肾俞穴位埋线对原发性骨质疏松症骨密度影响的研究

目的探讨肾俞穴位埋线治疗原发性骨质疏松症的临床有效性及可行性。方法将70例患者随机分为埋线组、乐力组和埋线乐力组进行临床治疗6个月,记录各组治疗前、后疼痛评分及腰24、左髋部骨密度值,采用SPSS13.0软件包进行统计学处理。组内分层采用t(x±s)检验,组间采用方差分析、秩和检验。结果①疼痛评分:埋线组和埋线乐力组治疗后明显改善,与治疗前比较,差异均有非常显著意义(P<0.001);乐力组于治疗前后比较,差异无显著意义(P>0.05);治疗后埋线组与埋线乐力组比较,差异无显著意义(P>0.05),两组分别与乐力组比较,差异有非常显著性意义(P<0.001)。②骨密度:埋线组和埋线乐力组治疗后腰、髋部均有提高,与治疗前比较,髋Nect、Ward差异均有显著意义(P<0.05);乐力组治疗后腰、髋部升降不定,与治疗前比较,差异无显著性意义(P>0.05);治疗后埋线组和埋线乐力组分别与乐力组比较,髋Nect、G.T差异有显著性意义(P<0.05),埋线组和埋线乐力组比较,差异无显著性意义(P>0.05)。结论肾俞穴位埋线对原发性骨质疏松症临床疼痛和骨密度减少均有明显疗效。口服乐力胶囊对原发性骨质疏松症临床疼痛和骨密度减少均无明显疗效。

BONE MINERAL ANALYSIS OF WHOLE BODY IN 292 NORMAL SUBJECTS ASSESSED BY DUAL X-RAY ABSORPTIOMETRY

Objective. To study the whole body bone mineral changes in normal subjects.Methods. Bone mineral was measured by dual X-ray absorptiometry(DXA) in 292 normal subjectsaged 10～79 years, including 152 females and 140 males. They were divided into age-groups by decade.Results. In males, the ages with peak value of total bone mineral content (TBMC), total bone min-eral density (TBMD), anteroposterior spine BMD(L2-4 BMD) were in the 30～39,20～39, 20～29 age-groups respectively. In females, they were all in the 30～39 age-group. Peak values of TBMC, TBMD,L2-4 BMD were higher in males than those in females. Loss of bone mineral for females was more pro-nounced than that for males. Loss of L2-4 BMD was more pronounced than TBMD.Conclusion. This study provides the normal bone mineral data of whole body for males and females,and the characteristic of changes.

Treatment of osteoporosis in men using dehydroepiandrosterone sulfate

OBJECTIVE: To study the effect of dehydroepiandrosterone sulfate (DHEAS) treatment of osteoporosis in men with T(BMD) > or = 2.5SD. METHODS: Eighty-six patients were randomly divided into two groups: treatment group (n = 44) and control group (n = 42). DHEAS (100 mg q.d.) was given to the treatment group for 6 months. Bone mineral density, (BMD), biochemical markers of bone absorption and formation and other serum biochemical markers were measured before and after DHEAS treatment. Drug side effects were also evaluated. RESULTS: After oral administration of DHEAS (100 mg q.d.) for 6 months, the serum concentrations of DHEAS and IGF-I in the treatment group were 93.75% +/- 16.1% and 17.71% +/- 4.2% higher respectively than those in the control group (P

Clinical observation on acupuncture for male osteoporosis

Objective To compare the therapeutic effects of acupuncture combined with drug and simple drug for treatment of male osteoporosis. Methods Fifty-five cases were divided into a comprehensive therapy group （observation group, 25 eases） and a medication （control group, 30 cases） randomly. The observation group was treated with acupuncture and moxibustion at Pishu （脾俞BL 20）, Shenshu （肾俞 BL 23）, Mingmen （命门 GV 4）, Shenque （神阙 CV 8） and so on combined with oral administration of Alendronate, while the control group was treated with oral administration of Alendronate simply. The improvement of both Integral of Clinical Symptoms （ICS） and Bone Mineral Density （BMD） of two groups were observed after 6 months treatment. Results The ICS of two groups after treatment both decreased significantly （both P〈0.001）, and the decreasing degree in observation group was more significant than that in control group （P〈0.001）. The BMD of lumbar vertebrae and femur in observation group increased obviously than that before treatment （P〈0.01, P〈0.05）. The increasing degree of BMD of lumbar vertebrae in observation group after treatment was more obvious than that in control group （P〈0.05）. There were abdominal pain, diarrhea, nausea, vomiting, dyspepsia and other adverse reaction in control group, while the degree and occurrence rate of those in observation group alleviated and decreased obviously. Conclusion The effect of acupuncture combined with drug for male osteoporosis is good with little adverse reaction. This method is better than taking Alendronate.

