补肾健脾通络方治疗老年骨质疏松症的临床疗效

Clinical Observation and Mechanism of Bushen Jianpi Tongluo Fang in Treating Senile Osteoporosis

目的:探讨补肾健脾通络方治疗老年骨质疏松症的临床疗效。方法:选取2016年4月至2017年2月山东大学齐鲁医院门诊及住院部收治的骨质疏松症患者80例。按照随机数字表法随机分为观察和对照组,每组40例,对照组患者口服复方氨基酸螯合钙,1粒/次,1次/d;静脉滴注锝[99Tc]亚甲基二磷酸盐注射液,1次/d;观察组在对照组的基础上加用补肾健脾通络方,开水冲服,早晚各1次。10 d为1个疗程,观察3个疗程。治疗前后采用视觉模拟评分法(VAS)评估患者的疼痛程度。治疗前后采用骨密度扫描仪测量骨密度。采用全自动生化仪检测血钙、血磷、血碱性磷酸酶;运用酶联免疫吸附试验(ELISA)检测2组患者治疗前后外周血巨噬细胞集落刺激因子(M-CSF)。结果:治疗后2组VAS疼痛评分均降低(P <0. 05),观察组优于对照组(P <0. 05),观察组总有效率(90. 00%)优于对照组(72. 50%)(P <0. 05)。治疗后2组仅血钙较治疗前升高(P <0. 05)且观察组优于对照组(P <0. 05),血磷、血碱性磷酸酶组间、组内差异均无统计学意义(P> 0. 05)。治疗后2组M-CSF均降低(P <0. 05),观察组优于对照组(P <0. 05)。结论:补肾健脾通络方有效改善老年骨质疏松症的临床症状,其机制可能与血钙的升高和M-CSF的降低有关。

Objective：To investigate the clinical effects and mechanisnl of Bushen Jianpi Tongluo Fang in the treatment of senile osteoporosis. Methods ：A total of 80 patients with osteoporosis adnfitted in our hospital from April 2016 to February 2017 were se- lected and randomly divided into observation group and control group, with 40 cases in each group. The control group ： oral calcium 1 capsule/time, 1 time/day; intravenous infusion of Yunke 1 time/day; the observation group was received Bushen Jianpi Tongluo Decoction based on the control group, 1 time in the morning and evening. 10 days as a course of treatment, and 3 courses were observed. VAS pain score scale was used to assess the degree of pain before and after treatment. Bone nfineral density was measured before and after treatment. Automatic biochenfical analyzer was used to detect serum caleium, serum phosphorus, serum alkaline phosphatase; Enzyme-linked immunosorbent assay （ELISA） was applied to detect concentration changes of peripheral blood mac- rophage colonystimulating factor （M-CSF） in two groups before and after treatment. Results：l ） After treatment, the VAS pain scores of the two groups were decreased （P 〈 0. 05）, and the observation group was better than the control group （P 〈 0. 05）. The total effective rate of the observation group （90%） was better than that of the control group （72. 50% ） （P 〈0. 05）. 2） Only cal- cium increased of two group after treatment （P 〈 0. 05）, and the observation group was better than the control group （ P 〈 0. 05）. The sermn phosphorus, sermn alkaline phosphatase within and between groups were not significantly different （ P 〉 0. 05 ）. 3 ） MCSF in both groups decreased after treatment （P 〈 0.05 ） , and the observation group was better than the control group （P 〈 0. 05 ）. Conclusion：The clinical symptoms of Bushen Jianpi Tongluo Decoction can effectively improve senile osteoporosis, and the mechanism may be associated with reduced serum calcium and the increase of M-CSF.