益元壮骨膏方治疗肝肾阴虚型原发性骨质疏松症临床效果及对骨密度的影响

Clinical Efficacy of Yiyuan Zhuanggu Ointment in the Treatment of Patients with Primary Osteoporosis of Liver-kidney Yin Deficiency Type and Its Effects on Bone Mineral Density

目的观察益元壮骨膏方治疗肝肾阴虚型原发性骨质疏松症(OP)患者临床效果及对骨密度(BMD)的影响。方法回顾性分析2017年10月—2021年6月收治的肝肾阴虚型原发性OP 106例的临床资料。按照治疗方法分为观察组和对照组各53例。对照组给予碳酸钙D_(3)片和骨化三醇胶丸治疗,观察组在对照组基础上给予益元壮骨膏方治疗。观察2组临床效果,比较治疗前、治疗6个月后2组中医证候积分、疼痛程度、不同部位BMD、骨代谢指标水平。结果观察组总有效率高于对照组(P<0.05)。治疗后6个月,2组各中医证候积分、视觉模拟评分法评分、血清骨碱性磷酸酶、抗酒石酸酸性磷酸酶-5b、Ⅰ型原胶原N-端前肽水平均较治疗前降低,且观察组低于对照组(P<0.05)。2组L_(2~4)、股骨颈、股骨大转子BMD及血清骨钙素水平均较治疗前升高,且观察组高于对照组(P<0.05)。结论益元壮骨膏方治疗肝肾阴虚型原发性OP效果显著,能有效改善患者中医证候,减轻疼痛,增加BMD,提升骨代谢水平。

Objective To observe the clinical efficacy of Yiyuan Zhuanggu Ointment in the treatment of patients with primary osteoporosis(OP)of liver-kidney yin deficiency type and its effects on the level of bone mineral density(BMD).Methods The clinical data of 106 patients with primary OP of liver kidney yin deficiency type admitted from October 2017 to June 2021 were analyzed retrospectively.According to the treatment methods,they were divided into the observation group(n=53)and the control group(n=53).The control group was treated with Calcium Carbonate D_(3) Tablets and Calcitriol Capsules,and the observation group was treated with Yiyuan Zhuanggu Ointment on the basis of the control group.The clinical effects of the two groups were observed,and the TCM syndrome score,pain severity,BMD in different parts of body,and bone metabolism index levels of the two groups were compared before and at 6 months after treatment.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).At 6 months after treatment,the TCM syndrome score,visual analogue scale(VAS)score,serum bone alkaline phosphatase,tartrate resistant acid phosphatase-5b,and N-terminal propeptide of typeⅠprocollagen in both groups were lower than those before treatment,and lower in the observation group than in the control group(P<0.05).The levels of L_(2-4),femoral neck,femoral trochanter BMD and serum osteocalcin in both groups were higher than those before treatment,and higher in the observation group than in the control group(P<0.05).Conclusion Yiyuan Zhuanggu Ointment has a significant effect in the treatment of primary OP of liver-kidney yin deficiency type,and can effectively improve TCM syndromes,reduce pain level,increase BMD,and enhance bone metabolism.