补肾健脾针刺法治疗老年男性原发性骨质疏松症的临床疗效评估研究

目的初步评估单纯补肾健脾针刺法对老年男性原发性骨质疏松症的临床疗效。方法将60例首次确诊为原发性骨质疏松症的老年男性随机分为针刺组和假针刺组。针刺组选择双侧肾俞、脾俞、命门、足三里、关元穴和疼痛部位的阿是穴。假针刺组针刺点为针刺组穴位旁开2寸处。手法进针,留针30 min,每周2次,3个月为一个疗程。评估指标为治疗前后两组患者的VAS疼痛评分、中医证候改善情况及两组患者腰椎及左侧股骨颈的骨密度(bone mineral density,BMD)值。结果经过3个月的治疗,针刺组的VAS疼痛评分较治疗前显著降低(t=16.307,P<0.01),而假针刺组并没有发生大的变化(P>0.05);治疗后,两组间的VAS疼痛评分差异有统计学意义(P<0.01)。治疗后,针刺组的中医证候改善的总有效率明显高于假针刺组(χ~2=33.61,P<0.05)。治疗后,针刺组的腰椎及左侧股骨颈BMD值较治疗前有提高趋势,但这种差异并没有统计学意义(P>0.05);而假针刺组腰椎及左侧股骨颈的BMD值较治疗前并没有发生大的变化(P>0.05)。结论短疗程的单纯补肾健脾针刺法可以改善老年男性原发性骨质疏松症患者的疼痛症状和中医证候,并且这种临床症状的改善要早于骨密度的改善。

Clinical efficacy analysis of acupuncture treatment on primary osteoporosis in elderly male patients: tonifying kidney and strengthening spleen acupuncture

Objective To observe the clinical effects of short-term acupuncturing treatment to tonify kidney and strengthen spleen on primary osteoporosis in elderly male patients. Methods 60 elderly male patients with primary osteoporosis were randomly divided into true acupuncture group and sham acupuncture group, with 30 men in each group. The true acupuncture group received bilateral acupuncture at Shen shu point (BL 23), Pi shu point (BL 20), Ming men point (DU 4), Zusanli point (ST 36), Guanyuan point (RN 4) and Ashi point at the most painful point, with needles retaining time of 30 min each time, twice a week for 3 months. The acupuncture points of the sham acupuncture group is 2 inches by the side of the true acupuncture points with the same treatment course. Assessments included VAS scores, TCM syndrome grade and bone mineral density (BMD) of lumbar spine and left femoral neck in each group before and after treatment. Results After 3-month treatment, VAS scores in the true acupuncture group decreased significantly (t=16.307, P<0.01), but not in the sham acupuncture group (t=0.302, P>0.05), and there were significant differences between the two groups (t=72.58, P<0.01). TCM syndrome grade and total effective rate of the true acupuncture group were significantly superior to those of the sham acupuncture group (X2=33.61, P<0.05).There was an increasing trend, but not significant increase in the BMD of both lumbar spine and left femoral neck before and after therapy in the true acupuncture group; there were little changes in BMD in the sham acupuncture group before and after therapy. Conclusion The short-course therapy of acupuncture, to tonify kidney and strengthen spleen, in elderly male patients with primary osteoporosis may improve both pain symptom and TCM syndrome, and these improvements predate the improvement in bone density.