强骨胶囊联合鲑鱼降钙素针剂辅助治疗老年骨质疏松性压缩骨折临床观察

Clinical observation of Qianggu capsules combined with salmon calcitonin injection in the treatment of osteoporotic compression fractures in the elderly

目的探讨强骨胶囊联合鲑鱼降钙素针剂辅助治疗老年骨质疏松性压缩骨折临床疗效及影响。方法 257例胸腰椎骨质疏松性骨折患者随机分为3组,观察组口服强骨胶囊同时肌肉注射鲑鱼降钙素注射液,对照I组口服强骨胶囊,对照Ⅱ组肌肉注射鲑鱼降钙素针剂。观察临床疗效,测定治疗前和治疗后骨密度(BMD),血骨钙素(BGP)、血钙、血磷浓度及碱性磷酸酶。尿液中尿钙,尿羟脯氨酸,尿肌酐的含量,并计算尿钙/尿肌酐与羟脯氨酸/尿肌酐比值。结果观察组总有效率明显优于对照I组和对照II组(P<0.05)。治疗后,3组BMD明显升高,痛觉评分均明显降低(P<0.01),尤其观察组更加明显(P<0.05)。治疗后,3组骨钙素较治疗前有明显的升高(P<0.05或0.01),碱性磷酸酶和羟脯氨酸/尿肌酐较治疗前有明显的下降(P<0.05或0.01),尤其治疗组明显优于对照I组和对照II组。治疗后对照组I组和观察组血钙较治疗前有明显的下降(P<0.05),但3组组间无差异性(P>0.05)。治疗后,3组血磷和尿钙/尿肌酐较治疗前变化不明显,组间比较无差异性(P>0.05)。结论骨胶囊和鲑鱼降钙素治疗老年骨质疏松性骨折疗效肯定,能缓解疼痛,促进愈合和降低骨折的再发生,无明显不良反应。

Objective To investigate the clinical efficacy and the influence of Qianggu injection in the treatment of osteoporotic compression fractures in the elderly. Methods capsules combined with salmon calcitonin Two hundred and fifty-seven patients with osteoporotic thoracolumbar vertebral fractures were randomly divided into 3 groups. Patients in the observation group took oral medication of Qianggu capsules, combined with an intramuscular injection of salmon calcitonin injection. Patients in control group I took oral medication of Qianggu capsules only, and patients in control group II were intramuscularly injected with salmon calcitonin injection only. The clinical efficacy was observed. Bone mineral density （ BMD ） and the serum levels of osteocalcin （ BGP）, calcium, phosphorus, and alkaline phosphatase were detected before and after the treatment. Urinary contents of calcium, hydroxyproline, and creatinine were also detected. The calcium/creatinine ratio and hydroxyproline/creatinine ratio in urine were calculated. Results The total effective rate in the observation group was significantly higher than that in the control group I and the control group II （P 〈 0. 05 ）. After the treatment, BMD in all 3 groups increased obviously, and pain scores decreased significantly （ P 〈 0.01 ）, especially in the observation group （ P 〈 0. 05 ）. Serum level of BGP in 3 groups increased significantly after the treatment compared with that before the treatment （ P 〈 0. 05 or 0. 01 ）, while the level of alkaline phosphatase and the ratio of hydroxyproline/creatinine decreased significantly （P 〈0. 05 or 0. 01 ）, especially in the observation group. After the treatment, the serum level of calcium in the control group I and observation group decreased significantly than that before the treatment （P 〈 0.05 ）, but no significant difference among 3 groups was observed （ P 〉 0.05 ）. After the treatment, no significant changes of serum phosphorus and urinary calcium/creatinine in 3 groups were observed, and no significant difference among 3 groups was observed （P 〉 0. 05）. Conclusion The efficacy of Qianggu capsules combined with salmon calcitonin in the treatment of osteoporoticfractures in the elderly is assured. It can relieve pain, promote fracture healing, reduce the recurrence of fractures, and has no obvious adverse reaction.