钙三醇、依替膦酸二钠、枸橼酸钙联合应用对骨质疏松性脊椎骨折患者骨痛及骨密度的影响

背景骨质疏松性脊椎骨折是绝经后妇女和老年女性最常见的骨折类型.优选哪类药物及治疗处方对其治疗会产生最优效果和最小副作用正在研究中.目的观察钙三醇、依替膦酸二钠、枸橼酸钙联合治疗骨质疏松性脊椎骨折临床效果及副作用.设计自身对照研究.地点和对象2001-01/2003～04哈尔滨医科大学第二附属医院门诊和住院患者中诊断骨质疏松性脊椎骨折患者25例,男4例,女21例;年龄59～98岁,平均(74±10)岁,原发性骨质疏松症20例,继发性骨质疏松症5例.干预给予钙三醇0.5μg,1次/d口服,枸橼酸钙3片,3次/d口服,两药连续应用10～11周;依替膦酸二钠0.2 g,2次/d两餐之间口服,连用2周.3种药共用12～13周(3个月)为1个周期.主要观察指标①用药前后骨痛缓解情况.②骨密度值.③其他症状的改善情况.结果服药1个月临床骨痛症状开始缓解,3个月大部分患者骨痛明显缓解,半年后骨痛症状基本消失.骨密度测定,用药半年后,全部患者L2～4骨量均有升高,均值骨密度升高0.098 g/cm2,未出现新骨折,患者对药物耐量性好无明显副作用.结论钙三醇、依替膦酸二钠、枸橼酸钙联合治疗骨质疏松性骨折临床疗效好,效果肯定,无明显药物不良反应,患者耐受性、依从性好,可做为治疗骨质疏松性脊椎骨折的首选治疗处方.

Effects of combined treatment of Rocaltrol, Etidronate and Sisterly on bone pain and bone mineral density in osteoporosis patients with vertebral fracture

BACKGROUND: Osteoporotic vertebral fracture is major fracture in post-menopause women and aged women. Optimal drugs and therapies are under study. The Optimization effect and the minimum side effect are also on study.OBJECTIVE: To observe the clinical efficacy and side effects of the combined treatment of Rocaltrol, Etidronate and Sisterly for osteoporotic vertebral fracture.DESIGN: A self-controlled trial.SETTING and PARTICIPANTS: Twenty-five patients with osteoporotic vertebral fracture from the Second Affiliated Hospital of Harbin Medical University were included in the study from January 2001 to March 2003 (4 men and 21 women; mean age: (74±10), range: 59 -98), including 20 patients of primary osteoporosis, and 5 patients of secondary osteoporosis.INTERVENTIONS: Rocaltrol, 0.5μg, was orally administered once every day and Sisterly 3 tablets bid after each meal. Both drugs were applied for consecutive 10- 11 weeks. Then Etidronate was added, 0.2 g bid between two meals for consecutive two weeks. The combined therapy of these three drugs were used for 12 - 13 weeks(3 months) as a cycle. MAIN OUTCOME MEASURES: Bone pain before and after drug; bone mineral density; and other symptoms.RESULTS: Bone pain was slightly relieved one month after therapy and apparently relieved three months later. After six months of treatment, bone pain almost disappeared. Bone mineral density of L2-4 in all the patients increased by 0. 098 g/cm2(mean) and no new bone fracture was found. All patients tolerated these three medicines well and no obvious side effect was observed.CONCLUSION: The combined therapy of Rocaltrol, Etidronate and Sisterly have good effects on osteoporotic vertebral fracture without obvious side effects. Patients have good toleration and good compliance. It can be used as the first-line therapy for osteoporotic vertebral fracture.