原发性骨质疏松症中医证型分布及其与骨折关系研究

Distribution of Chinese Syndrome Types in Patients with Primary Osteoporosis and Its Relationship with Bone Fracture

目的探讨骨质疏松症患者中医证型分布及其与骨折的关系。方法对2007年1月—2009年1月在西苑医院就诊的180例原发性骨质疏松症患者按照标准进行中医辨证分型,统计骨折发生率,对所得结果采用SPSS13.0进行统计分析。结果原发性骨质疏松症发病率男女性别比为1∶3(41例∶139例),女性高于男性。中医辨证属三种证型,即肾虚型14例(7.8%),脾肾两虚型39例(21.7%),脾肾两虚血瘀型127例(70.6%),各证型病例分布比较差异有统计学意义(P<0.05)。180例患者中,有骨折史23例(12.78%),其中肾虚型1例(4.34%),脾肾两虚型4例(17.39%),脾肾两虚血瘀型18例(78.26%)。50～59岁骨折2例(5.3%);60～69岁9例(15.0%);两组间比较差异有统计学意义(P<0.05),而70～80岁骨折发生率为12例(12.24%)。结论脾肾两虚兼血瘀型骨折的风险高于单纯肾虚型和脾肾两虚型,60～69岁是骨质疏松症患者骨折的高危年龄。

Objective To study the distribution of Chinese syndrome type in patients with primary osteoporosis （POP） and its relationship with bone fracture. Methods Materials of 180 POP patients who visited Xiyuan Hospital were investigated, their incidence of bone fracture observed and Chinese syndrome types differentiated. And the outcomes were analyzed statistically using SPSS 13.0. Results The morbidity of POP in female was higher than that in male, the sex ratio （M/F） being 1∶3 （41 cases vs 139 cases）. Chinese syndrome type distribution in the POP patients was： Shen-deficiency syndrome （SDS） type in 7.8% patients （14 cases）, Pi-Shen deficiency syndrome （PSDS） type in 21.7% （39 cases）, Pi-Shen deficiency and blood-stasis syndrome （PBS） type in 70.6% （127 cases）, the difference of partition between types was significant （P0.05）. Bone fracture had occurred in 12.78% （23 cases） of patients, the occurrence in patients with different types was 4.34%, 17.39%, and 78.26%, respectively. Incidence of bone fracture was also different in patients of various age section, being 5.3% in 50—59 years section, up to 15.0% in 60—69 years section （P0.05）, and down to 12.24% in 70—80 years Section. Conclusion The risk of bone fracture in POP patients of PBS type is higher than that in those with SDS or PSDS type, and 60-69 years is the high risk age section of bone fracture in POP patients.