云克联合维生素D3治疗脑卒中后骨质疏松症的临床效果观察

Clinical observation of Yunke combined with vitamin D3 in the treatment of osteoporosis caused by brain stroke

目的观察云克联合维生素D3治疗脑卒中后骨质疏松的临床疗效。方法将脑卒中后骨质疏松患者60例随机分为A、B、C组各20例。3组患者均常规使用碳酸钙D3片,在此基础上,A组给予云克联合维生素D3治疗,B组采用云克治疗,C组采用维生素D3治疗。分别检测治疗前及治疗3个月、6个月后3组患者的疼痛积分、血清25-(OH)D、骨钙素水平L2~4骨密度(BMD)及股骨颈BMD。结果治疗前3组VAS评分、1,25-(OH)2-VitD3水平、BGP水平、L2~4BMD及股骨颈BMD比较差异均无统计学意义(P>0.05);治疗后3个月3组VAS评分均低于治疗前,C组VAS评分高于A组和B组,治疗6个月后A组VAS评分低于B组和C组,且B组低于C组,差异均有统计学意义(P<0.05)。治疗3个月、6个月后3组1,25-(OH)2-VitD3水平均高于治疗前,A组高于B组,治疗后3个月、6个月3组骨钙素(BGP)水平均低于治疗前,差异有统计学意义(P<0.05),但组间比较差异均无统计学意义(P>0.05)。治疗后3个月、6个月3组L2~4BMD均高于治疗前,治疗后6个月A组高于B组和C组,差异均有统计学意义(P<0.05)。治疗前及治疗后3个月3组股骨颈BMD比较差异均无统计学意义(P>0.05);治疗后6个月3组股骨颈BMD高于治疗前,且A组高于B组和C组,差异有统计学意义(P<0.05)。结论云克联合维生素D3治疗脑卒中后骨质疏松临床疗效较好,为预防和治疗脑卒中后骨质疏松提供新思路。

Objective To observe the clinical effect of Yunke combined with vitamin D3 in the treatment of osteoporosis caused by brain stroke.Methods 60 patients identified as osteoporosis caused by brain stroke were randomly divided into group A,B and C,each of 20 cases.Three groups were routinely treated with calcium carbonate.On this basis,group A were treated with Yunke combined with VitD3,group B were treated with Yunke and group C was treated with VitD3.The pain scores,serum 25-(OH)D,osteocalcin levels L2~4 lumbar spine bone mineral density(BMD)and femoral neck BMD were measured before treatment and after 3 months and 6 months of treatment.Results There were no significant differences in VAS score,1,25-(OH)2-VitD3 level,BGP level,L2~4 lumbar spine BMD and femoral neck BMD between the three groups before treatment(P>0.05);The VAS scores of three groups were lower than those before treatment at 3 months after treatment,the VAS scores of group C were higher than those of group A and group B,After 6 months of treatment,the VAS scores of group A were lower than those of group B and C,and group B was lower than group C,the differences were statistically significant(P<0.05).After 3 months and 6 months of treatment,the levels of 1,25-(OH)2-VitD3 in three groups were higher than those before treatment,and those in group A were higher than those in group B,the BGP levels in 3 groups at 3 months and 6 months after treatment were lower than before treatment,the difference was statistically significant(P<0.05),but there was no significant difference between the groups(P>0.05).At 3 months and 6 months after treatment,the BMD of lumbar vertebrae in 3 groups of L2~4 were higher than before treatment,At 6 months after treatment,group A was higher than group B and group C,and the difference was statistically significant(P<0.05).There was no significant difference in the BMD of the femoral neck between the three groups before treatment and 3 months after treatment(P>0.05).At 6 months after treatment,the BMD of the femoral neck in the 3 groups was higher than that before the treatment,and higher than the B and C groups,the difference was statistically significant(P<0.05).Conclusion Yunke combined with vitamin D3 has a good clinical effect in the treatment of osteoporosis after stroke,and provides a new idea for the prevention and treatment of osteoporosis caused by stroke.