【摘要】：目的探討自擬益腎健脾化瘀方治療絕經(jīng)后脾腎陽虛型骨質(zhì)疏松癥的臨床療效。方法選取2016年1月-2017年1月我院收治的120例絕經(jīng)后骨質(zhì)疏松癥患者,將其按照隨機數(shù)字法隨機分為觀察組和對照組,每組60例,2組均給予碳酸鈣D3片,在此基礎(chǔ)上,對照組給予仙靈骨葆膠囊,觀察組給予自擬益腎健脾化瘀方劑,2組均治療3月。結(jié)果治療后2組腰背疼痛、腰膝酸軟、夜尿增加、畏寒肢冷、神疲倦怠及總評分均顯著下降(P0.01),但觀察組下降更為明顯(P0.01);治療后觀察組總有效率為93.33%,顯著高于對照組(80.00%,P0.01);2組腰椎L2~L4、股骨頸、股骨大轉(zhuǎn)子、Ward's三角骨密度均較治療前顯著增加(P0.01),但觀察組增加更為明顯(P0.01);2組骨特異性堿性磷酸酶(B-ALP)、抗酒石酸酸性磷酸酶(TRACP)均較治療前顯著下降(P0.01),觀察組下降更為明顯(P0.01);2組雌二醇(E2)、胰島素生長因子(IGF-1)均較治療前顯著上升(P0.01),觀察組上升更為明顯(P0.01);2組患者不良反應(yīng)發(fā)生率比較差異無統(tǒng)計學意義(P0.05)。結(jié)論采用自擬益腎健脾化瘀方可以顯著改善絕經(jīng)后脾腎陽虛型骨質(zhì)疏松癥的臨床癥狀,同時可改善患者骨代謝和骨密度,其作用機制可能與提高雌激素和IGF-1水平有關(guān)。
[Abstract]:Objective to investigate the clinical effect of Yishen Jianpi Huayu recipe in treating postmenopausal osteoporosis with deficiency of spleen and kidney yang. Methods 120 postmenopausal osteoporosis patients admitted to our hospital from January 2016 to January 2017 were randomly divided into observation group (n = 60) and control group (n = 60). The control group was treated with Xianling Gu Bao capsule, the observation group with self-made prescription of tonifying kidney and spleen and removing blood stasis, and the two groups were treated for 3 months. Results after treatment, the pain of the back of the waist, the weakness of the waist and knee, the increase of nocturnal urine, the chills of the cold limbs, the burnout of the cold limbs and the total score of the two groups were significantly decreased (P0.01), but the decrease was more obvious in the observation group (P0.01). The total effective rate of the observation group was 93.33, which was significantly higher than that of the control group (80.00g / P0.01). The bone mineral density of L2P L4, femoral neck, greater trochanter of femur and Ward's triangle in both groups were significantly higher than those before treatment (P0.01), but the increase in observation group was more obvious (P0.01). Bone specific alkaline phosphatase (B-ALP) and tartrate-resistant acid phosphatase (TRACP) were significantly decreased in both groups (P0.01), especially in the observation group (P0.01). The levels of estradiol (E2) and insulin growth factor (IGF-1) in both groups were significantly higher than those before treatment (P0.01), especially in the observation group (P0.01). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion the self-made prescription of tonifying spleen and removing blood stasis can significantly improve the clinical symptoms of osteoporosis with deficiency of spleen and kidney yang after menopause, as well as improve bone metabolism and bone mineral density. The mechanism may be related to the increase of estrogen and IGF-1 levels.
【作者單位】： 江西省婦幼保健院婦科;江西省婦幼保健院病理科;
【基金】：江西省衛(wèi)計委科技計劃課題(20165443)
【分類號】：R259

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