激素替代疗法联合阿仑膦酸钠治疗绝经后骨质疏松的临床研究

目的观察激素替代疗法(HRT)联合阿仑膦酸钠治疗绝经后骨质疏松患者的疗效。方法采用随机、对照研究。69例绝经后骨质疏松症患者,随机分为联合用药组(联合组)、雌激素替代治疗组(雌激素组)和阿仑膦酸钠治疗组(阿仑膦酸钠组),每组23例。联合组每2周服尼尔雌醇片1mg,每3个月末10d加服安宫黄体酮6mg/d,同时给予阿仑膦酸钠70mg,每周1次口服。雌激素组为安慰剂+尼尔雌醇片和安宫黄体酮,阿仑膦酸钠组为安慰剂+阿仑膦酸钠。所有受试者均加服钙尔奇D600mg/d(每片含元素钙600mg和VitD125IU)。观察各组治疗后患者腰椎骨密度、血钙、血磷等骨代谢指标的变化及疼痛症状改善情况。结果通过1年治疗,3组患者的L1～4骨密度均有显著上升,其中联合组骨密度的上升更为明显(P<0.01),骨痛症状明显缓解,总有效率为100%,联合组的显效率高于其他两组。结论HRT联合阿仑膦酸钠治疗绝经后骨质疏松症,较单独用药更能有效地改善骨痛,提高骨密度值。

Clinical effect of HRT combined with alendronate on postmenopausal osteoporosis

Objective To study the effect of HRT combined with alendronate on postmenopausal osteoporosis.Methods Sixty nine postmenopausal osteoporosis patients were randomly divided into three groups:therapeutic alliance group,HRT group,alendronate group.Patients in therapeutic alliance group received 1 mg nilestriol once two weeks,and Amen 6mg/d for 10 days at the end of every three months,at the same time patients were given 70 mg alendronate once a week.Patients in HRT group received dummy,nilestriol and Amen.Patients in alendronate group received dummy and alendronate.Each patient of the three groups received 600 mg calcium supplement once a day for one years.The efficacy was assessed by determining the subsequent changes in bone mass density(BMD) of lumbar spine,blood calcium,ALP,blood phosphorus and pain.Results After a year of repeated therapy circle,bone pain of patients in therapeutic alliance group was more obviously relieved than those of other groups,and BMD improved more obviously (P<0.01).Conclusion HRT combined with alendronate for treatment of postmenopausal osteoporosis can obviously relieve bone pain and elevate BMD.