强骨膏方改善绝经后骨量减少患者生活质量的临床疗效评价

目的 评价强骨膏方对绝经后骨量减少患者生活质量的影响。 方法 纳入2015年10月—2016年12月在浙江中医药大学附属第二医院骨伤科就诊的120例绝经后骨量减少妇女为研究对象，平均年龄(57.67±2.86)岁，按随机数表法分为强骨膏方组(60例)和阿仑膦酸钠组(60例)，均干预1年。采用电化学发光免疫分析技术测量血清Ⅰ型原胶原氨基端肽(PINP)及Ⅰ型胶原羧基端肽交联(β-CTX)等骨转换指标水平。用双能X线骨吸收仪测量腰椎、髋部骨密度。采用SF-36量表(中文版)分别于治疗前、治疗1年后对患者生活质量改善情况进行评估，评分量表由36个详细条目组成。 结果 共108例患者完成研究，强骨膏方组56例，阿仑膦酸钠组52例。治疗1年后，2组组内患者血清PINP、β-CTX水平均较治疗前显著降低，且治疗后组间血清PINP、β-CTX水平及其平均百分比变化差异均有统计学意义(均P<0.001)；2组组内治疗前后患者髋部、腰椎骨密度值比较，差异均无统计学意义(均P>0.05)，但2组治疗后组间腰椎(P<0.001)、髋部(P=0.022)骨密度平均百分比变化差异均有统计学意义,且强骨膏方组优于阿仑膦酸钠组。治疗前，强骨膏方组和阿仑膦酸钠组患者的SF-36评分分别为(112.38±2.13)分、(111.79±2.06)分，2组间差异无统计学意义(P=0.147)；2组组内治疗前后比较，差异均有统计学意义(均P<0.001)，2组于治疗1年后组间比较，差异有统计学意义(P<0.001)，且强骨膏方组生活质量评分明显高于阿仑膦酸钠组。 结论 采用强骨膏方治疗不仅能够显著降低绝经后骨量减少妇女血清骨转换水平改善腰椎、髋部骨密度，并能显著提高患者生活质量。 

Effect of Qianggu Paste on improving the quality of life of postmenopausal patients with osteopenia

Objective To evaluate the effect of Qianggu Paste (QGP) on the quality of life of postmenopausal patients with osteopenia. Methods A total of 120 women with a mean age (57.67±2.86) years treated in the 2st affiliated hospital of zhejiang chinese medica university were enrolled in this study from October 2015 to December 2016. They were randomly divided into the QGP group (60 cases) and the alendronate (ALN) group (60 cases) and received treatment for 1 year. The BTMs such as PINP and β-CTX were measured. Lumbar and hip bone mineral density (BMD) were measured. The SF-36 was used to evaluate the improvement of patients' quality of life before treatment and after 1 year of treatment. The SF-36 consists of 36 detailed entries. Results A total of 108 patients completed the study, 56 in the QGP group and 52 in the ALN group. After 1 year of treatment, the serum levels of BTMs in the two groups were significantly lower than those before treatment, and there were significant differences in serum PINP, β-CTX levels and their mean percentages between the two groups after treatment (both P<0.001). There was no significant difference in hip and lumbar BMD before and after treatment and between the two groups (P>0.05), but between the two groups, the mean percentage change of lumbar BMD (P<0.001) and hip BMD (P=0.022) were statistically significant, and the QGP group was better than the ALN group; before the assessment of the quality of life, the SF-36 scores of the QGP group and the ALN group were (112.38±2.13) and (111.79±2.06), respectively. There was no significant difference between the two groups (P=0.147). There were significant differences after the treatment in the two groups (P<0.001). There was a statistically significant difference between the group of the QGP group and the ALN group after 1 year of treatment (P<0.001), and the quality of life score of the QGP group was significantly higher than that of the ALN group. Conclusion The treatment with QGP group could significantly reduce the serum BTMs of women with osteopenia and also could make the BMD better and significantly improve the quality of life of patients.