Yi Jin Jing （Sinew-transforming Qigong Exercises） for primary osteoporosis in the elderly： a clinical trial

Objective：To observe the clinical efficacy of Yi Jin Jing （Sinew-transforming Qigong Exercises） for primary osteoporosis in the elderly.Methods：Eighty old patients with primary osteoporosis were randomized into a Yi Jin Jing group and a medication group,40 cases in each group.The Yi Jin Jing group was intervened by Yi Jin Jing （Sinew-transforming Qigong Exercises） training,while the medication group was intervened by oral administration of alendronate sodium tablet.Prior to and after 6-month intervention,the bone mineral density （BMD） of the proximal femur,visual analog scale （VAS） and activities of daily living （ADL） were estimated.Results：There were no significant differences in the BMD of the proximal femur,and VAS and ADL scores between the two groups before the intervention （P〉0.05）.After 6-month intervention,the above items all improved significantly in both groups （both P〈0.01）;the improvements in VAS and ADL scores in Yi Jin Jing group were more significant than those in the medication group （P〈0.01）,while the between-group difference in the BMD of the proximal femur was statistically insignificant （P〉0.05）.Conclusion：Practice of Yi Jin Jing （Sinew-transforming Qigong Exercises） can effectively ameliorate the BMD in the elderly with primary osteoporosis,and it can reduce the pain and improve ADL,with a better general effect compared to oral administration of alendronate sodium tablet.

Analysis on the risk factors of second fracture in osteoporosis-related fractures

Objective： To explore the clinical characteristics and risk factors of refracture in patients suffering from osteoporosis-related fractures as well as effective interventions. Methods： From January 2006 to January 2008, both out-patients and in-patients in our hospital who were over 50 years old and suffered from osteoporosis-related fractures were selected for this research. They were divided into fracture group and refracture group. The refracture rate was followed up for 2 years, during which 11 patients developed refracture, thus were included in the refracture group. Therefore, 273 patients, 225 first-fracture cases, aged （67.7± 8.5） years, and 48 refracture cases, aged （72.7±9.5） years, were included in this study. General data including age and sex, fracture types, femoral neck bone mineral density （BMD） T-scores tested by dual-energy X-rays absorptiometry （DEXA）, Charlson index, time-frame between two fractures as well as mobility skill assessment were collected and analyzed by single-factor and multivariate statistical methods. Results： Females accounted for 70.2% of the fracture group and 77.1% of the refracture group. The most common refracture type was vertebral fracture for the first time and femoral neck fracture for the second time during the followup. The second fracture happened 3.7 years after the first one on average. The refracture rate was 2.12% within one year, and 4.66% within two years. Risk factors for a second fracture in osteoporotic fracture patients included age （〉75 years, HR=1.23, 95%CI 1.18-1.29; 〉85 years, HR=1.68, 95% CI 1.60-1.76）, female sex （HR=1.36, 95%CI 1.32-1.40）, prior vertebral fractures （HR= 1.62, 95%CI 1.01-2.07）, prior hip fractures （HR=1.27, 95%CI 0.89-2.42）, BMD T-score〈-3.5 （HR-1.38, 95%CI 1.17-1.72） and weakened motor skills （HR=1.27, 95%CI 1.09-1.40）. Conclusions： The risks of second fracture among patients with initial brittle fracture are substantial. There is adequate time between the first and second fractures for interventions to reduce the risks of refracture, especially for the old women with a vertebral or hip fracture. Medication, motor functional rehabilitation and fall-down prevention training are helpful.

