六味地黄汤加味治疗绝经后骨质疏松症的临床观察

Clinical Observation of Modified Liuwei Dihuang Decoction for Postmenopausal Osteoporosis

[目的]观察六味地黄汤加味治疗绝经后骨质疏松症的临床疗效。[方法]选择绝经后妇女中有临床表现的60例患者为观察对象,运用六味地黄汤加味(熟地、山萸肉、淮山药、泽泻、丹皮、茯苓、骨碎补、续断、仙灵牌)为主方,视其肾阴、肾阳、肾气虚随证加减,每天1剂,1个月为1个疗程,2个疗程后评价疗效,并测定患者的血清激素水平和骨密度指标。[结果]本组60例,治疗两个疗程后显效42例,占70.00%;有效10例,占16.67%;无效8例,占13.33%,总有效率为86.67%。治疗后患者的右膝关节超声振幅衰减系数(αBRA)、超声传导速度(vSOS)和骨硬度指数(pSTI)等骨密度指标均有提高(与治疗前比较,P<0.01);治疗后患者的血清雌二醇(E2)、促卵泡激素(FSH)、黄体生成素(LH)水平均有提高(与治疗前比较,P<0.01)。[结论]中药六味地黄汤能有效治疗绝经后妇女骨质疏松症,改善患者的骨密度;其疗效机制可能与其调节患者的血清雌激素水平有关。

[Objective] To observe the therapeutic effect of Modified Liuwei Dihuang Decoction (MLDD) for post-menopausal osteoporosis (PO) . [Methods] Sixty cases of PO were treated with MLDD, a prescription mainly composed of Radix Rehmanniae Preparata, Fructus Corni, Rhizoma Dioscoreae, Rhizoma Alismatis, Cortex Moutan, Poria, Rhi-zoma Drynariae, Radix Dipsaci, etc. One dose was given a day and one month constituted a treatment course. The treatment lasted two courses. After treatment, the therapeutic effect was evaluated and the serum levels of hormones and parameters of bone density were also detected. [Results] After treatment, 42 (70.00%) were markedly effective, 10 (16.67%) effective, 8 (13.33%) ineffective, and the total effective rate was 86.67% . Bone density parameters such as ultrasonic amplitude attenuation coefficient, ultrasonic conducting velocity, bone sclerosis index were increased as compared with those before treatment ( P < 0.01) ; serum levels of estradiol (?) , follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were also increased (P < 0.01). [Conclusion] MLDD has a certain effect for the treatment of PO and can increase the bone density; its therapeutic effect may be related to the regulation of serum estrogen level.