自拟补肾活血方配合口服钙剂与维生素D治疗老年性骨质疏松症临床研究

目的：评价自拟补肾活血方配合口服钙剂和维生素D治疗老年性骨质疏松症(osteoporosis, OP)的临床疗效。方法将符合入选标准的120例OP患者按随机数字表法分为2组各60例。全部患者均常规服用钙剂和维生素 D，补肾活血方组在此基础上加用自拟补肾活血方，依降钙素组在此基础上，每周肌肉注射20 U依降钙素。评估老年性OP患者腰背痛和骨关节痛的VAS评分，比较治疗前后腰椎及股骨颈骨密度(bone mineral density, BMD)变化，以及血清钙、磷和碱性磷酸酶浓度变化。结果治疗后，补肾活血方组腰背痛(3.30±0.38)分比(4.32±0.51)分，t＝11.148]和骨关节痛(3.15±0.22)分比(3.87±0.26)分，t＝11.880]VAS 评分明显低于依降钙素组(P＜0.01)。补肾活血方组L2～4的BMDL2(0.74±0.15)g/cm2比(0.63±0.14)g/cm2，t＝4.153；L3(0.75±0.13)g/cm2比(0.70±0.10)g/cm2，t＝2.361；L4(0.76±0.06)g/cm2比(0.71±0.10)g/cm2，t＝3.321]均较依降钙素组升高(P＜0.05)。与依降钙素组比较，补肾活血方组血清钙(2.36±0.45)mmol/L 比(2.19±0.17)mmol/L，t＝2.737]、血清磷(1.28±0.12)mmol/L 比(1.22±0.13)mmol/L，t＝2.627]升高(P＜0.05)，碱性磷酸酶(89.20±9.41)U/L比(114.00±11.80)U/L， t＝12.733]明显降低(P＜0.01)。结论自拟补肾活血方可有效改善老年性OP患者的临床症状，升高BMD含量，疗效优于肌肉注射依降钙素治疗。

Bushen-Huoxue decoction combined with oral calcium and vitamin D for senile osteoporosis

Objective To evaluate the therapeutic effect ofBushen-Huoxue decoction combined with oral calcium and vitamin D for senile osteoporosis.Methods A total of 120 patients with OP were enrolled and randomly divided into aBushen-Huoxue decoction group (60 patients) and a elcatonin group (60 patients). Routine use of calcium and vitamin D was adopted. On this basis, theBushen-Huoxue decoction group was treated byBushen-Huoxue decoction combined with oral calcium and vitamin D, while the elcatonin group was treated by intramuscular injection of elcatonin with oral calcium and vitamin D. VAS of low back pain and bone joint pain was evaluated, the changes of BMD in the lumbar spine and femoral neck was observed, serum calcium and phosphorus, ALP concentration changes were also observed.Results After the treatment, the low back pain in the Bushen-Huoxue decoction group (3.30 ± 0.38vs.4.32 ± 0.51,t=11.148), bone joint pain (3.15 ± 0.22vs.3.87 ± 0.26,t=11.880) VAS were significantly lower than those in the elcatonin group.Bushen-Huoxue decoction group L2-4is BMD (L2: 0.74 ± 0.15 g/cm2vs.0.63 ± 0.14 g/cm2,t=4.153; L3: 0.75 ± 0.13 g/cm2vs. 0.70 ± 0.10 g/cm2,t=2.361; L4: 0.76 ± 0.06 g/cm2vs.0.71 ± 0.10 g/cm2,t=3.321) were significantly higher than those in the elcatonin group(P<0.05).Bushen-Huoxue decoction group serum calcium (2.36 ± 0.45 mmol/Lvs. 2.19 ± 0.17mmol/L,t=2.737), serum phosphorus (1.28 ± 0.12 mmol/Lvs.1.22 ± 0.13 mmol/L,t=2.627) were significantly higher than those in the elcatonin group (P<0.05), ALP (89.20 ± 9.41 U/Lvs.114.00 ± 11.80 U/L, t=12.733) was significantly lower than that in the elcatonin group (P<0.01).ConclusionBushen-Huoxue decoction can effectively improve the clinical symptoms of senile osteoporosis, and elevate BMD content. Its efficiency was better than intramuscular injection of elcatonin.