温针灸对绝经后骨质疏松症患者骨密度及生化指标的影响

目的:比较温针灸与药物治疗骨质疏松症的疗效,探讨温针灸的作用机制。方法:将40例患者随机分为针灸组和药物组,各20例。针灸组穴取大杼、肝俞、肾俞、足三里、阳陵泉等,予温针灸治疗,隔日1次,治疗45次;药物组口服维丁钙片,连续3个月。观察两组治疗前后的骨密度(BMD)及雌二醇(E_2)、骨钙素(BGP)和尿钙/尿肌酐比值(Ca/Cr)的变化及临床疗效。结果:治疗后,针灸组各部位的BMD均较治疗前明显提高(P<0.05,P<0.01),药物组治疗后BMD无明显提高(P>0.05),两组治疗后比较差异有统计学意义(P<0.05)。两组治疗后E_2水平均较治疗前明显增高(P<0.01),但两组间无明显差异(P>0.05);两组治疗后BGP均较治疗前明显降低(P<0.01),且针灸组较药物组降低更明显(P<0.05);针灸组治疗后Ca/Cr比值较治疗前明显降低(P<0.05),与药物组治疗后差异有统计学意义(P<0.01)。针灸组临床控制率为35.0%,药物组为5.0%,针灸组疗效优于药物组(P<0.01)。结论:温针灸治疗骨质疏松症疗效优于口服维丁钙片,有提高激素水平、延缓骨丢失的作用,是防治绝经后骨质疏松的有效方法。

Effects of warm needle moxibustion on bone mass density and biochemical indexes of bone metabolism in patients of postmenopausal osteoporosis

Objective To compare therapeutic effects of warm needle moxibustion and medication on osteoporosis and to study the mechanism.Methods Forty cases were randomly divided into an acupuncture group and a medica- tion group,20 cases in each group.The acupuncture group was treated by warm needle moxibustion at Dazhu (BL 11),Ganshu (BL 18),Shenshu (BL 23),Zusanli (ST 36),Yanglingquan (GB 34) etc.once other day,for 3 months;and the medication group was treated by oral administration of tablet Caltrate with Vit D_2 for 3 months. The changes of bone mass density (BMD),estradiol (E_2),osteocalcin (bone growth protein,BGP),urine calcium/ creatinine (Ca/Cr) in the two groups before and after treatment and therapeutic effects were investigated.Results After treatment,BMD significantly increased (P<0.05,P<0.01) in the acupuncture group and did not signifi- cantly changed in the medication group (P>0.05) with a significant difference between the two groups (P<0.05). After treatment E_2 level significantly increased as compared with before treatment in both of groups (P<0.01);af- ter treatment BGP significantly decreased as compared with before treatment in both of groups (P<0.01);after treatment Ca/Cr significantly decreased as compared with before treatment in the acupuncture group (P<0.05);af- ter treatment,there were significant differences in BGP and Ca/Cr between the two groups (P<0.05 or P<0.01). The clinically controlled rate in the acupuncture group and in the medication group were 35.0%,5.0%,respactive- ly,the therapeutic effect of the acupuncture group being better than that of the medication group (P<0.01).Con- clusion The therapeutic effect of warm needle moxibustion on osteoporosis is better than that of oral administration of tablet Caltrate with Vit D_2 and it can increase levels of hormones and delay bone loss.It is an effective method for preventing and treating postmenopausal osteoporosis.