联用鲑鱼降钙素、阿仑膦酸钠、钙尔奇D治疗老年骨质疏松症疗效观察

Clinical observation of combined application of salmon calcitonin,alendronate,and Caltrate D for the treatment of senile osteoporosis

目的评价联合应用鲑鱼降钙素、阿仑膦酸钠、钙尔奇D对老年骨质疏松症患者骨痛症状、骨代谢标记物、骨密度的影响。方法2011年6月～2012年6月间选取原发性骨质疏松症患者45例，随机分为对照组和治疗组，连续治疗24周。所有患者均每日口服1片钙尔奇D（600mg）；治疗组患者同时每周口服1片阿仑膦酸钠（70mg），每日经鼻吸入1喷鲑鱼降钙素（120IU）。各组分别于治疗前、治疗4周后、24周后进行疼痛分级评分。于治疗前、治疗24周后应用双能X线吸收法测定腰椎L14、左侧股骨颈骨密度，测定血清骨钙素、抗酒石酸酸性磷酸酶浓度。结果治疗组接受治疗24周后骨痛症状明显缓解，治疗组总有效率优于对照组（P〈0．05）。治疗组24周时骨钙素、抗酒石酸酸性磷酸酶浓度与治疗前相比差异有统计学意义（P〈0．05）。治疗组治疗前后腰椎L14骨密度均值差异有统计学意义（P〈0．05）；两组治疗前后左侧股骨颈骨密度差异无统计学意义（P〉0．05）。结论联用鲑鱼降钙素、阿仑膦酸钠、钙尔奇D治疗老年骨质疏松症临床疗效确切。

Objective To investigate the effect of the combined application of salmon calcitonin, alendronate, and caltrate D on ostealgia, bone metabolism markers, and bone mineral density in patients with senile osteoporosis. Methods Forty-five patients with primary senile osteoporosis were selected from June 2011 to June 2012. All the patients were randomly divided into control group and treatment group for 24-week treatment. All the patients received 600mg Caltrate D per day. Patients in treatment group received 70rag alendronate orally per week and 120IU nasal inhalation of salmon calcitonin per day. The visual analogue scale of ostealgia in both groups was assessed before the treatment and at the 4＇h and the 24＇h week after the treatment. The bone mineral density （BMD） of the lumbar vertebrae （L1-4） and the left femoral neck was detected using dual-energy X-ray absorptiometry before the treatment and at the 24th week after the treatment. Simultaneously, serum BGP and TRACP levels were detected. Results After the treatment, the symptom of ostealgia relieved significantly in treatment group. The total effective rate in treatment group was significantly higher than that in control group （P 〈 0. 05）. At the 24th week after the treatment, serum BGP and TRACP levels were significant different comparing to those before the treatment. BMD of the lumbar vertebrae （L1-4） was significantly different comparing to that before the treatment （ P 〈 0. 05 ）. BMD of the femoral neck had no significant difference （ P 〉 0.05 ）. Conclusion The combined application of salmon calcitonin, alendronate, and Caltrate D has definite efficacy for the treatment of senile osteoporosis.