仙灵骨葆胶囊联合钙剂治疗COPD缓解期患者继发骨质疏松症的临床研究

Clinical study of Xianling Gubao capsule combined with calcium in the treatment of secondary osteoporosis of COPD

目的分析钙剂联合仙灵骨葆胶囊对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者继发骨质疏松症的临床疗效。方法选取2016年1月至2017年10月在某三甲医院呼吸内科门诊及住院部收治的COPD缓解期并经确诊为继发骨质疏松症患者100例。按照随机数字表法分成观察组和对照组,每组50例。对照组口服碳酸钙D3片每天1片,观察组在上述治疗基础上于餐后口服仙灵骨葆胶囊治疗,1次3粒,1日2次,两组连续治疗3个月。比较两组治疗前后血清C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、Ⅰ型胶原羧基端肽β特殊序列(β-C-terminal telopeptide of type I collagen,β-CTX)、碱性磷酸酶(alkaline phosphatase,ALP)、骨钙素(osteocalcin,OC)、Ⅰ型前胶原氨基端前肽(N-terminal propeptide of typeⅠprocollagen,PINP)和骨密度(bone mineral density,BMD)水平的差异。结果治疗前,两组CRP、IL-6、TNF-α、β-CTX、ALP、OC、PINP、PINP/β-CTX和BMD水平差异均无统计学意义(均P>0.05);治疗后观察组CRP、IL-6、TNF-α、β-CTX、ALP、OC、PINP水平均低于对照组,组间比较差异均有统计学意义(均P<0.01),观察组PINP/β-CTX比值和BMD水平均显著高于对照组(均P<0.01)。结论与单用钙补充剂比较,钙补充剂联用仙灵骨葆胶囊能有效改善COPD缓解期患者骨代谢异常,调整骨代谢平衡,对COPD继发骨质疏松症有较好的治疗作用。

Objective To observe the clinical effect of Xianling Gubao capsule combined with calcium in the treatment of patients with secondary osteoporosis of chronic obstructive pulmonary disease(COPD).Methods A total of patients with secondary osteoporosis of COPD from January 2016 to October 2017 in our hospital were divided into control group and experimental group by the random number table,50 cases in each group.The control group was treated with calcium carbonate D3 tablet,1 tablet every day,and the experimental group was treated with Xianling Gubao capsule on the basis,3 capsules each time,2 times every day,treatment for 3 months.Serum C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),β-Cterminal telopeptide of type I collagen(β-CTX),alkaline phosphatase(ALP),osteocalcin(OC),N-terminal propeptide of typeⅠprocollagen(PINP),and bone mineral density(BMD)were examined and compared before and after treatment.Results Before treatment,there were no statistically significant differences in serum CRP,IL-6,TNF-α,β-CTX,ALP,OC,PINP,PINP/β-CTX,or BMD between the two groups(all P>0.05).After 3 months of treatment,the levels of serum CRP,IL-6,TNF-α,β-CTX,ALP,OC,PINP in the experimental group were significantly lower than those in the control group(all P<0.01),and PINP/β-CTX and BMD in the experimental group were significantly higher than those in the control group(both P<0.01).Conclusion Compared with calcium supplements alone,calcium supplements combined with Xianling Gubao capsule can effectively improve bone metabolism abnormalities in patients with stable COPD,adjust bone metabolism balance,and has a better therapeutic effect on secondary osteoporosis of COPD.