中药壮骨胶囊治疗Ⅰ型原发性骨质疏松症74例临床研究

目的　探讨中药壮骨胶囊对Ⅰ型原发性骨质疏松症的疗效及其与骨代谢的关系。方法　采用益肾健脾的中药壮骨胶囊治疗７４ 例绝经后妇女原发性骨质疏松症,并与钙尔奇Ｄ 治疗的３１ 例作对照。结果　３ 个月后,其总有效率达９１ ．８９ ％ ,骨质疏松程度、血ＡＬＰ、ＣＴ、Ｅ２ 皆显著改善,且显著优于对照组（ Ｐ＜ ０．０５ ～０．０１）。无明显副反应。结论　绝经后妇女骨质疏松症主要由肾虚所致,采用中药补肾健脾治疗,疗效显著优于补钙、雌激素的替代疗法等。壮骨胶囊有调整骨代谢作用。该药安全可长期服用     

Bone mineral density in patients with ossification of the posterior longitudinal ligament in the cervical spine

Bone mineral density (BMD) has not been clearly determined in patients with ossification of the posterior longitudinal ligament (OPLL) in the cervical spine. BMD in patients with OPLL was measured in the third vertebral body in the lateral projection and in the distal part of the radius in the anteroposterior projection using dual-energy X-ray absorptiometry (DXA). Patients with OPLL had significantly higher BMD than healthy controls in both the lumbar spine and radius. Observing BMD by gender and age group, high BMD was recognized especially in female patients over 60 years of age. Significantly increased BMD was observed in patients with ankylosing spinal hyperostosis (ASH) in addition to OPLL. These findings suggest that patients with OPLL may tend to develop systemic hyperostosis, leading to the pathological ectopic ossification observed in OPLL. Received: July 7, 1998 / Accepted: March 17, 1999     

深圳市13∽15岁正常少年超声骨密度研究

目的 :了解深圳地区 13～ 15岁少年超声骨密度状况 ;建立该年龄段少年超声骨密度正常参考值。方法 :选择13～ 15岁深圳居住的正常少年 15 8例为检测对象 ,用定量超声骨密度仪 (QU S)测定受检者足跟部骨密度 (BMD)值 ,同时测量受检者体重、身高。结果 :13～ 15岁少年 BMD值 (g/ cm2 )分别为 13岁 :男性 0 .5 2 8± 0 .0 86、女性 0 .5 4 2± 0 .117,14岁 :男性 0 .4 87± 0 .0 79、女性 0 .5 0 8± 0 .10 8,15岁 :男性 0 .5 0 1± 0 .2 2 5、女性 0 .6 0 9± 0 .2 34。身高增长速度的快与慢和BMD变化有密切关系 ,体重与 BMD呈正相关 (r=0 .82 0 ,P<0 .0 1)。 13～ 15岁女孩 BMD值高于男孩 BMD值 ;女性有月经初潮者 BMD值高于无月经初潮者。二者之间比较 ,差异均有显著性 (r=0 .978,P<0 .0 0 1;r=0 .989,P<0 .0 0 1)。结论 :13～ 15岁少年足跟部 BMD与性别有关、与身高增长快慢亦有关系 ,体重、雌激素对 BMD有明显的影响 ,在此时期应加强改善营养 ,增加补钙等干预措施。     

用于骨质疏松诊断的高速采集系统硬件设计

根据定量超声波检测原理,阐述了一种针对超声波发射信号和回波信号的高速采集系统.来自超声探头的信号通过前端的调理电路,在采样控制电路作用下,接受采样.所采数据在由CPLD芯片所设计的控制电路控制下,通过FI-FO缓存以及带USB2.0接口的单片机芯片,被传输至计算机.根据相关公式,只需计算出超声波发射信号和回波信号的时间差,即可获得定量超声波在受试者胫骨的皮质骨中传播速度.与定量超声波在正常胫骨中的传播速度相比较,可以为骨质疏松症提供便捷的诊断手段.     

强直性脊柱炎并骨质疏松97例临床观察

研究强直性脊柱炎(AS)骨质疏松和骨量减少的发生情况、相关因素及与骨代谢指标的关系.选97例AS患者作为观察组,分别检测其血沉(ESR)、C-反应蛋白(CBP)、HLA-B27、血钙(Ca)、血磷(P)、碱性磷酸酶(ALP),并进行全身疼痛评分、中医症状积分评定和晨僵时间、BATH功能指数(BASFI)、病情活动指数(BASDI)、颌柄距、指地距、枕墙距、Schober试验、胸阔活动度、脊柱活动度;用双能X线法(DEXA)测定腰椎、股骨颈、股骨转子部、Ward's三角区骨密度(BMD),检测骨钙素(BGP)、降钙素(H-CT)、甲状旁腺激素(PTH);42例检测了尿脱氧吡啶啉(D-Pyr).选102名健康人作为对照组,分别测定其腰椎、股骨颈、股骨转子部、Ward's三角区骨密度(BMD),31例检测了BGP、PTH、D-Pyr、Ca、P、ALP.结果AS患者发生骨质疏松者42例(42.27%),骨量减少者36例(37.11%);AS患者BGP较对照组显著降低,并与腰椎、股骨近端BMD呈正相关.PTH、尿D-Pyr较对照组显著增高,并与股骨近端BMD呈负相关.AS患者中急时相反应物ESR与腰椎、股骨近端BMD呈显著负相关,CBP与AS患者腰椎、股骨颈、三角BMD呈显著负相关,ESR、CRP与尿D-Pyr呈显著的正相关.腰椎BMD与全身疼痛评分、中轴关节压痛指数呈负相关性,股骨近端BMD与指地距、BASFI、BASDAI呈显著负相关,与Schober试验、脊柱活动度呈显著正相关.AS患者的腰椎BMD与HLA-B27显示了负相关性.表明骨质疏松或骨量减少在AS中普遍存在,其发生与遗传、废用、免疫炎症等因素相关.AS患者骨代谢的失衡以骨生成的减少、骨吸收的增加为特点;PTH的增高及免疫炎性反应与AS患者骨吸收的增加有关.     

