鲑鱼降钙素穴位注射治疗绝经后骨质疏松症:随机对照研究

Postmenopausal osteoporosis treated with acupoint injection of salmon calcitonin:a randomized controlled trial

目的:验证鲑鱼降钙素穴位注射治疗绝经后骨质疏松症的临床疗效。方法:将90例绝经后骨质疏松症患者随机分为3组,每组30例。穴注组穴取双侧肾俞、足三里,将100U(1mL)鲑鱼降钙素配0.9%氯化钠注射液至4mL,每穴注射1mL;空白组穴取双侧肾俞、足三里,每穴注射0.9%氯化钠注射液1mL;肌注组予鲑鱼降钙素100U臀大肌肌内注射。3组患者均2天治疗1次,共治疗2个月。检测患者治疗前后骨密度值(BMD)、骨源性碱性磷酸酶(NBAP)、Ⅰ型胶原C末端肽(CTX)、尿钙/肌酐(Ca/Cr)以及骨质疏松症症状评分。结果:3组患者治疗后NBAP、腰椎BMD高于治疗前(均P<0.05),CTX、尿Ca/Cr及症状评分低于治疗前(均P<0.05);治疗后,穴注组NBAP为(32.7±2.5)μg/L,高于空白组、肌注组(均P<0.05);穴注组CTX下降至(239.7±63.6)μmmol/L,尿Ca/Cr下降至0.525±0.274,两者均明显低于空白组和肌注组(均P<0.05);治疗后,穴注组腰椎BMD为(0.731±0.062)g/m2,高于空白组和肌注组(均P<0.05);治疗后穴注组症状评分为5.2±0.6,低于空白组和肌注组(均P<0.05)。结论:鲑鱼降钙素足三里、肾俞穴位注射治疗绝经后骨质疏松症疗效显著,能够刺激成骨细胞活性,抑制破骨细胞的骨吸收。

Objective To verify the clinical efficacy on postmenopausal osteoporosis treated with acupoint injection of salmon calcitonin.Methods Ninety patients of postmenopausal osteoporosis were randomized into three groups,30 cases in each one.In the acupoint injection group,Shenshu（BL 23）and Zusanli（ST 36）were selected bilaterally.The injection 4mL was prepared with salmon calcitonin 100U（1mL）and 0.9% sodium chloride injection.Each acupoint was stimulated with the injection,1mL.In the blank group,0.9% sodium chloride injection was applied to bilateral Shenshu（BL 23）and Zusanli（ST 36）,1mL at each acupoint.In the intramuscular injection group,salmon calcitonin 100 Uwas injected at gluteus maximus.The treatment was given once every two days in the patients of the three groups and lasted for 2months.The levels of bone mineral density（BMD）,bone alkaline phosphatase（NBAP）,C-terminal telopeptides of typeⅠcollagen（CTX）,urine calcium/creatinine（Ca/Cr）and the symptom score of osteoporosis were detected in the patients of the three groups before and after treatment.Results In the patients of the three groups,NBAP and BMD in lumbar vertebra after treatment were higher than those before treatment（all P〈0.05）;CTX,Ca/Cr and symptom score were lower than those before treatment（all P〈0.05）.After treatment,NBAP was（32.7±2.5）μg/L in the acupoint injection group,higher than those in the blank group and the intramuscular injection group（both P〈0.05）.In the acupoint injection group,CTX was reduced to（239.7±63.6）μmmol/L and Ca/Cr was reduced to 0.525±0.274,apparently lower than those in the blank group and intramuscular injection group（both P〈0.05）.After treatment,in the acupoint injection group,BMD of lumbar vertebra was（0.731±0.062）g/m^2,higher than the level of the rest two groups（both P〈0.05）.After treatment,the symptom score was 5.2±0.6in the acupoint injection group,lower than those in the blank group and intramuscular injection group（both P〈0.05）.Conclusion Salmon calcitonin injection at Zusanli（ST 36）and Shenshu（BL 23）achieves significant efficacy on postmenopausal osteoporosis,stimulating osteoblast activity and inhibiting bone absorption of osteoclast.