唑来膦酸配合补肾活血方治疗绝经后骨质疏松临床分析

Clinical effect of zoledronic acid combined with traditional chinese medicine in treatment of postmenopausal osteoporosis

目的观察唑来膦酸联合中药补肾活血方治疗绝经后骨质疏松症的临床疗效及不良反应,进一步指导临床用药。方法温州医科大学附属第一医院伤骨科80例绝经后骨质疏松患者随机分为4组,A组唑来膦酸针+中药补肾活血方,B组补肾活血方,C组唑来膦酸针,D组单用钙尔奇D。A、B、C 3组常规给予口服钙尔奇D。采用双能X线骨密度测量仪(DXA)测定治疗前后骨密度,并检测血清PINP、β-CTX。通过复诊及随访,判断其疗效,观察不良反应发生情况。结果 A、B、C 3组患者经治疗后骨密度较治疗前增加,且A组增加最为显著。其中A、C组PINP、β-CTX不同程度下降。D组治疗前后无明显变化。唑来膦酸针不良反应主要为发热、骨痛、肌痛等流感样症状,一般不超过3 d,未出现严重不良反应。结论唑来膦酸联合中药补肾活血方综合治疗可以明显提高绝经后骨质疏松患者的骨密度,缓解患者疼痛,降低新发骨折风险,并具有良好的耐受性和安全性。

Objective To study the clinical effects and adverse reactions of zoledronic acid combined with traditional Chi- nese medicine（ Bushenhuoxue prescription） in the treatment of postmenopansal osteoporosis. Methods 80 of postmeno- pausal osteoporosis in our department were randomly divided into 4 groups, group A received zoledronic acid and Bushen- huoxue prescription, group B received Bushenhuoxue prescription, group C received zoledronic acid, and all four groups re- ceived Calcium D orally. The hone mineral density before and after the treatment was determined by Dual-energy X-ray absorptiometry（DXA） ;the serum levels of Procollagen type I N-terminal propeptide （PINP） and telopeptide （[3-CTX） were also tested. The efficacy and adverse reactions were assessed through the follow-up. Results The bone mineral den- sity after the treatment increased in group A, B and C, especially in group A. The serum levels of PINP and[3-CTX in group A and C decreased to different extent, but not in group D. The main adverse reactions of Zoledronic acid included fever,bone pain,myalgia and other influenza-like symptoms which only lasted for 3 days or less. Conclusion The zole- dronie acid combined with traditional Chinese medicine（ Bushenhuoxue prescription） can obviously improve the bone min- eral density in patients with postmenopausal osteoporosis, alleviate patients ＇ pain, reduce the risk of new fracture, and has good safety and tolerability.