中医综合疗法联合运动干预治疗老年绝经后骨质疏松症临床研究

Clinical study on traditional Chinese medicine comprehensive therapy combined with exercise intervention in the treatment of elderly postmenopausal osteoporosis

目的:观察中医综合疗法联合运动干预治疗老年绝经后骨质疏松症(OP)的临床效果。方法:选取75例老年绝经后OP患者作为观察对象,按照随机数字表法将其分为治疗组(n=38,抗骨质疏松膏方+肾腧穴、脾腧穴埋线+运动干预+利塞膦酸钠片治疗)、对照组(n=37,运动干预+利塞膦酸钠片治疗)。治疗6个月后,评估两组临床疗效。比较治疗前、治疗6个月后两组中医证候积分(腰背疼痛、腰膝酸软、下肢疼痛、下肢痿弱、步履艰难)、疼痛程度[视觉模拟评分法(VAS)]、骨代谢指标[骨钙素(OC)、Ⅰ型原胶原N-端前肽(PINP)、β-胶原降解产物(β-CTX)]、生活质量[简明健康状况调查问卷(SF-36)]水平及不同部位骨密度(BMD)(腰椎L_(1~4)、股骨颈)水平。结果:治疗组临床总有效率97.37%,高于对照组的83.78%(P<0.05)。治疗前,两组各临床指标比较差异无统计学意义(P>0.05);治疗6个月后,治疗组各中医证候积分、VAS评分、血清OC、PINP、β-CTX水平均低于对照组(P<0.05);治疗组SF-36评分和腰椎L_(1~4)、股骨颈BMD水平高于对照组(P<0.05)。结论:中医综合疗法联合运动干预治疗老年绝经后OP患者效果显著,可改善患者临床症状,减轻疼痛,提升骨代谢水平,增加BMD,提高生活质量,值得临床应用。

Objective:To observe the clinical effects of traditional Chinese medicine(TCM)comprehensive therapy combined with exercise intervention in the treatment of elderly postmenopausal osteoporosis(OP).Methods:75 elderly patients with postmenopausal OP were divided into treatment group(n=38,anti-osteoporosis ointment+catgut embedding at kidney acupoint and spleen acupoint+exercise intervention+risedronate sodium tablets)and control group(n=37,exercise intervention+isedronate sodium tablets)according to the random number table method.After 6 months of treatment,the clinical efficacy of the two groups was evaluated.The scores of TCM syndromes(lumbago and back pain,soreness and weakness of waist and knees,lower extremity pain,lower extremity atrophy,difficulty walking,dizziness),pain level[Visual Analogue Scale(VAS)],bone metabolism indicators[osteocalcin(OC),procollagen type 1 N-terminal propeptide(PINP),β-collagen degradation product(β-CTX)],quality of life[MOS 36-item Short-Form Health Survey(SF-36)]and bone mineral densities(BMD)in different parts(lumbar spine L_(1~4),femoral neck)were compared among the two groups before treatment and after 6 months of treatment.Results:The clinical total effective rate of 97.37%in treatment group was higher than 83.78%in control group(P<0.05).Before treatment,there were no statistical differences in the clinical indicators between the two groups(P>0.05).After 6 months of treatment,the scores of TCM syndromes,VAS score and levels of serum OC,PINP andβ-CTX were lower in treatment group than those in control group(P<0.05).The SF-36 score and BMD of lumbar spine L_(1~4)and femoral neck in treatment group were higher compared to control group(P<0.05).Conclusion:TCM comprehensive therapy combined with exercise intervention has significant effects in the treatment of elderly patients with postmenopausal OP,and it can improve the clinical symptoms,relieve the pain,enhance the bone metabolism,increase the BMD,and promote the quality of life.