温阳补肾汤治疗肾阳虚型老年性骨质疏松症42例临床观察

Clinical Observation of Wenyang Bushen Decoction for Treatment of Senile Osteoporosis with Kidney Yang Deficiency:A Report of 42 Cases

目的:探讨温阳补肾汤治疗肾阳虚型老年性骨质疏松症的临床疗效。方法:将100例患者随机分为2组各50例,治疗组(完成42例)予温阳补肾汤口服,对照组(完成43例)予阿仑膦酸钠片口服,2组均同时口服钙尔奇D,治疗4周后观察2组患者治疗前后肾阳虚症状积分和疼痛积分,并检测骨代谢指标总骨Ⅰ型前胶原N端肽(P1NP)、β胶原特殊序列(β-CrossLaps)。结果:治疗后治疗组肾阳虚各项症状积分及总积分均较治疗前明显下降(P<0.05);各项指标(除腰背疼痛积分外)与对照组治疗后比较,差异有显著性性意义(P<0.05);治疗后对照组仅腰背疼痛积分较治疗前下降明显(P<0.05)。治疗后2组疼痛评分均较治疗前明显下降(P<0.05);治疗后2组间比较,差异无显著性意义(P>0.05)。治疗后2组P1NP较治疗前无明显改善(P>0.05)。治疗后2组β-CrossLaps较治疗前明显下降(P<0.05);但2组间比较,差异无显著性意义(P>0.05)。结论:温阳补肾汤能明显改善肾阳虚型老年性骨质疏松症患者疼痛症状和中医临床症状,临床疗效肯定。

Objective： To observe the therapeutic effects of Wen,yang Bushen Decoction （WYD） for senile osteoporosis with kidney yang deficiency. Methods： One hundred patients aged over 70 years were equally randomized into two groups. On the basis of treatment with oral use of Caltrate, the treatment group took WYD orally, and the control group took Alendronate Sodium Tablets orally. The treatment in both groups lasted for 4 weeks. The scores of symptoms of kidney yang deficiency, the pain scores and the bone metabolism indexes of amino-terminal propeptide of type 1 procotlagen（P1NP）and specific peptide of type I collagen β（β-CrossLaps） were evaluated. Results： Forty-two patients in the treatment group and 43 in the control group completed the treatment course. The scores of symptoms of kidney yang deficiency and their total scores were significantly decreased in the treatment group after treatment（P 〈 0.05 compared with those before treatment）, and differed from those in the control group（P 〈 0.05, except the lumbar and back pain scores）. Only lumbar and back pain scores were decreased in the control group after treatment（P 〈 0.05）. The pain scores were reduced in both groups after treatment（P 〈 0.05）, but the differences were insignificant（P 〉 0.05）. P1NP remained unchanged in both groups after treatment （P 〉 0.05）, but β-CrossLaps was decreased in both groups（P 〈 0.05）, the differences being insignificant in the two groups（P 〉 0.05）. Conclusion： WYS shows certain therapeutic effect for senile osteoporosis with kidney yang deficiency through relieving pain and the symptoms of kidney yang deficiency.