机械振动对绝经后骨质疏松患者骨密度影响

The effect of mechanical vibration on bone mineral density in patients with postmenopausal osteoporosis

目的观察机械振动对绝经后骨质疏松患者骨密度(BMD)的影响。方法随机选择2014年2月~2015年10月就诊于广州军区广州总医院骨科医院康复理疗科及骨质疏松门诊的绝经后骨质疏松患者60例,分为阿仑膦酸钠组(ALN组)和机械振动组(WBV组),每组30例,两组均给予抗骨质疏松基础治疗,分别于入组时、治疗6个月后测定骨密度。结果WBV组治疗6个月后L1~L4、左股骨颈、左股骨上端、Ward's三角、左股骨大粗隆BMD较治疗前明显增加,其中Ward's三角BMD变化率最大(8.37%),差异有统计学意义(P<0.05)。ALN组治疗6个月后L1~L4、左股骨颈、左股骨上端、左股骨大粗隆BMD较治疗前明显增加,其中L1~L4 BMD变化率最大(3.17%),差异有统计学意义(P<0.05);而Ward's三角BMD虽有增加,但治疗前后相比,差异不具有统计学意义(P>0.05)。治疗6个月后,WBV组左股骨(颈、上端、大粗隆)、Ward's三角的变化率均高于ALN组,而ALN组腰椎BMD变化率要高于WBV组。结论阿仑膦酸钠能明显增加腰椎骨密度;而机械振动对股骨、髋部骨密度提升明显,其中Ward's三角可以作为机械振动治疗指征和疗效判定指标;机械振动尤其适用于绝经后骨质疏松治疗。

Objective To investigate the effect of mechanical vibration on bone mineral density in patients with postmenopausal osteoporosis. Methods A clinical research study was conducted on 60 randomly selected patients with postmenopausal osteoporosis （aged 49-70 years） who were treated between February 2014 and October 2015 in the rehabilitation and physiotherapy department of orthopaedic hospital and osteoporosis clinic. The patients were randomly divided into the whole body vibration group （WBV） and the alendronate group （ALN） （both given base treatment at the same time）. Bone mineral density was analysed after a 6-month treatment. Results In the WBV group, after 6 months of treatment, indexes such as L1 ~ L4, left femoral neck, left upper femur, Ward＇s triangle, and the left femoral large tuberosity BMD increased significantly. Remarkable statistical differences were evident in the comparison of the differences before and after treatment：the highest change rate could be seen in the Ward＇s triangle BMD （8.37%）. The indexes listed above in the ALN group increased significantly compared with before treatment , also showing significant statistical differences. L1 ~ L4 BMD had the greatest change rate （3.17%）. Although the Ward＇s triangle BMD increased, little statistical value could be observed before and after treatment. The change rates of the left femur （neck, upper, big tuberosity） and Ward＇s triangle in the WBV group were higher than the ALN group after 6-month treatment, but the reverse was true for the change rate of the lumbar BMD. The difference in BMD in the two groups were not statistically significant. Conclusion Alendronate can obviously increase lumber vertebra density and mechanical vibration can increase femur and hip bone mineral density significantly. Ward＇s triangle can be used as a mechanical vibration treatment indication and as an outcome indicator. Mechanical vibration is especially suitable for postmenopausal osteoporosis treatment.