中药盐敷治疗脾肾亏虚型老年骨质疏松性腰背痛临床研究

A clinical study on salt application of traditional Chinese medicine in the treatment of senile osteoporotic low back pain with deficiency of spleen and kidney

目的:观察中药盐敷对脾肾亏虚型老年骨质疏松性腰背痛患者的临床疗效。方法:选取脾肾亏虚型老年骨质疏松性腰背痛患者180例,按就诊的先后顺序予编号,采用随机抽签法分为观察组(60例)、对照组Ⅰ(60例)、对照组Ⅱ(60例)。三组均予基础治疗,其中,观察组加予中药盐敷治疗,对照组Ⅰ加予空白盐敷治疗,对照组Ⅱ加予塞来昔布胶囊联合阿仑膦酸钠片治疗。疗程为1个月,观察三组临床疗效、骨密度、中医证候积分、腰背痛视觉模拟评分法(Visual Analogue Scale,VAS)评分、生化指标。结果:治疗结束后,观察组总有效率高于对照组Ⅰ、Ⅱ,差异有统计学意义(P<0.05)。三组的腰背痛VAS评分、中医证候积分较治疗前均有所降低,差异有统计学意义(P<0.05);组间比较显示,观察组治疗后的腰背痛VAS评分高于对照组Ⅱ,差异无统计学意义(P>0.05),但是明显低于对照组Ⅰ,差异有统计学意义(P<0.05)。观察组的中医证候积分明显低于对照组Ⅰ、Ⅱ,差异有统计学意义(P<0.05)。组内比较显示,观察组和对照组Ⅱ治疗后的血清骨钙素水平均较治疗前升高,两组的碱性磷酸酶水平均较治疗前降低,差异均有统计学意义(P<0.05);三组的骨密度与治疗前比较,差异无统计学意义(P>0.05);治疗后,三组的骨密度组间差异无统计学意义(P>0.05);比较观察组与对照组Ⅱ的骨钙素、碱性磷酸酶水平,组间差异均无统计学意义(P>0.05);但是观察组的骨钙素高于对照组Ⅰ,碱性磷酸酶水平低于对照组Ⅰ,差异均有统计学意义(P<0.05)。治疗后,三组的钙、磷水平的组间、组内比较,差异均无统计学意义(P>0.05)。结论:中药盐敷治疗脾肾亏虚型老年骨质疏松性腰背痛的临床效果显著,能有效降低疼痛评分、中医证候积分,改善骨钙素、碱性磷酸酶水平。

Objective:To observe the clinical effect of salt application of traditional Chinese medicine on senile osteoporotic low back pain with deficiency of spleen and kidney.Methods:A total of 180 elderly patients with osteoporotic low back pain of deficiency of spleen and kidney were randomly divided into the observation group(60 cases),the control group I(60 cases)and the control group II(60 cases).The three groups were given basic treatment.The observation group was treated by traditional Chinese medicine salt application,the control group I was treated by blank salt application,and the control group II was treated with celecoxib capsules plus alendronate sodium tablets.The course of treatment was 1 month.The clinical efficacy,bone mineral density,TCM syndrome score,VAS score of low back pain and biochemical indexes in the three groups were observed.Results:After treatment,the total effective rate in the observation group was higher than that in the control group I and II,and the differences were statistically significant(P<0.05).The VAS score and TCM syndrome score of low back pain in the three groups were lower than those before treatment,and the differences were statistically significant(P<0.05).The comparison between groups showed that the VAS score of low back pain in the observation group after treatment was higher than that in the control group II,the difference was not statistically significant(P>0.05),but it was significantly lower than that in the control group I,the difference was statistically significant(P<0.05).The TCM syndrome score in the observation group was significantly lower than the control group I and II(P<0.05).The comparison within each group showed that the serum osteocalcin level in the observation group and the control group II after treatment were higher than those before treatment,and the alkaline phosphatase level in the two groups were lower than those before treatment(P<0.05).There was no significant difference in bone mineral density among the three groups before treatment(P>0.05).After treatment,there was no significant difference in bone mineral density among the three groups(P>0.05).The levels of osteocalcin and alkaline phosphatase in the observation group and the control group II were not statistically significant(P>0.05).However,osteocalcin in the observation group was higher than that in the control group I,and the level of alkaline phosphatase was lower than that in the control group I,the difference was statistically significant(P<0.05).After treatment,there was no significant difference in the levels of calcium and phosphorus among and within the three groups(P>0.05).Conclusion:Salt application of traditional Chinese medicine has a significant clinical effect in the treatment of senile osteoporotic low back pain with deficiency of spleen and kidney.It can effectively reduce the pain score and TCM syndrome score,and improve the levels of osteocalcin and alkaline phosphatase.