低频脉冲电磁场治疗骨质疏松症的干预途径

Interventional pathway of low-frequency pulsed electromagnetic field in treating osteoporosis

目的:针对低频脉冲电磁场对骨折治疗的效果,探讨低频脉冲电磁场治疗骨质疏松症的干预途径。资料来源:应用计算机检索Medline1990-01/2005-04的文章,检索词“osteoporosis,electromagneticfields”,并限定语言种类为英语。同时计算机检索万方数据库资料系统与中国期刊全文数据库1994-01/2005-04的文章,限定文章语言种类为中文,检索词“骨质疏松,电磁场”资料选择:对资料进行初审,选取试验包括试验组和对照组的文献,筛除明显不符合随机试验的研究,对剩余的文献开始查找全文,进一步判断为随机对照试验。纳入标准:①随机对照试验,采用单盲、双盲或非盲法。②试验包含平行对照组。排除标准:重复性试验研究。资料提炼:共收集到20篇关于低频脉冲电磁场治疗骨质疏松症的随机对照试验文章,17个试验符合纳入标准。排除的3篇为重复的同一研究。资料综合:介绍脉冲电磁场的作用原理和发展过程,并分别针对低频脉冲电磁场治疗骨质疏松症的17个试验给予评价。低频脉冲电磁场对原发性和继发性骨质疏松模型动物的骨密度治疗效果较好,可明显改善骨小梁的结构,与药物联合使用时治疗效果更加明显。低频脉冲电磁场对骨质疏松症的细胞生物学研究也进行了分析,发现低频脉冲电磁场可刺激成骨细胞增殖,促进骨形成,提高骨密度,并具有缓解骨质疏松性疼痛的作用。结论:低频脉冲电磁场具有提高骨质疏松症患者骨含量,从而提高骨密度的作用。但应用时还存在能否增加抗骨折能力和治疗规范化两大问题。

OBJECTIVE： To investigate the interventional pathway of low-frequency pulsed electromagnetic field in ,treating osteoporusis aiming at the therapeutic effect of low-frequency pulsed electromagnetic field on osteoporosis. DATA SOURCES： An online search of Medline database was undertaken by using the keywords of “osteoporosis, pulsed electromagnetic fields” to identify the relevant article published in English from January 1990 to April 2005. Meanwhile, Wanfang database and Chinese journals full-text database were scanned with computer to search the relevant articles published in Chinese from January 1994 to April 2005 with the keywords of “osteoporosis, pulsed electromagnetic fields”. STUDY SELECTION： After the above search, the trials including treatment group and control group were selected, while the obvious non-randomized trials were excluded, and then the full-texts of the selected articles were searched for randomized controlled study. Inclusive criteria： ① randomized controlled study with single-blind, double-blind or non-blind method; ② experiments including parallel control group. Exclusive criteria： repetitive experimental study. DATA EXTRACTION： Twenty papers of randomized controlled trial about the low-frequency pulsed electromagnetic field in treating osteoporosis were collected, 17 of them accorded with the inclusive criteria, and the other 3 excluded ones were all repetitive studies. DATA SYNTHESIS： The principle and progress of low-frequency pulsed electromagnetic fields were introduced, and the 17 trials about low-frequency pulsed electromagnetic field in treating osteoporosis were evaluated respectively, Low-frequency pulsed electromagnetic field had better therapeutic effect on the bone mineral density of animal models of primary and secondary osteoporosis, could obviously ameliorate the bone trabecular structure, and the therapeutic effect was more obvious if it was used together with drugs. The cell biological study of low-frequency pulsed electromagnetic field in treating osteoporosis was also analyzed, it was found that low-frequency pulsed electromagnetic field could stimulate the proliferation of osteoblasts, promote bone formation, improve bone mineral density, and also played a role in relieving osteoporotic aching. CONCLUSION： Low-frequency pulsed electromagnetic fields can enhance the bone quantity of patients with osteoporosis, consequently enhance their bone mineral density. Whereas, there are two problems of whether could in osteoporosis therapy of low-frequency, pulsed electromagnetic fields that increase ability of resisting fracture and therapeutic standardization in the osteoporosis therapy by using low-frequency pulsed electromagnetic fields.