加味龟鹿养骨汤联合甲状旁腺激素对绝经后骨质疏松患者身体成分的影响

Study on the Effects of Jiawei Guilu Yanggu Decoction Combined with Parathyroid Hormone on the Body Composition of Patients with Postmenopausal Osteoporosis

目的:观察加味龟鹿养骨汤联合甲状旁腺激素对绝经后骨质疏松患者身体成分的影响。方法:选取2013年1月至2015年12月内蒙古医科大学附属医院收治住院的绝经后骨质疏松患者54例,记录年龄、BMI、病情等临床资料,根据随机数字表法分为对照组和观察组,每组27例,2组患者均采用甲状旁腺激素治疗,观察组在对照组的治疗基础上加用中药汤剂-加味龟鹿养骨汤,观察中医证候疗效、血清25-羟维生素D(25-OH-VD)水平、骨钙素(BGP)及β-Ⅰ型胶原羧基端肽(CTX)、骨密度等指标,评价加味龟鹿养骨汤对PMOP患者的作用。结果:治疗后观察组有效治愈率(96.29%)明显高于对照组(85.18%),差异有统计学意义(P<0.05);在治疗后,L1-4、股骨颈及股骨大转子的BMD差异有统计学意义(P<0.05),观察组与对照组比较,差异有统计学意义(P<0.01);治疗后CTX及BGP显著减少,25-OH-VD水平增加,而观察组比对照组更为明显(P<0.05);在12个月的随访中,观察组没有新的骨折发生,对照组2例患者出现新的骨折,包括髋部骨折1例,桡骨远端骨折1例。结论:加味承气汤对急性重症胰腺炎患者有一定的临床疗效,可调节患者25-OH-VD、BGP、CTX水平,增加患者骨密度,有效治疗绝经后骨质疏松症患者。

Objective： To observe the effects of Jiawei Guilu Yanggu Decoction combined with parathyroid hormone on the body composition of patients with postmenopausal osteoporosis. Methods： Fifty-four patients with postmenopausal osteoporosis who were admitted in Affiliated Hospital of Inner Mongolia Medical University from January 2013 to December 2015 were selected,and clinical data of age,BMI,and state of illness were recorded. By using lot method,all patients were randomly divided into control group（ 27 cases） and research group（ 27 cases） and were treated with parathyroid hormone therapy. On the basis of control group,the research group was added Jiawei Guilu Yanggu Decoction. The indicators of the effect of TCM syndromes,the levels of serum 25 hydroxyvitamin D（ 25-OH-VD）,osteocalcin（ BGP）,β-Ⅰ type collagen carboxy terminal peptide（ CTX）,and bone density were observed,and the effects of Jiawei Guilu Yanggu Decoction on patients with PMOP were evaluated. Results： After treatment,the effective cure rate of the patients in the research group was 96. 29%,which was significantly higher than that 85.18% of the control group,and the difference was statistically significant（ P〈0. 05）; After treatment,the BMD of L1-4,femoral neck and femoral greater trochanter were significantly different（ P〈0. 05）,and the difference between the research group and the control group was statistically significant（ P〈0. 01）; After treatment,the levels of CTX and BGP were significantly decreased and the level of 25-OH-VD was significantly higher. The research group was more significant than control group（ P〈0. 05）; During the 12 months＇ follow-up,no fracture occurred in the research group,and 2 cases of fracture occurred in the control group,including 1 case of hip fracture and 1 case of distal radius fractures. Conclusion： Jiawei Guilu Yanggu Decoction has a certain clinical efficacy in patients with severe acute pancreatitis. It can adjust the levels of 25-OH-VD,BGP,and CTX,increase bone mineral density,and effectively treat patients with postmenopausal osteoporosis.