A prospective analysis of concentration of 25-OHD between northern and southern district in Japan in year-round study

Although osteoporotic patients have already been recognized as having a low-volume vitamin D status, the concentration of active vitamin D precursor has not been studied in detail. This trial aimed to clarify the concentration of 25-hydroxyvitamin D (25-OHD), which is a natural type of vitamin D and compare between 2 separate areas in Japan. To compare and clarify the concentration of 25-OHD between 2 separate areas, Japanese patients who were diagnosed as having osteoporosis based on bone mineral density were studied. We analyzed 2 different hospitals’ patients whose residence is separated into a northern district (Akita city: north latitude 39” 43’) and a southern district (Shizuoka city: north latitude 34” 58’). Both of them have completely different daylight hours. Three-hundred sixty eight patients (174 in Akita, 194 in Shizuoka) were enrolled in this trial to compare the differences of concentration of 25-OHD by Welch’s t t-test. There were significant differences in the concentration of 25-OHD and age between them. Akita patients were significantly higher than that of Shizuoka patients despite Shizuoka having much daylight hours of Akita. In conclusion, there might be no relationship between the concentration of 25 OHD and exposure to sunlight.     

材料和孔隙率对可降解支架内骨形成的影响

目的 研究可降解支架植入人体后的骨修复,不同材料和孔隙率对支架内骨形成的影响.方法 根据骨折愈合自然反应机理,运用有限元方法,结合支架几何结构,搭建以材料降解曲线和骨重建控制方程为基础的计算耦合模型.通过这一平台,选择5种材料、4种孔隙率的支架代表性体积元进行计算模拟分析,并通过骨密度和支架最大应力反映这一动态过程.结...     

红曲对去势大鼠血清激素水平、骨密度和骨生物力学影响

目的:研究红曲对去势大鼠血清激素水平、骨密度和骨生物力学影响,并探讨其作用机理.方法:取12周龄的雌性wistar大鼠40只,其中30只打开腹腔去除双侧卵巢,逐层缝合,另10只予以单纯打开腹腔不切除卵巢.将大鼠分为A组(模型组)、B组(红曲治疗组)、C组(阳性对照组)、D组(假手术组)四组,饲养12周后,分别予以生理盐水、红曲水提液、α-D3水溶液及生理盐水灌胃.灌胃12周后,活杀各组动物,以双能X线、骨密度测定仪测定骨密度.取血清用放免法测定血清中骨钙素、降钙素.通过三点弯曲试验,记录载荷--变形曲线,测定骨生物力学指标.结果:经过12周的红曲水提液灌胃治疗,明显提高了去势大鼠的血清激素水平、骨密度,并能改善去势大鼠的骨力学性能.结论:红曲可提高去势大鼠骨密度值,改善骨的生物力学性能.推测其作用可能是通过改变血清激素水平来实现的.     

六味地黄丸联合唑来膦酸治疗妇女绝经后骨质疏松的临床研究

目的探讨六味地黄丸联合唑来膦酸治疗妇女绝经后骨质疏松的临床效果。方法选取2015年6月—2017年1月广东医科大学附属医院收治的86例绝经后骨质疏松患者,随机分为对照组和治疗组,每组各43例。对照组静脉滴注唑来膦酸注射液,5 mg/次,1次/年。治疗组在此基础上口服六味地黄丸,8丸/次,3次/d。所有患者均连续治疗12个月。观察两组的临床疗效,比较两组治疗前后视觉模拟(VAS)评分、简明健康状况调查量表(SF-36)评分、腰椎1~4骨质密度(BMD)、全髋关节骨BMD、左侧股骨颈BMD、Ⅰ型原胶原氨基端前肽(PINP)、β-胶原降解产物(β-CTX)、碱性磷酸酶(ALP)、骨钙素(BGP)的变化情况。结果治疗后,对照组和治疗组的总有效率分别为79.07%、95.35%,两组比较差异有统计学意义(P0.05)。治疗后,两组VAS评分、血清PINP、β-CTX、ALP及BGP水平显著降低,SF-36评分、腰椎1~4 BMD值、全髋关节骨BMD值、左侧股骨颈BMD值显著升高,同组治疗前后比较差异有统计学意义(P0.05);治疗后,治疗组VAS评分、血清PINP、β-CTX、ALP及BGP水平低于对照组,SF-36评分、腰椎1~4 BMD值、全髋关节骨BMD值、左侧股骨颈BMD值高于对照组,两组比较差异有统计学意义(P0.05)。结论六味地黄丸联合唑来膦酸治疗妇女绝经后骨质疏松具有较好的临床疗效,可有效缓解患者疼痛症状,增加骨密度,提高生活质量,具有一定的临床推广应用价值。