阿仑膦酸钠联合金天格胶囊对女性骨质疏松症患者骨代谢指标的影响

Effect of alendronate combined with Jintiange capsules on bone metabolic markers in female patients with osteoporosis

目的探讨阿仑膦酸钠联合金天格胶囊对女性骨质疏松症患者骨代谢指标的影响。方法选取2015年2月至2018年2月重庆市长寿区人民医院收治的5075岁女性骨质疏松症患者160例。依据就诊序号将患者分为观察组和对照组,各80例。2组患者均常规补充钙剂,对照组给予阿仑膦酸钠片口服治疗,观察组在对照组基础上联合金天格胶囊口服治疗,2组均连续用药8个月。比较2组治疗后的临床疗效、治疗前后腰椎L24和股骨颈的骨密度、骨代谢指标水平变化及不同状态时腰背痛程度,观察治疗期间不良反应发生情况。结果治疗后观察组总有效率明显高于对照组[95. 0%(76/80)比85. 0%(68/80)](χ^2=4. 444,P=0. 035)。与治疗前比较,治疗后观察组腰椎L24及股骨颈骨密度均明显增加,且明显大于对照组[(0. 81±0. 27)g/cm3比(0. 72±0. 20)g/cm^3、(0. 79±0. 26)g/cm^3比(0. 71±0. 11)g/cm^3](均P <0. 05)。与治疗前比较,治疗后2组血清骨钙素、骨特异性碱性磷酸酶及25-羟基维生素D3水平均明显升高,且观察组明显高于对照组[(21. 1±3. 0)μg/L比(15. 9±2. 3)μg/L、(48. 9±3. 0)μg/L比(24. 8±2. 6)μg/L、(38±4)μg/L比(26±4)μg/L](P <0. 05或P <0. 01);2组Ⅰ型胶原C末端肽水平均明显降低,且观察组明显低于对照组[(0. 23±0. 06)μg/L比(0. 53±0. 12)μg/L](均P <0. 01)。与治疗前比较,治疗后2组静息时、翻身时及前屈后伸时疼痛视觉模拟量表评分均明显降低,且观察组明显低于对照组[(2. 4±0. 9)分比(3. 9±1. 2)分、(2. 5±1. 3)分比(4. 1±1. 9)分、(2. 4±1. 2)分比(4. 0±1. 3)分](均P <0. 01)。治疗期间2组均未出现明显不良反应。结论阿仑膦酸钠联合金天格胶囊可更明显地降低女性骨质疏松症患者疼痛程度,调节骨代谢,增加骨密度,安全有效。

Objective To explore the clinical efficacy of alendronate combined with Jintiange capsules in the treatment of female osteoporosis and the influence on bone metabolic markers. Methods A total of 160 women aged 50-75 years with osteoporosis admitted to People’ s Hospital of Changshou Chongqing from February 2015 to February 2018 were divided into experiment group and control group according to the number of admission,with80 cases in each group. Both groups had routine calcium supplement;the control group took alendronate;the experiment group took alendronate and Jintiange capsules. Clinical efficacy was assessed after 8 months of treatment. Bone mineral density( BMD) of lumbar vertebrae L24 and femoral neck,levels of bone metabolic markers and degree of backache were determined before and after treatment. Adverse reactions were observed during treatment. Results The total effective rate in experiment group was significantly higher than that in control group[95. 0%(76/80) vs 85. 0%(68/80)](χ^2= 4. 444,P = 0. 035). After treatment,BMD values of lumbar vertebrae L24 and femoral neck significantly increased in experiment group and they were significantly higher than those in control group[(0. 81 ± 0. 27)g/cm^3 vs(0. 72 ± 0. 20) g/cm^3,(0. 79 ± 0. 26)g/cm^3 vs(0. 71 ± 0. 11) g/cm^3](all P < 0. 05). Levels of serum osteocalcin,bone-specific alkaline phosphatase and 25-hydroxyvitamin D3 significantly increased after treatment in both groups;the levels in experiment group were significantly higher than those in control group[(21. 1 ± 3. 0)μg/L vs(15. 9 ± 2. 3)μg/L,(48. 9 ± 3. 0)μg/L vs(24. 8 ± 2. 6)μg/L,(38 ± 4)μg/L vs(26 ± 4)μg/L](P < 0. 05 or P < 0. 01);CTX-Ⅰ level significantly decreased in both groups and it was significantly lower in experiment group than that in control group [( 0. 23 ± 0. 06)μg/L vs(0. 53 ± 0. 12)μg/L](P < 0. 01). Scores of Visual Analogue Scale for backache during resting,turhing over,flexion and extension significantly decreased after treatment in both groups;the scores in experiment group were significantly lower than those in control group [( 2. 4 ± 0. 9) vs( 3. 9 ± 1. 2),( 2. 5 ± 1. 3) vs( 4. 1 ± 1. 9),(2. 4 ± 1. 2) vs(4. 0 ± 1. 3)]( all P < 0. 01). There was no significant adverse reaction occurring during treatment. Conclusion Alendronate combined with Jintiange capsules treating female osteoporosis can effectively relieve pain,regulate bone metabolism and increase BMD;the safety is satisfactory.