利维爱治疗绝经后骨质疏松症

本文报告了应用利维爱治疗绝经后骨质疏松症（ＰＭＯ）８６例，年龄５０～８１岁，平均６５±０．０３岁。绝经时间为５～２３年，平均１４年。应用利维爱２．５ｍｇ，隔日一次，口服，３个月为一个疗程。自觉症状改善者（有效率）为９１．８％，治疗前后分别用ＬｕｎａｒＤＰＸ－Ｌ型双能Ｘ线骨密度仪检测Ｌ２～４的骨密度（ＢＭＤ），治疗后５０～６９岁组明显提高（ｐ＜０．０１），７０～８１岁组ＢＭＤ无明显提高（ｐ＞０．０５）。治疗后没有一例出现再来月经者。本治疗结果表明利维爱是治疗绝经后骨质疏松症的较好的性激素类药物。     

应用鲑鱼降钙素及物理疗法联合治疗原发性骨质疏松症

目的观察鲑鱼降钙素（Calcitonin，CT）和低频脉冲电磁场（low frequency transduction pulsedelectromagnetic fields）治疗联合作用在治疗原发性骨质疏松症（primary osteoporosis）中的效果，比较联合作用与单纯应用药物所产生的效果的异同。方法将存在骨质疏松性骨痛同时经DEXA骨密度仪（BMD machines）检测T值低于标准值2．0以下的老龄原发性骨质疏松症患者76人随机分为两组：①单纯应用鲑鱼降钙素组（36人）；②联合应用药物及低频电磁场组（36人），两组同时每日给予钙而奇D600片1粒，CT按每日肌肉注射50IU，10d后改为隔日肌注50IU连续应用2个月，低频电磁场治疗采用天津金希统公司生产的XT2000B型OP治疗仪，频率为20～40Hz，每天治疗20min，共治疗30d，6个月后复查骨密度。结果两组均取得较好的镇痛效果（分别为84％和97％），同时骨密度均有所增加。结论联合治疗能够更进一步增加腰椎骨密度，在镇痛方面也能取得更好的效果。     

降钙素对骨质疏松症治疗的临床观察

目的 研究降钙素在骨质疏松症（OP）治疗中对骨密度（BMD）的作用。方法 198例根据自愿选择分为钙剂组92例，降钙素＋钙剂组102例，其中各组按疗程分为3个月和6个月两个亚组；钙剂组：每日口服元素钙600mg，维生素D125U。降钙素＋钙剂组：每日口服元素钙600mg，维生素D125U；鲑降钙素50IU（商品名密钙息，北京诺华制药有限公司），肌肉注射，每d1次，连续14d，接着隔日1次，连续14次，以后为每周2次直至完成疗程。治疗前及疗程结束后，采用双能X线骨密度仪测定前后位k。腰椎及非优势侧（左）股骨颈骨密度。结果 降钙素＋钙剂组缓解疼痛快而有效。降钙素＋钙剂组腰椎和股骨颈骨密度在3个月和6个月治疗后均有显著提高，6个月组骨密度提高大3个月组（P〈0．01），腰椎疗效优于股骨颈。结论 降钙素治疗骨质疏松症有明显疗效，选择适当的长疗程患者受益更大。     

依降钙素治疗老年骨质疏松症疗效分析

目的观察依降钙素治疗老年骨质疏松症的疗效。方法依降钙素组37例(男性13例,女性24例,年龄72～89岁),予依降钙素20lU肌注,每周2次,连续4周,后改为每周一次,3个月为一个疗程;对照组36例(男性13例,女性23例,年龄70～86岁),予安慰剂维生素E口服30mg/次,每日4次,共3个月。结果依降钙素组骨痛缓解有效率达92%～100%。维生素E组为17%～29%,组间差异有显著的统计学意义(P<0.01)。结论与单纯口服钙对照组治疗相比,依降钙素肌内注射可有效地缓解骨质疏松性骨痛。     

穴位注射鲑鱼降钙素治疗老年骨质疏松症的临床研究

目的探讨穴位(三阴交,足三里)注射鲑鱼降钙素治疗骨质疏松症的临床效果。方法对我院2003年6月～2009年7月治疗老年骨质疏松症患者79例(穴位注射鲑鱼降钙素治疗41例,常规臀大肌注射鲑鱼降钙素治疗38例)进行回顾性分析,根据治疗前及治疗两个月后以DTX-100型BMD仪测定左前臂远端1/3桡骨骨密度(g/cm2)值及临床症状进行评估。结果穴位注射鲑鱼降钙素治疗的总有效率95.1%,臀大肌注射鲑鱼降钙素治疗的总有效率78.9%。结论穴位注射鲑鱼降钙素是治疗老年骨质疏松症的一种、安全实用、简便的方法,值得临床推广。     

