联合应用阿仑膦酸钠及替勃龙对围绝经期及绝经后妇女骨质疏松症的疗效观察

目的评价联合应用阿仑膦酸钠及替勃龙对围绝经期及绝经后妇女骨质疏松症的影响。方法征集2008年7月~2010年12月妇科更年期门诊骨量减少或骨质疏松症的围绝经期及绝经后患者77例,随机分为两组,实验组:口服阿仑磷酸钠70mg每周1次+替勃龙2.5mg每日1次+复方氨基酸鳌合钙1000mg每日1次;对照组:口服复方氨基酸鳌合钙1000mg每日1次。两组均连续服药48周。治疗前、后采用双能X线吸收法测定腰锥1-4节(L1-L4)、股骨颈、大粗隆及Ward′s三角区骨密度(BMD);同时抽血清检测FSH及E2水平。结果两组在治疗48周后临床疼痛等症状均明显改善与好转,有效率分别为89.19%和63.64%,有显著差异(P<0.05);试验组股骨颈、大粗隆、Ward′s三角区及平均骨密度均较治疗前显著提高(P<0.05),两者增幅为0.81%、1.05%、1.64%和0.89%;试验组能有效降低FSH和升高E2水平,与治疗前相比,差异均有显著性(P<0.05);治疗后两组相比,两者改变率差异均有显著性(P<0.05)。结论联合应用阿仑膦酸钠及替勃龙在治疗围绝经期及绝经后妇女骨质疏松症效果良好。

The curative effect of Combining application of Alendronate and Tibolone on perimenopausal and postmenopausal women with osteoporosis

OBJECTIVE To evaluate the effects of combination of Alendronate and Tibolone treating osteoporosis for perimenopause or menopause.METHODS 77 women who were perimenopause or menopause with low bone mineral density or osteoporosis were applied from 2008.7 to 2010.12 for 48 weeks.They were divided into 2 groups randomly：experimental group：taking bisphosphonates 70mg/w ＋ tibolone 1.25mg/qd＋Osteoform 1000mg·d-1 oral;control group：taking the Osteoform 1000mg·d-1 oraly.BMD on lumbar 1～4、femoral neck、greater trochanter、Ward′s triangle and average BMD as well as FSH、E2 was measured before and after treatment.RESULTS Two groups were good for improving the pain significantly,the ratio of efficiency was 89.19% and 63.64%.There was significant difference between two groups（P〈0.05）.Changes of BDM of femoral neck（0.81%）、greater trochanter（1.05%）、Ward′s triangle（1.64%）and average BMD（0.89%） respectively in experimental group,the difference between before and after treatment was statistically distinct（P〈0.05）.There was significant difference comparison of therapeutic effects after treatment between two groups.The change of FSH、E2 respectively,both of them the difference between before and after treatment was statistically dinstinct（P〈0.05）.There was significant difference comparison of therapeutic effects after treatment both of them.CONCLUSION The combination of Alendronate and Tibolone was effective in treating osteoporosis for perimenopause or menopsuse.