绝经后骨质疏松症中医证型与握力的研究

Study on TCM syndromes and grip strength in postmenopausal osteoporosis

目的探讨绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)患者中医证型与握力的关系。方法选取2017年11月至2018年10月在济南各社区及山东中医药大学附属医院骨质疏松门诊纳入的绝经后骨质疏松症女性142例(骨质疏松组)、绝经后非骨质疏松症女性39例(非骨质疏松组)。依照中医辨证分型将骨质疏松组患者分为肝肾阴虚、脾肾阳虚及肾虚血瘀三型,采集所有受试者一般指标,研究握力在绝经后骨质疏松症中医证型上是否存在差异。结果骨质疏松组年龄、绝经年限高于非骨质疏松组,差异有统计学意义(P<0.05),骨质疏松组身高、体重、体质量指数(body mass index,BMI)、握力和骨密度(bone mineral density,BMD)水平均低于非骨质疏松组,差异有统计学意义(P<0.05)。三组中医证型的年龄、绝经年限、身高、BMI比较差异无统计学意义(P>0.05),肝肾阴虚组体重大于脾肾阳虚组,差异有统计学意义(P<0.05)。三组中医证型的握力由大到小依次为肝肾阴虚组、肾虚血瘀组、脾肾阳虚组,三组之间两两比较均有统计学意义(P<0.05)。结论脾肾阳虚型骨质疏松症患者握力较低,脾肾对肌力的影响具有普遍性的意义。

Objective To study the relationship between TCM syndromes and grip strength of postmenopausal osteoporosis(PMOP)patients.Methods Selected 142 cases of postmenopausal osteoporosis women(osteoporosis group)and 39 cases of postmenopausal non-osteoporosis women(non-osteoporosis group)included in Jinan communities and the osteoporosis clinics of Affiliated Hospital of Shandong University of Traditional Chinese Medicine from November 2017 to October 2018.According to the TCM syndrome differentiation,the patients in osteoporosis group were divided into three groups:Liver and kidney yin deficiency group,spleen and kidney yang deficiency group and kidney deficiency and blood stasis group,the general indicators of the subjects were collected.Study whether there is any difference in grip strength on the TCM syndromes of postmenopausal osteoporosis.Results The age and menopause years of the osteoporosis group were higher than those of the non-osteoporosis group(P<0.05).The height,weight,body mass index(BMI),grip strength and bone mineral density(BMD)of the osteoporosis group were lower than those of the non-osteoporosis group.The difference was statistically significant(P<0.05).There was no statistically significant difference in age,menopause years,height and BMI among the three groups of TCM syndromes(P>0.05).The weight of liver and kidney yin deficiency group was greater than that of spleen and kidney yang deficiency group(P<0.05).The three groups which the grip strength from large to small were liver and kidney yin deficiency group,kidney deficiency and blood stasis group,spleen and kidney yang deficiency group,and the comparison among the three groups was statistically significant(P<0.05).Conclusion The spleen and kidney yang deficiency osteoporosis patients had lower grip strength.The effect of spleen and kidney on the muscle strength was of universal significance.