摘要
目的探讨仙灵骨葆胶囊联合阿伦磷酸钠片对绝经后骨质疏松症(OP)伴肥胖症患者脂质代谢、骨代谢及骨密度(BMD)的影响。方法选取126例绝经后OP伴肥胖症患者,按照随机数字表法分为观察组和对照组,各63例。观察组口服仙灵骨葆胶囊、阿伦磷酸钠片,对照组仅口服阿伦磷酸钠片治疗,均持续用药6个月。治疗前后检测2组血清脂质代谢、骨代谢指标,采用视觉模拟疼痛(VAS)评分法评估骨骼疼痛症状。结果治疗后,观察组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、总Ⅰ型前胶原氨基端延长肽(TP1NP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、N-端骨钙素(N-OC)、甲状旁腺激素(PTH)、高密度脂蛋白胆固醇(HDL-C)、总维生素D(Vit-D)水平分别为(2.74±0.59)mmol·L^(-1)、(1.32±0.42)mmol·L^(-1)、(2.54±0.49)mmol·L^(-1)、(36.40±7.41)μg·L^(-1)、(0.51±0.15)pg·L^(-1)、(19.16±4.02)μg·L^(-1)、(4.56±0.79)pmol·L^(-1)、(1.15±0.19)mmol·L^(-1)及(57.76±9.69)nmol·L^(-1),对照组分别为(3.33±0.52)mmol·L^(-1)、(1.84±0.45)mmol·L^(-1)、(3.24±0.51)mmol·L^(-1)、(41.96±6.80)μg·L^(-1)、(0.63±0.16)pg·L^(-1)、(21.71±4.61)μg·L^(-1)、(5.60±0.82)pmol·L^(-1)、(1.07±0.20)mmol·L^(-1)及(51.96±8.80)nmol·L^(-1),观察组TC、TG、LDL-C、TP1NP、β-CTX、N-OC及PTH水平低于对照组,HDL-C、Vit-D水平高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组腰椎L2~4、左侧股骨近端、全胯BMD水平及VAS评分分别为(0.82±0.17)g·cm^(-2)、(0.77±0.10)g·cm^(-2)、(0.75±0.09)g·cm^(-2)及(0.99±0.29)分,对照组分别为(0.76±0.17)g·cm^(-2)、(0.70±0.11)g·cm^(-2)、(0.70±0.10)g·cm^(-2)及(1.46±0.41)分,观察组腰椎L_(2~4)、左侧股骨近端、全胯BMD水平较对照组升高,VAS评分较对照组降低,差异均有统计学意义(P<0.05)。结论仙灵骨葆胶囊联合阿伦磷酸钠片可改善绝经后OP伴肥胖症患者脂质代谢、骨代谢及BMD,对缓解骨骼疼痛有一定效果。
Objective To explore effects of Xianling Gubao Jiaonang combined with alendronateonlipid metabolism,bone metabolism and bone mineral density(BMD)in patients with postmenopausal osteoporosis(OP)and obesity.Methods 126 postmenopausal OP patients with obesity were randomly divided into observation group and control group,63 cases in each group.The experimental group was treated by oral administration of Xianling Gubao Jiaonang and alendronate tablets,while the control group was treated by oral administration of alendronate tablets alone,and the medication in the two groups lasted for 6 months.Serum indexes of lipid metabolism and bone metabolism were detected before and after treatment,and symptoms of bone pain were visual evaluated with the visual analogue scale(VAS)score.Results Before treatment,there was no significant difference in serum lipid metabolism and bone metabolism index levels between the two groups(P>0.05);after treatment,cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C)in the experimental group,total type I procollagen amino terminal extension peptide(TP1NP),type I collagen carboxy terminal peptideβspecial sequence(β-CTX),N-terminal osteocalcin(N-OC),parathyroid hormone(PTH),high-density lipoprotein cholesterol(HDL-C),and total vitamin D(Vit-D)levels were(2.74±0.59)mmol·L^(-1),(1.32±0.42)mmol·L^(-1),(2.54±0.49)mmol·L^(-1),(36.40±7.41)μg·L^(-1),(0.51±0.15)pg·L^(-1),(19.16±4.02)μg·L^(-1),(4.56±0.79)pmol·L^(-1),(1.15±0.19)mmol·L^(-1),(57.76±9.69)nmol·L^(-1),the control group were(3.33±0.52)mmol·L^(-1),(1.84±0.45)mmol·L^(-1),(3.24±0.15)mmol·L^(-1),(41.96±6.80)μg·L^(-1),(0.63±0.16)pg·L^(-1),(21.71±4.61)μg·L^(-1),(5.60±0.82)pmol·L^(-1),(1.13±0.20)mmol·L^(-1),(51.96±8.80)nmol·L^(-1),The levels of TC,TG,LDL-C,TP1NP,β-CTX,N-OC and PTH in the observation group were lower than those in the control group,while the levels of HDL-C and Vit-d in the observation group were higher than those in the control group(P<0.05).After treatment,the BMD and VAS scores of lumbar L2-4,left proximal femur and full hip in the observation group were(0.82±0.17)g·cm^(-2),(0.77±0.10)g·cm^(-2),(0.75±0.09)g·cm^(-2) and(0.99±0.29)scores,while those in the control group were(0.76±0.17)g·cm^(-2),(0.70±0.11)g·cm^(-2),(0.70±0.10)g·cm^(-2) and(1.46±0.41)scores,the BMD of lumbar L_(2-4),left proximal femur and whole hip in the observation group were higher than those in the control group,and the VAS score was lower than that in the control group(P<0.05).Conclusion Xianling Gubao Jiaonang combined with alendronate can improve lipid metabolism,bone metabolism and BMD in postmenopausal OP patients with obesity,and has a certain effect on relieving bone pain.
作者
蔡成
何光亮
CAI Cheng;HE Guangliang(Department of Orthopedic, the Second People’s Hospital of Anyang, Anyang Henan 455000,China)
