针刺联合雷火灸治疗绝经后骨质疏松患者腰背痛的临床观察

目的观察在药物治疗基础上针刺联合雷火灸治疗绝经后骨质疏松症(PMOP)患者腰背痛的临床疗效及安全性。方法纳入216例肾虚血瘀型PMOP患者,随机分为对照组和观察组,每组108例。两组均口服阿仑膦酸钠片和碳酸钙D3片;对照组给予单纯针刺治疗;观察组在对照组治疗基础上予雷火灸治疗。分别于治疗前后评估患者腰背痛、腰膝酸软症状评分和疼痛视觉模拟量表(VAS)评分,并检测血清碱性磷酸酶(ALP)、雌二醇(E2)、骨钙素(BGP)和b-胶原特殊序列(b-CTX)和骨密度(BMD)水平。比较两组临床疗效和不良反应发生情况。结果观察组总有效率为89.8%,明显高于对照组的78.7%,差异具有统计学意义(P<0.05)。观察组治疗后腰背痛、腰膝酸软症状评分和VAS评分均明显低于治疗前(P<0.05),血清E2水平明显高于治疗前(P<0.05),ALP、BGP和b-CTX水平明显低于治疗前(P<0.05)。观察组治疗后的腰背痛、腰膝酸软症状评分和VAS评分均明显低于对照组(P<0.05),血清E2、ALP、BGP水平均明显高于对照组(P<0.05),b-CTX水平明显低于对照组(P<0.05)。两组均未出现严重不良反应。结论在口服药物基础上,针刺联合雷火灸治疗绝经后骨质疏松症可调节骨形成与骨吸收的平衡,缓解患者腰背痛,且安全性较好。

Clinical Observation of Acupuncture Combined with Thunder-fire Moxibustion for Back Pain in Patients with Postmenopausal Osteoporosis

Objective To observe the clinical efficacy and safety of acupuncture plus thunder-fire moxibustion in treating back pain in patients with postmenopausal osteoporosis(PMOP),based on pharmacological treatment.Method A total of 216 patients with PMOP of kidney deficiency and blood stasis type were randomized into a control group and an observation group,with 108 cases in each group.The two groups were both given oral administration of Alendronate sodium and Calcium carbonate and vitamin D3 tablets.In addition,the control group was given acupuncture and the observation group was given thunder-fire moxibustion based on the intervention given to the control group.The back pain,aching and weakness in the lower back and knee and visual analogue scale(VAS)were scored before and after treatment in the patients;the levels of serum alkaline phosphatase(ALP),estrogen(E2),bone gamma-carboxyglutamic acid(Gla)-protein(BGP)andβ-cross-laps(β-CTX)as well as bone mass density(BMD)were detected.The clinical efficacy and adverse reactions were compared between the two groups.Result The total effective rate was 89.8%in the observation group,notably higher than 78.7%in the control group,and the difference was statistically significant(P<0.05).In the observation group,the scores of back pain,aching and weakness in the lower back and knee and VAS dropped markedly after treatment(P<0.05),the serum E2 level rose significantly(P<0.05),and the levels of ALP,BGP andβ-CTX declined notably(P<0.05).After treatment,the scores of back pain,aching and weakness in the lower back and knee and VAS were significantly lower in the observation group than in the control group(P<0.05),the level of serum E2,ALP and BGP were notably higher in the observation group than in the control group(P<0.05),and the level ofβ-CTX was significantly lower in the observation group than in the control group(P<0.05).There were no serious adverse reactions in the two groups.Conclusion On the basis of oral medication,acupuncture plus thunder-fire moxibustion can regulate the balance between bone formation and bone absorption and mitigate back pain in treating PMOP with satisfactory safety rating.