运动疗法对骨质疏松症患者的临床作用研究

Clinical effect of exercise therapy on the patients with osteoporosis

目的根据原发性骨质疏松症患者生活质量评定量表（OQOLS）评分及骨代谢等生化指标的变化，评价运动疗法对骨质疏松症患者的临床作用。方法将符合纳入标准的94例原发性骨质疏松症患者随机分为基础治疗组和运动疗法组，基础治疗组予钙剂加活性维生素D的治疗，运动疗法组在基础治疗的基础上加用五行健骨操，两组疗程均为90d。观察两组患者治疗前后0QOLS量表评分及骨代谢生化指标的变化。结果基础治疗组（33例）治疗后25-羟基维生素D（25（0H）D]较治疗前升高，运动疗法组（29例）治疗后25（OH）D较治疗前升高（61．2±11．1）mmol／L与（48．1±26．2）mmol／L（P〈0．01），其中运动疗法组较基础治疗组升高明显（P〈0．05）。同时两组骨碱性磷酸酶（BALP）均较治疗前降低。两组治疗前后OQOLS量表比较，除运动疗法组躯体活动方面差异无统计学意义（P〉O．05），其余各项比较差异均有统计学意义（P〈0．05）。结论基础治疗和运动疗法均可升高骨质疏松症患者的25（OH）D和降低BALP，运动疗法对骨质疏松症患者的生活质量具有一定的改善作用。

Objective To evaluate the clinical effect of exercise therapy on patients with osteoporosis according to osteoporosis quality of life scale （OQOLS）and the changes in biochemical markers of bone metabolism. Methods Totally 94 patients with primary osteoporosis were randomly divided into 2 groups： the intervention group [exercise therapy （Wu Xing Jian Gu Cao） with calcium/vitamin D supplementation for 90 days] and the control group （only calcium/vitamin D supplementation for 90 days]. OQOLS and the changes in biochemical markers of bone metabolism were observed before and after treatment. Results Compared with before treatment, 25- hydroxy vitamin D[25-（OH） D]levels were increased in control group （33 cases） and intervention group （29 cases） after treatment [（61.2±11.1） mmol/L vs. （48.1±26.2）mmol/L, both P〈0. 001% ,and the enhanced level was higher in the intervention group than in the control group （P%0.05）. Compared with before treatment, bone alkaline phosphatase （BALP） was decreased in control and intervention group after treatment （both P〈0.05）. There were significant differences in OQOLS in both groups between before and after treatment except for the function of physical activities in intervention group （P〈0.05）. Conclusions The basic and exercise therapy can both increase [25-（OH） D] level, reduce BALP, and have clinical effects on bone metabolism, while exercise therapy has an improvement in osteoporosis quality of life in patients with osteoporosis.