自拟补肾强骨汤治疗老年肝肾不足型风湿性关节炎合并骨质疏松患者的效果及对骨代谢、关节功能和炎症因子水平的影响

Effect of self-made Bushen Qianggu Decoction on bone metabolism,joint function and inflammatory factors in elderly patients with rheumatoid arthritis of liver and kidney insufficiency combined with osteoporosis

目的探究自拟补肾强骨汤治疗老年肝肾不足型风湿性关节炎(RA)合并骨质疏松(OP)患者的效果及对骨代谢、关节功能和炎症因子水平的影响。方法选取2021年1月至2022年12月上饶市人民医院收治的60例老年RA合并OP患者作为研究对象,按照随机数字表法分为试验组(n=30)和对照组(n=30)。对照组给予碳酸钙D3片+骨化三醇软胶囊联合锝[99Tc]亚甲基二膦酸盐注射液治疗,试验组在对照组的基础上配合使用自拟补肾强骨汤。比较两组患者的临床疗效,治疗前后的骨密度、骨代谢指标、关节功能及炎症因子水平变化,记录治疗期间不良反应的发生情况。结果试验组患者的治疗有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05);试验组患者治疗后的L2~L4椎体骨密度(BMD)、骨钙素(BGP)高于对照组,骨碱性磷酸酶(BALP)水平、关节功能指数(DAS28)低于对照组,差异有统计学意义(P<0.05);试验组患者治疗后的白细胞介素-6(IL-6)、C反应蛋白(CRP)及红细胞沉降率(ESR)低于对照组,差异有统计学意义(P<0.05);两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论自拟补肾强骨汤治疗老年肝肾不足型RA合并OP患者的疗效确切,可有效提高骨密度水平,改善骨代谢,恢复关节功能,降低炎症因子水平,且不良反应少。

Objective To explore the effect of self-made Bushen Qianggu Decoction on bone metabolism,joint function and inflammatory factors in elderly patients with rheumatoid arthritis(RA)of liver and kidney insufficiency combined with osteoporosis(OP).Methods A total of 60 elderly RA patients with OP admitted to Shangrao People's Hospital from January 2021 to December 2022 were selected as the research objects.According to the random number table method,they were divided into the experimental group(n=30)and the control group(n=30).The control group was treated with Calcium Carbonate D3 tablets+Calcitriol Soft Capsules combined with Technetium[99Tc]Methylenediphosphonate Injection,and the experimental group was treated with self-made Bushen Qianggu Decoction on the basis of the control group.The clinical efficacy,bone mineral density,bone metabolism index,joint function and inflammatory factor levels before and after treatment were compared between the two groups,and the adverse reactions during treatment were recorded.Results The effective rate of the experimental group was 93.33%,which was higher than 73.33%of the control group,and the difference was statistically significant(P<0.05).After treatment,the L2-L4 vertebral bone mineral density(BMD)and osteocalcin(BGP)of the experimental group were higher than those of the control group,and the bone alkaline phosphatase(BALP)level and joint function index(DAS28)were lower than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the interleukin-6(IL-6),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)of the experimental group were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).