鲑鱼降钙素治疗老年骨质疏松症的临床研究

目的观察鲑鱼降钙素注射液在治疗老年骨质疏松症中的疗效。方法102例骨质疏松症患者随机分成两组：研究组和对照组,研究组采用鲑鱼降钙素联合钙剂治疗,对照组单纯使用钙剂治疗。结果研究组患者经过治疗后骨密度增加显著（P〈0.01）;疼痛缓解率达82%;生活能力明显提高,均与对照组相比有显著差异（P〈0.01）。结论鲑鱼降钙素在治疗老年骨质疏松症中疗效良好。     

强筋健骨胶囊联合鲑鱼降钙素治疗绝经后骨质疏松症短期疗效临床研究

目的探索强筋健骨胶囊联合鲑鱼降钙素治疗绝经后骨质疏松症短期疗效。方法 150例绝经后骨质疏松症患者随机分为治疗组(n=75)和对照组(n=75)。对照组给予鲑鱼降钙素治疗,治疗组给予强筋健骨胶囊联合鲑鱼降钙素治疗,为期3个月。检测治疗后两组患者数字疼痛评分(numerical rating scale,NRS)、视觉模拟疼痛评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)和JOA下腰功能评分(Japanese Orthopaedic Association Scores, JOA)改变,血清I型前胶原N端前肽(PINP)和血清I型胶原羧基末端肽(β-CTX)的水平改变;同时记录治疗有效率和药物不良反应。结果治疗前,两组骨代谢指标和NRS、VAS、ODI、JOA评分比较不具有统计学意义(P0.05)。治疗3个月后,两组NRS、VAS、ODI、JOA评分都有不同程度的改善,其中治疗组的上述评分改善更明显,和对照组比较有明显的统计学意义(P0.05);同时各组血清PINP和β-CTX水平均降低,而治疗组改变更明显,两组比较有明显的统计学意义(P0.05)。治疗组治疗有效率显著高于对照组,而药物不良反应比较无统计学意义(P0.05)。结论强筋健骨胶囊联合鲑鱼降钙素治疗绝经后骨质疏松症短期疗效显著。     

古溪针刀辅助鲑降钙素治疗老年骨质疏松症的临床疗效分析

目的分析古溪针刀辅助鲑降钙素治疗老年骨质疏松症的临床疗效。方法将我院收治的66例老年骨质疏松症患者随机分为观察组33例,对照33例。观察组患者行古溪针刀辅助鲑降钙素联合钙剂治疗,对照组患者行鲑降钙素联合钙剂治疗。两组患者及治疗6个月、12个月后均测量骨密度、评价疼痛控制情况、生活能力改善情况等。结果对照组疼痛、日常生活能力、腰椎及左髋关节骨密度均在治疗后6、12个月有所改善,但与观察组对比发现,观察组治疗后6个月疼痛得到明显缓解(P0.05),日常生活能力、腰椎及左髋关节骨密度得到明显提高(P0.05),且在治疗12个月后日常生活能力、腰椎及左髋关节骨密度仍在不断改善(P0.05)。结论古溪针刀辅助鲑降钙素治疗的临床疗效显著,能快速缓解老年骨质疏松症患者疼痛,并有效提高其骨密度和日常生活能力,控制骨量的的减少,避免发生病理性骨折。     

鲑鱼降钙素联合低频脉冲电磁场治疗绝经后妇女骨质疏松症的临床观察

目的 通过对鲑鱼降钙素联合低频脉冲电磁场(pulsed electromagnetic fields,PEMFs)治疗绝经后骨质疏松症患者疗效的观察及分析,为绝经后骨质疏松症寻找到安全可靠,更具有良好疗效的治疗方案。方法 选择90个病例,随机分为3组：A组为试验组：联合应用鲑鱼降钙素及低频电磁场组(30人);B组为对照组1：单纯应用低频电磁场组(30人);C组为对照组2：单纯应用鲑鱼降钙素组(30人),每组同时每日给予一定剂量的钙剂及维生素D;A、C组肌注鲑鱼降钙素（CT）50 U,1次/d,连续1w,然后隔天1次,连续1w,最后每周2次至疗程结束;A 、B组均采用天津市同业科技发展有限公司生产的TY-PEMF-B型OP治疗仪实施低频电磁场治疗,频率8~16Hz,每次治疗40 min,共治疗30 次; 治疗前及治疗后第2、4、8周分别测定患者视觉模拟痛疼评分(VAS),并对3组患者进行治疗前及治疗后3、6个月腰椎及股骨颈BMD的测量。结果 鲑降钙素联合骨质疏松治疗仪与单纯使用降钙素治疗或骨质疏松治疗仪治疗相比骨密度显著提高,试验组与对照组对比P<0.05。结论 鲑降钙素联合骨质疏松治疗仪治疗绝经后妇女骨质疏松症疗是一种安全、疗效更好的方法。     

