碳酸钙维生素D_3及鲑鱼降钙素联合脉冲电磁场治疗老年女性骨质疏松症的临床观察

Effects of calcium carbonate,vitamin D_3 and calcitonin combined with pulsed electromagnetic fields on osteoporosis in elderly women

目的观察碳酸钙维生素D3及鲑鱼降钙素联合脉冲电磁场治疗老年女性骨质疏松症的疗效。方法老年女性原发性骨质疏松症96例,随机分为对照组和观察组,每组48例。对照组给予口服碳酸钙维生素D3(每天1片)及降钙素鼻喷剂(每天喷两次,每次120 IU)治疗12个月,观察组在对照组治疗的基础上加用脉冲电磁场治疗8周。治疗前及治疗后第1、2、4、8周分别测定患者视觉模拟疼痛评分(VAS),治疗前及治疗后1年对患者进行腰椎骨密度(BMD)测量。结果观察组和对照组在治疗前及治疗后1、2、4、8周,VAS评分分别为:(6.7±2.1),(2.6±0.9),(1.8±0.5),(1.4±0.3),(1.1±0.2)和(6.6±2.0),(4.5±1.3),(4.0±1.1),(3.2±1.0),(2.7±0.8)。治疗后两组患者的疼痛均能获得减轻,而且治疗时间越长,疼痛减轻越明显,但观察组比对照组疼痛缓解得更快(P<0.01)。治疗前观察组和对照组的腰椎BMD分别为:(0.737±0.083)和(0.739±0.083),治疗后1年则分别为(0.793±0.082)和(0.791±0.081),观察组与对照组比较,BMD差别无统计学意义(P>0.05),而各组治疗前后比较,BMD升高均具有统计学意义(P<0.01)。结论碳酸钙维生素D3及鲑鱼降钙素治疗老年女性骨质疏松症疗效确切,联合短疗程脉冲电磁场治疗对缓解疼痛具有协同作用,但对治疗后1年的腰椎骨密度的增加似乎无影响。

Objective To study effects of calcium carbonate,vitamin D3 and calcitonin combined with short course of pulsed electromagnetic fields on osteoporosis in elderly women.Methods 96 elderly women with primary osteoporosis were randomized to the study group or control group with 48 in each.Patients in control group received calcium carbonate vitamin D3(1 tablet/day) and calcitonin nasal spray(120 IU,twice daily) for 12 months.On the basis of control treatment,pulsed electromagnetic fields were added on the patients in the study group for 8 weeks.Visual analogue scale(VAS) was evaluated before treatment and at week 1,2,4,8 after treatment.Bone mineral density(BMD) was detected before treatment and at 1 year after treatment.Results VAS before treatment and at week 1,2,4,8 after treatment in the study group and control group were(6.7±2.1),(2.6±0.9),(1.8±0.5),(1.4±0.3),(1.1±0.2) and(6.6±2.0),(4.5±1.3),(4.0±1.1),(3.2±1.0),(2.7±0.8),respectively.Pain relief was achieving in all patients.With a longer treatment,the pain was more obviously relieved.But the relief achieved in the study group is earlier and more than that of the control group.BMD before treatment in the study group and control group were(0.737±0.083) and(0.739±0.083),respectively.After treatment for 1 year,BMD were(0.793±0.082) and(0.791±0.081).The difference of BMD between the study and control group was not statistically significant(P>0.05).But the BMD after treatment showed a statistically significant increase compared with that before treatment(P<0.01).Conclusion Calcium carbonate,vitamin D3 and calcitonin shows a firm efficacy on the treatment of osteoporosis in elderly women.The combination therapy with short course of pulsed electromagnetic fields shows a synergistic effect on pain relief.But there seems to be not an obvious effect on the increase of BMD at1year after treatment.