综合治疗在改善绝经后骨质疏松症中的应用价值

Application value of comprehensive therapy in treating postmenopausal osteoporosis

目的探讨综合治疗方案在改善绝经后骨质疏松症中的应用价值。方法本前瞻性研究对象为2013年12月至2014年12月在揭阳市揭阳区第二人民医院骨科接受诊治的500例绝经后骨质疏松症患者。按照随机数字表法将患者分为综合治疗组(研究组)和基础治疗组(对照组)。研究组250例,平均年龄(65±11)岁。对照组250例,平均年龄(66±13)岁。所有患者均签署知情同意书,符合医学伦理学规定。研究组患者接受包括体内钙代谢调节、性激素替代治疗、促进钙质吸收和止痛治疗在内的综合治疗方案;对照组患者仅接受包括促钙质吸收和止痛治疗的基础治疗方案。比较两组患者治疗6个月后的Ⅰ型胶原羟基端肽β降解产物(C-terminal cross-linking telopeptide of typeⅠcollagen,β-CTX)水平、骨密度水平和SRS-22问卷调查表评分。两组资料的比较采用t检验。结果治疗6个月后,研究组患者股骨颈和Wards三角区的骨密度水平分别为(771±97)mg/cm3和(549±91)mg/cm3,明显高于对照组的(741±91)mg/cm3和(537±87)mg/cm3(t=8.963、9.689,P<0.05);研究组患者SRS-22问卷调查评分为(81±15)分,明显高于对照组的(70±13)分(t=9.131,P<0.05);研究组患者β-CTX水平为(0.49±0.08)μg/L,明显高于对照组的(0.47±0.08)μg/L(t=2.795,P<0.05)。结论综合治疗方法治疗绝经后骨质疏松症具有较基础治疗方法更佳的临床疗效,能显著缓解患者的疼痛,提高患者的骨密度水平和改善患者的生活质量。

ObjectiveTo investigate the application value of comprehensive therapy in treating postmenopausal osteoporosis.Methods A total of 500 patients with postmenopausal osteoporosis in the Second People’s Hospital of Jiedong District, Jieyang between December 2013 and December 2014 were included in this prospective study. These patients were divided into the comprehensive therapy group （study group） and the basic therapy group （control group） according to the random number table method. Two hundred and fifty patients were included into the study group with an average age of （65±11） years old, while other 250 patients were included into the control group with an average age of （66±13） years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. Patients in the study group were given comprehensive therapy including regulation of calcium metabolism, hormone replacement therapy, promotion of calcium absorption and pain relief treatment. Patients in the control group were only given basic therapy including promotion of calcium absorption and pain relief treatment. C-terminal cross-linking telopeptide of typeⅠcollagen （β-CTX）, bone mineral density and the SRS-22 questionnaire score were compared between the two groups after 6 months of treatment. These data of two groups were compared usingt test.Results After six months of treatment, the average bone mineral density level of the femoral neck and Wards triangle in the study group was （771±97） mg/cm3 and （549±91） mg/cm3 respectively; which was significantly higher than （741±91） mg/cm3 and （537±87） mg/cm3 of the control group respectively （t=8.963, 9.689,P〈0.05）. The average SRS-22 questionnaire score of the study group was 81±15, which was significantly higher than 70±13 of the control group （t=9.131,P〈0.05）;β-CTX of the study group was （0.49±0.08） μg/L, which was significantly higher than （0.47±0.08） μg/L of the control group （t=2.795,P〈0.05）.Conclusion Comprehensive therapy has a better clinical curative effect on patients with postmenopausal osteoporosis than basic therapy, allowing to significantly release pain and greatly improve bone mineral density level and quality of life.