联合药物治疗对骨质疏松骨折术后骨痛的疗效观察

Effect of combined medication on osteoporotic bone pain after osteoporotic fracture surgery

目的考察联合用药对骨质疏松骨折患者术后骨痛的缓解作用。方法纳入2015年1月至2016年12月73例原发性骨质疏松合并胸腰椎压缩骨折伴骨痛的患者作为研究对象。患者均经手术治疗,术后应用基础抗骨质疏松药物(碳酸钙D_3及活性维生素D_3)。将73例患者随机分为A、B两组,A组(37例)术后在应用基础抗骨质疏松药物的基础上加用阿仑磷酸钠片,B组(36例)加用阿仑磷酸钠片和依降钙素。比较两组治疗前及治疗6个月后的骨痛情况、骨密度及不良反应发生情况。结果 A、B两组治疗6个月后的骨痛VAS评分分别为(2.39±0.73)分和(1.05±0.34)分,均较治疗前[分别为(4.58±0.97)分和(4.62±1.04)分]显著改善(P<0.05),且B组改善更为明显(P<0.05)。治疗6个月后A组与B组的腰椎骨密度分别为(0.815±0.140)g/cm^2和(0.794±0.112)g/cm^2,均较治疗前[分别为(0.709±0.126)g/cm^2和(0.713±0.130)g/cm^2]显著改善(P<0.05),但两组间比较差异无显著性(P>0.05)。两组药物不良反应均较轻,血清钙、磷水平无明显异常。结论联合用药可改善骨质疏松骨折患者术后的骨痛,增加骨密度,且药物不良反应轻。

Objective To investigate the clinical efficacy of combined medication on bone pain after osteoporotic fracture surgery. Method From January 2015 to December 2016, 73 patients with primary osteoporosis combined with vertebral compression fractures and bone pain were treated in our department. All patients were treated with surgery and postoperative basic anti OP drugs. The patients were randomly divided into group A（37 cases, taking alendronate tablets） and group B（36 cases taking alendronate sodium and calcitonin）. The bone pain, bone mineral density and adverse reactions were compared between the two groups before and after operation. Result Compared with the treatment before of them [（4.58±0.97） and（4.62±1.04） respectively], VAS pain scores in the group A and group B were（1.05±0.34） and（2.39±0.73） respectively, they were all significantly improved（P〈0.05）, and in group B it was improved more significantly（P〈0.05） than that in group A. After 6 months of treatment lumbar bone mineral density（g/cm-2） in group A and group B were respectively（0.815±0.140） and（0.794±0.112）, they were significantly improved（P〈0.05） comparing with the treatment before of them [（0.709±0.126） and（0.713±0.130） respectively], but the difference between the two groups was not statistically significant（P〈0.05）. The adverse drug reactions in the two groups were all small, and the serum calcium and phosphorus results were all not abnormal. Conclusion Combination of anti OP drugs can improve the bone pain in patients with osteoporotic fracture, increase their bone mineral density by continuous medication, and has little adverse drug reactions.