Nandrolone decanoate and intranasal calcitonin as therapy in established osteoporosis

This study used a randomized, 2 × 2 factorial design to evaluate over 2 years the effect of intranasal salmon calcitonin and intramuscular nandrolone decanoate on bone mass in elderly women with established osteoporosis. The study was double masked in relation to calcitonin and open in relation to nandrolone decanoate. One hundred and twenty-three women aged 60–88 years who had sustained a previous osteoporotic fracture, or had osteopenia, were recruited through an outpatient clinic. Women were assigned to one of four groups: (1) daily placebo nasal spray, (2) 400 IU intranasal calcitonin daily, (3) 20 intramuscular injections of 50 mg nandrolone decanoate (given as two courses of 10 injections) plus placebo nasal spray, or (4) 20 injections of 50 mg nandrolone decanoate plus 400 IU intranasal calcitonin daily. All subjects received 1000 mg calcium supplementation daily. Outcomes measured included changes in bone mineral density (BMD) at the lumbar spine, as measured by dual-energy quantitative computed tomography (DEQCT), in BMD of the proximal femur, and BMD and bone mineral content (BMC) of the lumbar spine and forearm, as measured by dual-energy X-ray absorptiometry (DXA). Significant positive changes from baseline in DXA BMC at the lumbar spine were observed over 2 years in the calcitonin group (5.0±1.9%, mean ± SE) and in the nandrolone deconate group (4.7±1.9%) but not in the placebo group (1.1±2.2%) or the combined therapy group (0.7±1.8%). Modelling based on the 2×2 factorial design revealed that nandrolone decanoate was associated with a 3.8±1.8% (p<0.05) gain in DXA BMD at the proximal femur. Modelling also revealed that calcitonin treatment was associated with a loss of 11.5±4.7% in DEQCT BMD at the lumbar spine and a loss of 3.7±1.8% in DXA BMD at the proximal femur (p<0.05). There was in vivo antagonism between the two medications of 7.9±3.9% for DXA BMC at the lumbar spine. Both agents caused positive changes from baseline in lumbar spine BMC. Nandrolone decanoate had beneficial effects on BMD at the proximal femur. This dose of intranasal calcitonin was associated with deleterious effects on trabecular BMD at the lumbar spine and total BMD at the proximal femur. There may be significant clinical antagonism between these two medications.     

Raloxifene对去卵巢大鼠子宫内膜的影响

目的 比较EVISTA（Raloxifene）和Livial用于治疗去卵巢大鼠骨质疏松时对子宫内膜的影响。方法 32只4月龄雌性SD大鼠随机分为4组：假手术组、模型组、Raloxifene组及Livial组,每组8只,用药实验60d,处死大鼠取子宫,对大鼠子宫内膜进行形态学检查。结果 模型组、Raloxifene组和Livial组大鼠子宫内膜腺体数目均比假手术组少,P＜0．01;Raloxifene组与模型组子宫内膜形态相似：子宫内膜腺体缩小,内膜上皮较薄;Livial组子宫内膜上皮有增宽趋势,少数可见轻至中度鳞状上皮化生和不典型增生。结论 在治疗去卵巢大鼠骨质疏松的过程中,Raloxifene对子宫内膜无明显作用,Livial对大鼠可能有促进子宫内膜上皮生长趋势和不典型增生,提示临床应用中需注意定期妇科检查。     

降钙素对雄性去势大鼠骨丢失的预防作用

雄激素减少是老年男性原发性骨质疏松症形成的重要原因之一。本研究以雄性大鼠去势造成骨质疏松症动物模型，观察雄激素对骨质丢失的影响，并观察降钙素对骨质疏松症的预防作用。结果显示雄性大鼠去势后骨量显著降低。骨钙素及２４小时尿羟脯氨酸显著升高，提示为高转化型骨质疏松症。形态计量学显示会势后大鼠骨量减少主要表现为小梁骨厚度的减少，小梁连续性尚可，尚未出现断裂及穿孔。降钙素可抑制骨吸收，增加骨量，改善骨结构的异常，可预防去势大鼠骨质的丢失。     

