骨质疏松症患者年龄、中医证型与腰椎压缩性骨折发生关系研究

Study of the relationship between the onset of lumbar compression fractures with age and TCM syndromes in osteoporosis patients

目的探讨骨质疏松症患者年龄、中医证型与腰椎压缩性骨折发生的关系。方法将55~85岁的骨质疏松症患者800例分为肝肾不足、脾肾两虚、脾肾两虚兼血瘀3种证型;对确诊为原发性骨质疏松症身高降低≥3 cm的患者,行腰椎L1~L4椎体骨密度BMD值测量,结合X线Genant半定量法,测量腰椎L1~L4椎体前缘高度和投影面积,判断腰椎压缩性骨折的发生率。结果 800例老年骨质疏松身高变矮≥3 cm的患者,其腰椎压缩性骨折的发生率为81.5%;年龄增加骨折发生率升高,55~65岁组为10.58%,66~75岁组为27.24%,76~85岁组为61.38%。脾肾两虚兼血瘀型是压缩性骨折的高发证型,发生率为69.79%,高于肝肾不足型(6.55%)和脾肾两虚型(19.31%),差异有统计学意义(P﹤0.01)。结论骨质疏松身高变矮患者腰椎压缩性骨折发生率随增龄而递增,脾肾两虚兼血瘀是骨质疏松致腰椎压缩性骨折的高发证型。

Objective To study the relationship between the onset of lumbar compression fractures with age and TCM syndromes in osteoporosis patients. Methods 800 patients diagnosed as osteoporosis aged between 55 and 85 were grouped into liver and kidney deficiency syndrome,spleen and kidney deficiency syndrome,and spleen and kidney deficiency syndrome; those primary osteroposis patients with height lose≥3 cm were given L1-L4 lumbar vertebral bone mineral density BMD value measurement（ France MEDILINK dual light energy Xray absorptiometry,DEXA）,combined with X-ray Genant semi-quantitative method to measure the lumbar L1 ~ L4 anterior vertebral height and projection area and determine the incidence of lumbar compression fracture. Results Among 800 cases of elderly osteoporosis with height lose≥3 cm,the incidence of lumbar compression fracture was 81. 5%. In fracture patients,the fracture incidence was increased with ages as it was 10. 58% in 55-65 year-old group,27. 24% in 66-75 year-old group,and 61. 38% in 76-85 year-old group. Syndrome of spleen and kidney deficiency accompanied with blood stasis had the highest incidence of it of 69. 79%,much higher than that of syndrome of liver and kidney deficiency（ 6. 55%） and syndrome of spleen and kidney deficiency（ 19. 31%）; and the differences were statistically significant（ P〈0. 01）. Conclusion The incidence of lumbar compression fracture in patients with primary osteoporosis is increased with ages,syndrome of spleen and kidney deficiency with blood stasis has the highest fracture rate among three TCM syndromes.