补肾健脾通络方结合五行健骨操对老年骨质疏松脾肾两虚证患者骨密度、骨代谢及炎症水平的影响

Effects of Bushen Jianpi Tongluo formula combined with five elements bone-building exercises on bone mineral density,bone metabolism and inflammation in elderly patients with spleen-kidney deficiency syndrome of osteoporosis

目的:观察补肾健脾通络方结合五行健骨操对老年骨质疏松脾肾两虚证患者骨密度、骨代谢及炎症水平的影响。方法:选取100例老年骨质疏松脾肾两虚证患者,采用简单随机法分为两组。西药组给予碳酸钙D_(3)联合骨化三醇治疗,综合组在西药组基础上给予补肾健脾通络方结合五行健骨操干预。比较两组治疗前后动态平衡、骨密度、骨代谢、炎症水平及中医症候积分差异,统计不良反应。结果:综合组治疗后睁眼和闭眼的动态平衡参数低于西药组(均P<0.05)。综合组股骨颈和腰椎骨密度(BMD)及骨钙素(BGP)、总Ⅰ型前胶原氨基端前肽(T-PINP)、25-(OH)D_(3)治疗后较治疗前升高,综合组治疗后高于西药组(均P<0.05)。综合组C反应蛋白(CRP)、β-胶原特殊序列(β-CTX)、巨噬细胞集落刺激因子(M-CSF)、肿瘤坏死因子-α(TNF-α)治疗后较治疗前降低,综合组治疗后低于西药组(均P<0.05)。综合组中医症候积分治疗后较治疗前降低,综合组治疗后低于西药组(均P<0.05)。两组不良反应比较,差异无统计学意义(P>0.05)。结论:补肾健脾通络方结合五行健骨操可减轻老年骨质疏松脾肾两虚证患者炎症反应,改善骨密度和骨代谢,提高平衡功能。

Objective:To observe the effects of Bushen Jianpi Tongluo formula combined with five elements bone-building exercises on bone mineral density,bone metabolism and inflammation in elderly patients with spleen-kidney deficiency syndrome of osteoporosis.Methods:A total of 100 elderly patients with spleen-kidney deficiency syndrome of osteoporosis were divided into two groups by simple random method.The western medicine group was treated with calcium carbonate D_(3) combined with calcitriol,and the comprehensive group was treated with Bushen Jianpi Tongluo formula combined with five elements bone-building exercises on the basis of western medicine group.Dynamic balance,bone mineral density,bone metabolism,inflammation level and TCM syndrome score were compared before and after treatment,and adverse reactions were counted.Results:After treatment,the dynamic balance parameters of open and closed eyes in comprehensive group were lower than those in western medicine group(all P<0.05).Bone density(BMD),osteocalcin(BGP),total type Ⅰ procollagen amino terminal propeptide(T-PINP) and 25-(OH)D_(3) in the comprehensive group were higher after treatment than before treatment,and those in the comprehensive group were higher than those in the western medicine group(all P<0.05).C-reactive protein(CRP),β-collagen special sequence(β-CTX),macrophage colony-stimulating factor(M-CSF) and tumor necrosis factor-α(TNF-α) in the comprehensive group were lower after treatment than before treatment,and those in the comprehensive group were lower than those in the western medicine group(all P<0.05).After treatment,the TCM syndrome score of comprehensive group was lower than that before treatment,and that of comprehensive group was lower than that of western medicine group(all P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Bushen Jianpi Tongluo formula combined with five elements bone-building exercises can reduce inflammation in elderly patients with osteoporosis,improve bone mineral density and bone metabolism,and enhance balance function.