左归丸联合阿仑膦酸钠片治疗绝经后骨质疏松症的临床研究

Clinical Study of Zuogui Pills Combined with Alendronate Sodium Tablets in the Treatment of Postmenopausal Osteoporosis

目的探讨左归丸联合阿仑膦酸钠片治疗绝经后骨质疏松症的临床疗效及作用机制。方法选取2016年8月—2018年10月本院妇科收治的绝经后骨质疏松症患者102例,按照随机数字表法分为观察组和对照组,每组51例。对照组患者予以阿仑膦酸钠片口服治疗,观察组患者在对照组治疗基础上予以左归丸口服。比较2组患者治疗前后腰椎及股骨近端骨密度(BMD)水平变化,比较2组患者治疗前后血清抗酒石酸酸性磷酸酶-5b(TRACP-5b)及组织蛋白酶K(CTSK)水平变化,比较2组患者临床疗效。结果治疗后,2组患者腰椎及股骨近端BMD水平均较治疗前明显升高,且观察组显著高于对照组(P<0.05);2组患者血清TRACP-5b及CTSK水平均较治疗前明显下降,且观察组显著低于对照组(P<0.05);观察组患者临床治疗总有效率为92.16%,显著高于对照组的70.59%(P<0.05)。结论应用左归丸联合阿仑膦酸钠片治疗绝经后骨质疏松症患者可显著升高腰椎及股骨近端BMD水平,提高临床疗效,其治疗机制可能与降低血清TRACP-5b及CTSK水平有关。

Objective To explore the clinical efficacy and mechanism of Zuogui pills combined with alendronate sodium tablets in the treatment of postmenopausal osteoporosis. Methods From August 2016 to October 2018,one hundred and two patients with postmenopausal osteoporosis were selected and randomly divided into observation group and control group according to random digital table method,with 51 cases in each group.The patients in the control group were treated with alendronate sodium tablets orally,while the patients in the observation group were treated with Zuogui pills on the basis of the control group.The levels of bone mineral density(BMD) in lumbar vertebrae and proximal femur were compared before and after treatment between the two groups.The serum levels of tartrate-resistant acid phosphatase-5b(TRACP-5b)and cathepsin K(CTSK)were compared before and after treatment between the two groups.The clinical effects of the two groups were compared. Results After treatment,the levels of BMD in lumbar vertebrae and proximal femur in both groups were significantly higher than those before treatment,and the levels in the observation group were significantly higher than those in the control group( P <0.05).The levels of serum TRACP-5b and CTSK in both groups were significantly lower than those before treatment,and the level in the observation group was significantly lower than that in the control group( P <0.05).The total effective rate of the observation group was 92.16%,which was significantly higher than that in the control group(70.59%)( P <0.05 ). Conclusion The treatment of postmenopausal osteoporosis with Zuogui pills combined with alendronate sodium tablets can significantly increase the levels of BMD in lumbar vertebrae and proximal femur,and improve the clinical efficacy in patients.The mechanism may be related to the decreased of the serum levels of TRACP-5b and CTSK.