综合干预方案调治绝经后骨质疏松症患者血瘀质的临床研究

Clinical Study on Treating Postmenopausal Osteoporosis of Blood Stagnation Constitution with Comprehensive Intervention Regimen

目的:探讨综合干预方案调治绝经后骨质疏松症(postmenopausal osteoporosis,PMOM)患者血瘀质的临床疗效。方法:将血瘀质PMOM患者100例按随机数字表法分为2组各50例,对照组给予碳酸钙D3片+骨化三醇胶丸+依降钙素注射液治疗,试验组在对照组基础上采用综合干预方案(八段锦+中医药膳+活血胶囊)治疗。2组均连续治疗1年。分别于治疗前及治疗3月、6月、12月后测定2组患者血瘀质积分、VAS评分及骨转换生化标志物[血清骨钙素(BGP)、尿脱氧吡啶啉/肌酐(DPD/Cr)],并测量2组患者治疗前及治疗6月、12月后腰椎(L2~4)骨密度T值,同时观察2组患者治疗期间不良反应发生情况。结果:2组患者治疗3月、6月、12月后血瘀质积分、VAS评分、DPD/Cr含量较治疗前均有不同程度下降,试验组下降幅度较对照组明显,差异有统计学意义(P<0.05);BGP含量、骨密度T值较治疗前均有不同程度升高,试验组上升幅度较对照组明显,差异有统计学意义(P<0.05);治疗期间2组患者均无不良反应发生。结论:采用综合干预方案调治血瘀质PMOM能够改善患者血瘀体质、缓解腰背部疼痛、改善骨代谢、增加骨密度。

Objective:To discuss clinical effects of comprehensive intervention regimen in the treatment for postmenopausal osteoporosis(PMOM).Methods:All 100 PMOM patients were allocated to two groups according to random number table method,the control group were treated with calcium carbonate D3 tables+calcitriol soft capsules+elcatonin injection,the experiment group adopted comprehensive intervention regimen(eight-sectioned exercise+TCM diet+blood-activating capsules)on the foundation of the therapy the control group received.Both groups were treated for one year consecutively.To detect the integrals of blood stagnation constitution,VAS scores,biochemical markers of bone turnover[serum bone gla protein(BGP),urinary deoxypyridinoprid/creatinine(DPD/Cr)before treating,in 3,6 and 12 months after treating of both groups respectively,to measure bone mineral density(BMD)of lumbar vertebra(L2~4)before treating,in 6 and 12 months after treating between both groups,to observe the incidence of adverse reaction simultaneously between both groups during therapeutic period.Results:Constitutional integrals,VAS scores,DPD/Cr contents of both groups in 3,6 and 12 months after treating decreased to different extents than before treating,the decrease of the experiment group was more notable than that of the control group,and the difference was statistically significant(P<0.05).BGP contents and BMD values raised partly,the rise of the experiment group was more obvious than that of the control group,and the difference had statistical meaning(P<0.05);no adverse reaction happened in both groups during therapeutic period.Conclusion:Comprehensive intervention regimen in the treatment for PMOM patients could improve the constitution,relieve lumbar and back pain,raise bone metabolism and increase BMD.