四物汤加减治疗绝经后骨质疏松症效果观察

Clinic observation of Siwu decoction in the treatment of post-menopause osteoporosis

目的探讨四物汤加减治疗绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)的临床效果。方法选择2014年2月—2015年2月收治的PMOP患者60例,随机分为中药治疗组、西药对照组和基础对照组各20例,基础对照组给予钙剂+维生素D治疗,西药对照组给予植物雌激素+钙剂+维生素D治疗,中药治疗组给予四物汤+钙剂+维生素D治疗,比较三组患者治疗效果,数据进行统计学分析,P<0.05为差异有统计学意义。结果中药治疗组骨密度明显高于其余两组,差异均有统计学意义(t=4.142、5.780,均P<0.05);治疗后,中药治疗组I型前胶原氨基端延长肽(nterminal propeptide of type I procollagen,P1NP)、骨钙素(osteocalcin,OST)、I型胶原羧基端降解产物(β-C-terminal telopeptide of type I collagen,β-CTX)、血清25-羟基维生素(25-hydroxyvitamin,25-(OH)]D_3以及血清雌二醇(estradiol,E_2)改善效果明显优于其余两组,差异均有统计学意义(均P<0.05);中药治疗组各项症状积分改善效果明显优于其余两组,差异均有统计学意义(均P<0.05);中药治疗组疼痛缓解效果明显优于其余两组(χ~2=4.902、7.656,均P<0.05)。结论四物汤加减治疗PMOP可有效改善患者骨代谢,提高骨密度,改善症状体征,缓解疼痛,临床效果显著。

Objective To investigate the clinic effect of Siwu decoction in the treatment of PMOP. Methods 60 Patients with PMOP from Februray 2014 to february 2015 were randomly divided into the TCM group, western the medicine group and the control group, 20 cases in each group. The control group was given ealcium＋VD, the western medicine group was given phytoestrogen＋calcium＋VD, and the TCM group was given Siwu decoction＋ealcium＋VD. The clinic effect of the three groups was compared. The data was statistically analyzed, if P〈0.05, difference had statistical sense. Results After treatment, BMD of the western medicine group was higher than the control group, BMD of the TCM group was significantly higher than the other two groups, the difference was statistically significant （P〈0.05）. After treatment, the improvement effect of PINP, OST, β-CTX, 25- （OH）Ds, E2 in the western medicine group were better than the control group, the improvement effect P1NP, OST, β-CTX, 25- （OH）D3, E2 in the TCM group were better than the other two groups, the difference was statistically significant （P〈0.05）. After treatment, symptom integral improvement effect of western medicine group were better than control group, the improvement effect of the symptom integral in the TCM group were better than the other two groups, the difference was statistically significant （P〈0.05）; the pain relieving effect in the TCM group were better than the other two groups, the difference was statistically significant （P〈O.05）. Conclusion Siwu decoction in the treatment of PMOP can significantly improve bone metabolism, increase SMD, improve signs and symptoms, relief pain and it has a remarkable clinical effect.