片,0.6 g·d-1,口服。对照组服用仙灵骨葆胶囊,3粒/次,2次/d。观察组内服用补肾健骨方加减,1剂/d,常规水煎,分早晚2次服用。两组疗程均为6个月。采用双能X射线骨密度测量仪测量治疗前后股骨颈和腰椎L2-4的骨密度;检测治疗前后血清钙(Ca)、血清磷(P)、碱性磷酸酶(ALP)和骨钙素(BGP)水平;采用世界卫生组织生存质量测定量表简表(WHOQOL-BRIEF)进行治疗前后生活质量评价;治疗前、治疗后2,4,6个月对主要症状、体征进行评分;记录骨折发生情况。结果:治疗后观察组股骨颈和腰椎L2-4的骨密度略显高于对照组(P<0.01);治疗后观察组Ca和BGP略显高于对照组,ALP低于对照组(P<0.01);治疗后观察组自身生存质量、自身健康状况总的主观感觉、生理、心理、社会关系等维度评分均高于对照组(P<0.01);治疗后2,4,6月观察组主要症状体征评分略显低于对照组(P<0.01);观察组骨质疏松症总有效率为94%,优于对照组的78%(P<0.05);两组骨折发生率均较低,组间差异无统计学意义。结论:补肾健骨方加减能提高POP患者骨密度,促进骨形成,抑制骨吸收,减轻临床症状,提高生活质量。

Treatment of Bushen Jiangu Decoction on 50 Cases with Primary Osteoporosis

Objective: Curative effect of Bushen Jiangu decoction on primary osteoporosis (POP) and influence on bone mineral density, patients' qualities of lives and biochemical index of bone metabolism were investigated. Method: One hundred patients with POP were randomly divided into control group and observation group (50 cases) according to the order of diagnosis. Patients in both groups received non-drug guidance and oral administration of calcium carbonate-D3 chewable tablets, 0.6 g per day. Patients in control group took Xianling Gubao capsules orally, 3 grains each time, twice a day. Patients in observation group received modified Bushen Jiangu decoction, 1 dose a day,and took twice daily. Course of treatment in two groups were both for 6 months. Bone mineral density of neck of femur and 2^nd and 4^th lumbar vertebra (L_2-4) were measured by dual energy X ray absorption meter before and after treatment, and levels of serum calcium (Ca), serum phosphorus (P), alkaline phosphatase (ALP) and bone gla protein (BGP) were detected. Qualities of lives were evaluated by determination of the scale of World Health Organization Qualities of Life-Brief(WHOQOL-BRIEF). Main symptoms and signs were graded before treatment and at the 2nd, 4th and 6th mouth after treatment. Occurrence of fracture was recorded. Result: Bone mineral density of neck of femur and lumbar vertebra (L_2-4) in observation group were higher than those in control group (P<0.01) after treatment. Levels of Ca and BGP in observation group were higher than those in control group (P<0.01), however level of ALP was lower than that in control group. Total scores of qualities of lives, state of health, overall subjective sensation, physiology, mentality and social relations in observation group were higher than those in control group(P<0.01). Scores of main symptoms and signs in observation group were all lower than those in control group at the 2nd, 4th and 6th mouth after treatment (P<0.01). The total effective rate of treating osteoporosis in observation group was 94%, which is superior to that in control group (78%) (P<0.05). Rates of occurrence of fracture in both groups were lower, but there was no significant difference between two groups. Conclusion: Modified Bushen Jiangu decoction can improve bone mineral density of patients with POP, promote bone formation, restrain bone resorption, relieve clinical symptoms and improve qualities of lives.