苁蓉牛膝汤加味联合阿仑膦酸钠治疗骨质疏松症的效果及对骨折发生率的影响

Modified Congrong-niuxi decoction combined with alendronate sodium in the treatment of osteoporosis and its influence on incidence rate of fracture

目的 探讨苁蓉牛膝汤加味联合阿仑膦酸钠治疗骨质疏松患者的效果及骨折风险。方法 我院94例骨质疏松症患者,按就诊序号单双号分为研究组(苁蓉牛膝汤加味联合阿仑膦酸钠治疗)与对照组(仅阿仑膦酸钠治疗)各47例,疗程均为12周。比较两组用药前后中医症候积分、骨特异性碱性磷酸酶(BAP)、I型胶原C端肽(CTX-1)、骨型碱性磷酸酶(BALP)及全甲状旁腺素(iPTH)变化;测量并比较两组用药前后骨密度变化;比较两组用药前后肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)及白介素-6(IL-6)变化;使用视觉模拟评分法(VAS)评价两组用药前后躯体疼痛变化情况;随访半年,统计两组骨折发生情况。结果 用药后研究组腰背疼痛、四肢酸软、头晕目眩及肌肉无力等中医症候积分低于对照组(P<0.05);BAP、BLAP、CTX-1及iPTH水平低于对照组(P<0.05);股骨颈、L2-4、髋关节及Wards三角区骨密度高于对照组(P<0.05);TNF-α、hs-CRP及IL-6水平低于对照组(P<0.05);用药后3、6、12周研究组疼痛评分低于对照组(P<0.05);研究组骨折发生率低于对照组(P<0.05)。结论 针对骨质疏松症患者,采用苁蓉牛膝汤加味联合阿仑膦酸钠进行治疗,可明显改善患者腰背疼痛、四肢酸软等症状,促进骨密度与骨代谢的恢复,减轻炎症反应,有助于预防骨折发生。

Objective To explore the effect of modified Congrong-niuxi decoction combined with alendronate sodium in the treatment of patients with osteoporosis and the fracture risk.Methods Ninety-four patients with osteoporosis in our hospital were classified into a study group and a control group by means of the admission sequence odd-even numbers, 47 in each group. The study group was treated with modified Congrong-niuxi decoction combined with alendronate sodium and the control group was treated with alendronate sodium alone. All the patients were treated for 12 weeks. The TCM syndrome scores and changes in bone-specific alkaline phosphatase(BAP), type I collagen C-terminal peptide(CTX-1), bone alkaline phosphatase(BALP) and intact parathyroid hormone(iPTH) were compared before and after medication between the two groups. The changes in bone mineral density were measured and compared before and after medication between the two groups. Levels of tumor necrosis factor-α(TNF-α), high-sensitivity C-reactive protein(hs-CRP) and interleukin-6(IL-6) before and after medication were also compared. Visual Analogue Score(VAS) was used to evaluate the body pain before and after medication. The occurrence of fracture in both groups was statistically analyzed after half a year of follow-up.Results The TCM syndrome scores such as waist soreness, lower limb weakness, light-headedness and muscle weakness in the study group after medication were lower when compared to the control group. The levels of BAP, BLAP, CTX-1 and iPTH in the study group were lower than those in the control group. The bone mineral densities of the femoral neck, L2-4, hip joint and Wards triangle area were higher while the levels of TNF-α, hs-CRP and IL-6 were lower in the study group than those in the control group(P<0.05). The pain score was lower in the study group at 3, 6 and 12 weeks after medication when compared to the control group(P<0.05). The fracture incidence in the study group was lower than that in the control group(P<0.05).Conclusion For patients with osteoporosis, treatment regimen with modified Congrong-niuxi decoction combined with alendronate sodium can markedly improve the symptoms such as waist soreness and lower limb weakness, promote the recovery of bone mineral density and bone metabolism, alleviate the inflammatory response and help prevent the occurrence of fracture.