益肾强骨膏方联合肌力训练对老年骨质疏松症患者骨密度、下肢肌力及跌倒风险的影响

Effect of Yishen Qianggu Cream Combined with Muscle Strength Training on Bone Mineral Density, Lower Limb Muscle Strength and Fall Risk for Elderly Patients with Osteoporosis

目的:观察益肾强骨膏方联合肌力训练对老年骨质疏松症(OP)患者骨密度、下肢肌力及跌倒风险的影响。方法:将2020年6月~2021年6月我院收治的104例老年OP患者分为观察组与对照组,各52例。对照组给予常规西药治疗,观察组在对照组基础上给予益肾强骨膏方联合肌力训练治疗。比较两组临床疗效,观察两组治疗前、治疗3个月后不同部位骨密度(BMD)(股骨颈、股骨粗隆、Ward三角)水平、骨相关标志物[骨钙素(BGP)、Ⅰ型胶原C端肽(CTX-Ⅰ)、骨碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶5b(TRACP-5b)]、下肢肌力、步态与平衡[Tinetti平衡与步态评估量表、计时起走测试(TUG)]情况。结果:观察组临床有效率为98.08%,高于对照组的86.54%(P<0.05)。治疗3个月后,两组不同部位BND水平较治疗前均升高(P<0.05),观察组高于对照组,但差异无统计学意义(P>0.05)。两组BGP水平、伸屈肌力、Tinetti平衡与步态评分较治疗前升高,观察组组高于对照组(P<0.05);CTX-Ⅰ、BALP、TRACP-5b水平、TUG较治疗前降低,观察组低于对照组(P<0.05)。结论:益肾强骨膏方联合肌力训练对老年OP患者疗效显著,能有效改善骨吸收、骨转化水平,提高骨密度和下肢肌力,对行走平衡及步态稳定性有较好的增强作用,可有效避免因跌倒而发生骨质疏松性骨折。

Objective:To observe the effect of Yishen Qianggu Cream combined with muscle strength training on bone mineral density,lower limb muscle strength and fall risk for elderly patients with osteoporosis(OP).Methods:104 elderly patients with OP treated in the hospital between June 2020 and June 2021 were divided into an observation group and a controlled group,with 52 cases in each group.The controlled group was given conventional western medicine treatment,while the observation group was treated with Yishen Qianggu Cream combined with muscle strength training on the basis of the controlled group.The clinical efficacy of the two groups was compared,and the bone mineral densities(BMD)of different parts(femoral neck,femoral trochanter,Ward’s triangle),bone-related markers[bone gla protein(BGP),C-terminal telopeptide of type I collagen(CTX-I),bone alkaline phosphatase(BALP),tartrate-resistant acid phosphatase 5 b(TRACP-5 b)],lower limb muscle strength and gait and balance[Tinetti Balance and Gait Assessment Scale,Timed Up and Go Test(TUG)]were observed in the two groups before treatment and after 3 months of treatment.Results:The clinical effective rate of 98.08%in the observation group was higher than 86.54%in the controlled group(P<0.05).After 3 months of treatment,the BND values of different parts in the two groups were increased compared with those before treatment(P<0.05),and the BND values in the observation group were higher than those in the controlled group(P>0.05).The BGP level,extensor strength and flexor strength and Tinetti balance and gait score in the two groups were higher than those before treatment,and the above indicators were higher in the observation group than those in the controlled group(P<0.05).The levels of CTX-I,BALP and TRACP-5 b and TUG were reduced compared to before treatment,and the indicators in the observation group were lower compared with those in the controlled group(P<0.05).Conclusion:Yishen Qianggu Cream combined with muscle strength training has a significant efficacy for elderly patients with OP.It can effectively improve the bone resorption and bone turnover and increase the bone mineral density and lower limb muscle strength,and it has a good improvement effect on walking balance and gait stability and can effectively avoid the occurrence of osteoporotic fractures due to falls.