Mechanical properties,bone mineral content,and bone composition (collagen,osteocalcin, IGF-I) of the rat femur: Influence of ovariectomy and nandrolone decanoate (anabolic steroid) treatment

Summary Nandrolone decanoate (ND) is an anabolic steroid with a positive effect on bone mass in osteoporotic patients. The mechanism of action, (i.e., reduction of bone resorption and/or Stimulation of bone formation), the ultimate effect on mechanical properties, and the most effective dosage are not yet clear. To address these issues, dose-related effects of the long-term effect of ND on Serum and bone biochemistry, bone mineral content, and bone mechanical properties in ovariectomized (OVX) rats (12 weeks old at the Start of the experiment) were Studied for 6 months. The results were compared with those obtained in agematched, intact, and OVX rats. OVX caused in the femur a significant increase in net periosteal bone formation and net endosteal bone resorption of bone collagen content and torsional strength, and of Serum alkaline phosphatase, osteocalcin, and insulin-like growth factor-I (IGF-I) levels, whereas cortical bone density and calcium/creatinine and phosphorus/creatinine in 24-hour urine were Significantly reduced.Treatment of OVX rats with 1 mg ND/14 days resulted in a Significant increase in periosteal bone formation, femur length, cortical and trabecular bone mineral content and density, torsion stiffness and Strength, and bone IGF-I content, and a decrease in Serum osteocalcin, urinary calcium/creatinine levels, and bone collagen content compared with OVX controls. The higher ND dosage of 2.5 mg/14 days did not improve the results. ND treatment did not reverse all changes induced by OVX to the level of the intact controls.These results indicate that ND acts as an antiresorptive drug and as a bone formation Stimulating drug. Furthermore, the increased bone mass and bone mineral density is associated with improved bone Strength and stiffness and the presence of an increased amount of IGF-I. IGF-I is a growth factor considered to play a role in the maintenance of normal skeletal balance by a paracrine or autocrine mechanism.     

二仙汤对去卵巢大鼠骨质疏松的影响

目的探讨二仙汤防治去卵巢大鼠骨质疏松的作用及其初步机制。方法实验SD大鼠分为假手术组、模型对照组、尼尔雌醇组和二仙汤高、中、低剂量组等6组,除假手术组施行假手术外,其余均行手术彻底摘除卵巢,术后连续10d以阴道涂片检测动情周期筛选动物,然后依照假手术组、模型对照组灌胃生理盐水,尼尔雌醇组灌胃尼尔雌醇(1.2 mg/(kg.w)),二仙汤高、中、低剂量组分别灌胃淫羊藿提取液(剂量依次为含生药12、8、4 g/kg),连续给药90 d,考察骨密度、骨生物力学,以及血清碱性磷酸酶(ALP)、抗酒石酸酸性磷酸酶(ACP)、超氧化物歧化酶(SOD)、丙二醛(MDA)的变化。结果与模型对照组相比,二仙汤能明显提高去卵巢大鼠骨密度(P0.01)、股骨三点弯曲最大弯应力(P0.01)和L5腰椎压缩载荷力(P0.01),提高血清ALP和SOD活性(P0.01),降低血清ACP和MDA的含量(P0.01)。结论二仙汤能明显改善去卵巢大鼠骨质疏松症,促进成骨细胞增殖分化、抑制破骨细胞功能,抗氧化应激可能是其机制之一。     

Combined treatment with calcitonin and 1,25-dihydroxyvitamin D3 for osteoporosis in women

Summary Twenty-two middle-aged women with severe osteoporosis were treated for 2 years with either 0.5 mg of synthetic human calcitonin subcutaneously three times per week combined with 0.5 g of calcitriol and 0.5 g of calcium per day orally or calcium only. The treatment with calcitonin plus calcitriol (12 patients) resulted in a significantly increased calcium absorption rate. The mean values for serum phosphate did not change during the treatment period and the mean values did not differ between the treatment groups, but the serum calcium and urinary Ca/Cr ratio increased somewhat in the group given the combined treatment. There was no evidence that the combined treatment improved the bone density in this study. It is possible that calcitriol, instead of increasing the effect of calcitonin by suppression of the parathyroid, might have counteracted its effect by increasing the bone resorption.     

