隔药饼灸治疗老年骨质疏松症临床研究

Clinical study of medicinal-cake-separated moxibustion for senile osteoporosis

目的:探讨隔药饼灸治疗老年骨质疏松症的临床疗效及其部分作用机制。方法:将60例老年骨质疏松症患者按随机数字表法随机分为观察组和对照组,每组30例。两组均予西药基础治疗,穴取1大椎、大杼、肝俞;2中脘、膻中、足三里;3脾俞、肾俞、命门;4神阙、关元。每次取1组穴位,4组穴位轮流选用。观察组予隔药饼灸,药物组成:补骨脂30g、熟地黄30g、白术30g、党参30g、淫羊藿20g、仙茅20g、丁香5g、肉桂5g。对照组予隔面饼灸。两组均每穴施灸5壮,隔日治疗1次,共治疗6个月。观察两组治疗前后的症状评分、腰椎及髋部骨密度(BMD)、血清Ⅰ型前胶原氨基端前肽(PINP)和β-Ⅰ型胶原羧基端肽(β-CTX)。结果:两组治疗后症状评分、血清β-CTX均低于治疗前,腰椎及髋部BMD、血清PINP均高于治疗前(均P<0.05);治疗后观察组症状评分、血清β-CTX均低于对照组,腰椎及髋部BMD、血清PINP均高于对照组(均P<0.05)。结论:隔药饼灸治疗老年骨质疏松症疗效显著,优于隔面饼灸。

Objective To explore the clinical efficacy and partial mechanism of medicinal-cake-separated moxibustion for senile osteoporosis.Methods Sixty cases of senile osteoporosis were randomly divided into an observation group and a control group according to the random digits table, 30 cases in each one.The two groups were both treated with basic treatment of western medicine.The acupoints included four groups： ① Dazhui （GV 14）, Dazhu （BL 11） and Ganshu （BL 18）;② Zhongwan （CV 12）, Danzhong （CV 17） and Zusanli （ST 36）;③ Pishu （BL 20）, Shenshu （BL 23） and Mingmen （GV 4）;④ Shenque （CV 8） and Guanyuan （CV 4）.Each group of acupoints was selected for one treatment.The observation group was treated with medicinal-cake-separated moxibustion, and the medicinal cake was consisted of fructus psoraleae （30 g）, prepared rehmannia root （30 g）, atractylodes （30 g）, codonopsis pilosula （30 g）, epimedium herb （20 g）, rhizoma curculiginis （20 g）, syzygium aromaticum （5 g） and cinnamon （5 g）.The control group was treated with wheat-flour-cake moxibustion.Each acupoint was treated with 5 moxa cones in the two groups.The treatment was given once every other day for six months.The symptom score, lumbar and hip bone mineral density （BMD）, serum type Ⅰ procollagen amino-terminal propeptide （PINP） and serum β-type Ⅰ collagen carboxy-terminal peptide （β-CTX） were observed before and after treatment.Results After treatment, the symptom score and serum β-CTX were significantly lowered （all P〈0.05）, while the lumbar and hip BMD and serum PINP were significantly increased （all P〈0.05） of the two groups.After treatment, the symptom score and serum β-CTX in the observation group were significantly lower than those in the control group （both P〈0.05）, while the lumbar and hip BMD and serum PINP in the observation group were significantly higher than those in the control group （all P〈0.05）.Conclusion The medicinal-cake-separated moxibustion has significant efficacy for senile osteoporosis, which is superior to wheat-cake-se-parated moxibustion.