自拟壮骨止痛汤治疗血液透析肾性骨病患者的临床探讨

Clinical study of self-made Zhuanggu Zhitong decoction in the treatment of patients with renal osteodystrophy after hemodialysis

目的 探讨自拟壮骨止痛汤治疗血液透析肾性骨病患者的临床效果.方法 将我院2015年1月至2016年4月收治的71例肾性骨病患者根据入院顺序编号并利用随机数表法分组,对照组（n=35）患者采用血液透析＋碳酸钙D3片治疗,观察组（n=36）患者予以血液透析＋自拟壮骨止痛汤治疗,对比两组患者的治疗效果.结果 治疗前两组患者全身骨痛、手足抽搐、腰酸背痛积分比较无明显差异（P＞0.05）,治疗后两组各项临床症状积分均明显下降,组内比较差异具有统计学意义（P＜0.05）,且观察组下降程度较对照组更明显,差异具有统计学意义（P＜0.05）;治疗前两组患者血钙、血磷、甲状旁腺激素比较无明显差异（P＞0.05）,治疗后两组各项生化指标均明显改善,组内比较差异具有统计学意义（P＜0.05）,且观察组改善程度更明显,各项生化指标均明显优于对照组（P＜0.05）;治疗前两组骨密度比较差异不显著（P＞0.05）,治疗后观察组骨密度明显低于对照组（P＜0.05）.结论 自拟壮骨止痛汤治疗血液透析肾性骨病患者的临床效果显著,值得临床推广.

Objective To explore the clinical effects of self-made Zhuanggu Zhitong decoction in the treatment of patients with renal osteopathy after hemodialysis. Methods From January 2015 to April 2016, 71 cases of renal bone disease patients in our hospital were numbered by the order of hospitalization, and randomly divided into two groups. Patients in the control group （n=35） were treated with hemodialysis ＋ calcium carbonate D3 tablets, while patients in the observation group （n=36） received hemodialysis ＋ self-made Zhuanggu Zhitong decoction treatment, the therapeutic effects between the two groups were compared. Results Before the treatment, there was no obvious difference in the integral of symptoms between two groups, such as the whole body bone pain, tetany, back pain （P〉0.05）; after the treatment, the clinical symptoms score of two groups were significantly declined, the differences were statistically significant （P〈0.05）, but the decline of the observation group was more obvious, the differences between the two groups were significant （P〈0.05）. Before the treatment, there was no obvious difference on blood calcium, blood phosphorus and parathyroid hormone between two groups （P〉0.05）; after the treatment, those biochemical indicators of the two groups significantly improved, the differences in the group were significant （P〈0.05）, but the improvement of observation group was more obvious, the biochemical indicators of observation group were significantly better than those of control group （P〈0.05）. Before treatment, the contrast of bone density between the two groups was not sig- nificant （P〉0.05）, after the treatment, the bone density of the observed group was significantly lower than that of the control group （P〈0.05）. Conclusion The self-made ZhturtrggtL Zhitorrg decoction in the treatment of patients with renal osteodystrophy after hemodialys can get good efficacy, which is worthy of popularization.