Calcitonin versus etidronate for the treatment of postmenopausal osteoporosis: A meta-analysis of published clinical trials

This review examines the evidence on the efficacy of calcitonin and etidronate in the prevention of osteoporosis and osteoporotic fractures. MEDLINE was searched for clinical trials on calcitonin or etidronate and reviews of the treatment of postmenopausal osteoporosis. The reference sections of the papers retrieved were again searched for trials on the treatments of interest. Two people independently collected data from the trials that met the inclusion criteria of the study. Weighted means in the change in bone mineral density (BMD) and differences in vertebral fracture rates were computed for calcitonin and etidronate separately. The existence of publication bias was investigated by funnel plots of effect size against sample size. Eighteen clinical trials and calcitonin and six with etidronate were included in the meta-analysis. The pooled change in vertebral BMD at the end of the studies was 1.97 (95% CI 1.77 to 2.17) with calcitonin and 3.20 (95% CI 2.92 to 3.48) with etidronate. Pooled change in proximal femur BMD was 0.32 (95% CI –0.27 to 0.91) with calcitonin and 2.42 (95% CI 2.16 to 2.68) with etidronate. The aggregated number of vertebral fractures prevented by the treatment was 59.2 per 1000 patient-years (95% CI 55.1 to 63.3) for calcitonin and 28.3 (95% CI 26.2 to 30.4) for etidronate. With the available evidence we cannot establish the superiority of either of the two drugs for the treatment of postmenopausal osteoporosis. The clinical trials are particularly lacking in data on hip fracture, the most important consequence of osteoporosis. In this situation consideration of the relative costs of the drugs is prominent.     

补肾中药对骨质疏松大鼠性激素影响的实验研究

目的　探讨补肾中药骨康对去势所造成骨质疏松大鼠性激素及骨密度的影响及性激素水平在骨质疏松发病中的作用。方法　通过切除大鼠睾丸和卵巢造成骨质疏松模型,观察中药骨康不同剂量对骨质疏松大鼠血睾酮（Ｔ）、血清雌二醇（Ｅ２）、ＢＭＤ 和ＢＭＣ的影响,并与特乐定、尼尔雌醇作阳性对照。结果　中药骨康高、中剂量防治的去势大鼠Ｔ 含量高于模型组（Ｐ＜ ０．０５ 和０．０１）,高、中、低剂量组的Ｅ２、全身及左、右股骨ＢＭＤ、ＢＭＣ高于模型组（Ｐ＜ ０．０５）。结论　骨康能提高去势大鼠血性激素含量、骨的骨矿含量及骨密度,其提高骨矿含量及骨密度的作用可能与其提高性激素水平有关。     

维生素K3对去卵巢大鼠骨质疏松预防作用的实验研究

绝经后骨质疏松的防治以药物为主要手段．近年来一些实验初步表明，维生素K可通过促进骨矿化和抑制骨吸收等作用减少绝经后骨量丢失．且无明显副作用。本实验进一步探讨维生素K3对击卵巢大鼠骨质疏松的预防作用，并将其效果与尼尔雌醇(CEE8)进行比较。结果显示，维生素K3组椎体和股骨端骨密度显著高于()VX组(P＜0．001)．光镜下骨小粱较0VX组增宽、致密，透射电镜下维生素K2组骨细胞呈功能活跃状态．胶原纤维排列较()VX组致密，分布亦均匀。CEE3组各项结果优于维生素K3组，VTK3 CEE3组优于单一用药组。以上结果表明．维生素K。可在一定程度上预防去卵巢大鼠骨质疏松，效果逊于尼尔雌醇，二者联合用药效果优于单用药。     

去势雌性大鼠骨质疏松症的药物干预疗效的评价

目的：评价阿仑膦酸钠、埃本膦酸钠和泰舒对去势雌性大鼠骨质疏松症的治疗效果。方法：手术切除雌性大鼠卵巢制成骨质疏松模型，随机分为4组，即阿仑膦酸钠组、埃本膦酸钠组、泰舒组和对照组，分别给予相应干预药物持续处理6个月。治疗模型给药前、给药后2个月和6个月，分别测定全身骨密度。治疗结束后，进行股骨干重、灰重、骨矿含量、骨生物力学 和骨组织形态计量学测定。结果：阿仑膦酸盐和埃本膦 钠组治疗后6个月后全身骨密度有明显升高，分别增高6．49％和7％；而泰舒组仅上升1．7％，对照组几无变化。埃本膦酸盐治疗后大鼠全身、腰椎骨密度及股骨干重、灰重、最大抗弯曲载荷和骨小梁面积均较其他组高。结论；埃本膦酸钠是比阿仑膦酸钠更有效的一种骨质疏松症治疗药物。