社区干预对老年骨质疏松症的疗效观察

Efficacy of community intervention on senile osteoporosis

目的评估社区干预对老年骨质疏松患者的疗效。方法筛选我院门诊老年骨质疏松患者120例,采用随机双盲法分成干预1组、干预2组和对照组。观察患者疼痛症状改善情况;监测治疗前及治疗1年后腰椎第1~4节（L1~4）及左股骨骨密度（BMD）变化。结果干预1组和干预2组患者治疗后,疼痛症状改善率分别为85%（34/40）和92%（37/40）。两干预组治疗后L1~4BMD值分别为（0.93±0.17）g/cm2和（0.94±0.12）g/cm2,股骨BMD值分别为（0.91±0.08）g/cm2和（0.93±0.11）g/cm2,均较治疗前明显增高,且与对照组相比,差异均有统计学意义（P〈0.05）;干预2组与干预1组相比,BMD值增高（P〈0.05）。结论健康教育指导和口服钙剂、骨化三醇能够改善骨质疏松症患者的疼痛症状、增加骨密度;加用维生素D,可进一步提高疗效。

Objective To evaluate the efficacy of community intervention in elder patients with osteoporosis. Methods 120 outpatients with osteoporosis from Jimenli Community Health Service Center in Haidian District in Beijing were randomly divided into interventional group 1, interventional group 2 and control groups in a double-blind method.Improvement of symptoms was observed in patients with pain.The changes of bone mineral density （BMD） in lumbar 1 to 4 （L1-4） and left femur before treatment and 1-year after treatment were monitored.Results The clinical pain related symptoms of patients in interventional group 1 and 2 after 1-year treatment were significantly improved. The improvement rates were 92%（34/40）and 94% （29/40）.The BMD values of interventional group 1 and 2 after 1 year treatment were significantly higher than before. After treatment, L1.4 BMD values were （0.93 ＋ 0.17）g/cm2 and （0.94 ＋ 0.17）g/cm2, while Femur BMD values were （0.91 ~ 0.08）g/cm2 and （0.89 ~ 0.12）g/cm2. The difference of BMD values between interventional group 1/2 and the control group was statistically significant （P〈0,05）, respectively. BMD values in interventional group 2 were further increased, compared with interventional group 1 （P〈0.05）. Conclusions Health education guidance and calcium and calcitriol could improve pain symptoms in osteoporosis patients, increase bone density. Addinz vitamin D. it could further imnrove the efficacy of natients with osteonorosis.