Therapeutic Efficacy Observation on Acupuncture for Postmenopausal Osteoporosis

Objective: To observe the clinical efficacy of acupuncture for post- menopausal osteoporosis (PMOP). Methods: A total of 64 PMOP cases were randomized into an observation group and a control group, 32 cases in each group. Acupuncture was employed in the observation group, versus oral Osteoform capsule in the control group. After 3-month treatment, the Bone Density (BD) and Estradiol (E 2 ) were measured respectively before and after treatment, followed by statistical analysis on clinical efficacies in the two groups. Results: The total effective rate of the observation group was 81.3%, showing a statistical difference compared with the control group (P<0.05). After treatment, the BD measurements in all body regions of the observation group were significantly elevated (P<0.05), showing a statistical difference compared with the control group (P<0.05). Also, the E 2 levels in both groups were significantly increased (P<0.01), showing no between-group statistical significance (P>0.05). Conclusion: Acupuncture has exact efficacy for PMOP and is therefore effective for the prevention and treatment of PMOP.

Efficacy evaluation of different forms of traditional Chinese health-preservation exercises for osteoporosis:a network meta-analysis

Objective To systematically evaluate the effects of different forms of traditional Chinese health-preservation exercises on osteoporosis(OP)using network meta-analysis.Methods A systematic search on Excerpta Medica Database(EMBASE),Springer Link,Allied and Complementary Medicine Database(AMED),PubMed,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Academic Journal Full-text Database(Wanfang)and Chongqing VIP Database(CQVIP)targeted the randomized controlled trials(RCTs)studying traditional Chinese exercises for OP published up to January 2020.Cochrane handbook was adopted to estimate the publication bias in the included studies,and statistical analysis was performed using Stata 14.0 and GeMTC 0.14.3 when data were extracted.Results Fifty RCTs were included in the network meta-analysis,comprising a total of 4505 OP patients.The network meta-analysis showed that in terms of visual analog scale(VAS)for pain,Tai Ji Quan(Tai Chi)was the most efficacious,followed by Yi Jin Jing(Sinew-transforming Qigong Exercises),Ba Duan Jin(Eight-sectioned Exercise),Wu Qin Xi(Five-animal Exercises),sports training,drug and blank control;in terms of bone mineral density(BMD)of femoral neck,Yi Jin Jing was the most efficacious,followed by Wu Qin Xi,Ba Duan Jin,Tai Ji Quan,sports training,blank control and drug;regarding the lumbar BMD,it was Yi Jin Jing,Tai Ji Quan,Ba Duan Jin,Wu Qin Xi,sports training,blank control and drug in the descending order of efficacy;in terms of serum alkaline phosphatase,it was Yi Jin Jing,Tai Ji Quan,sports training,Wu Qin Xi,Ba Duan Jin,drug and blank control in the descending order of efficacy.Conclusion The evidence to date suggests that the first choice for OP amongst the traditional Chinese exercises should be Yi Jin Jing,which can not only reduce the subjective pain,but also promote bone formation and increase BMD,though this conclusion requires more high-quality large-scale RCTs for further proof.

Experimental research into using bone-strengthening pill to treat ischemic necrosis of femoral head

OBJECTIVE:To study the use of a bone-strengthening pill to treat ischemic necrosis of the femoral head.METHODS:A model of castration in rats with osteoporosis and a model of ischemic necrosis in the bilateral femoral heads of young rats were used to detect bone density,bone formation measurements,lipid deposition in the femoral head,the distribution of capillaries in the femoral head and other relevant biochemical indices.RESULTS:In model rats,bone-strengthening pills were able to increase the bone density,the unit volume of bony trabeculae,the width of bony trabeculae,and the unit volume of the bony cortex.They could also enhance the mineral apposition rate in the femoral head and the seam width of osteoid deposition.Furthermore,there was a reduction in lipid deposition in the femoral head,and enriched distribution of arteries in the femoral head.Bone-related biochemical detections showed an increase in alkaline phosphatase staining and a decrease in tartaric acidic phosphatase staining.CONCLUSION:The results show that bone-strengthening pills can obviously promote bony growth,cause an increase in bone density,restore blood circulation,inhibit the occurrence and development of bony necrosis,and accelerate the repair of necrotic bones,with no toxic side-effects.