摘要
目的探讨杜仲健骨颗粒联合特立帕肽对老年女性骨质疏松症(OP)的治疗效果。方法选取2021年6月至2022年10月在河北省唐山中心医院就诊的100例老年女性OP患者为研究对象。采用随机数字表法分为西医组和中西医组,各50例。所有患者均实施基础治疗,西医组在基础治疗基础上应用特立帕肽皮下注射治疗;中西医组在西医组基础上加用杜仲健骨颗粒口服治疗。比较2组治疗前及治疗6个月后骨密度、骨代谢指标[Ⅰ型胶原C端肽(CTX-Ⅰ)、全段甲状旁腺激素(iPTH)与抗酒石酸酸性磷酸酶5b(TRACP-5b)]、中医证候积分及血清趋化素水平,同时比较2组疗效及药物不良反应(ADR)发生情况。结果研究阶段西医组和中西医组分别脱落2、3例,最终纳入评价的分别为48、47例。治疗6个月后,2组第2~4腰椎、股骨颈、大转子处骨密度均高于治疗前且中西医组均明显高于西医组,CTX-Ⅰ、iPTH、TRACP-5b水平、中医证候积分及血清趋化素水平均低于治疗前且中西医组均明显低于西医组,差异均有统计学意义(均P<0.05)。中西医组总有效率明显高于西医组[95.7%(45/47)比81.2%(39/48)],差异有统计学意义(χ2=4.873,P=0.027)。2组ADR总发生率差异无统计学意义(χ2=0.080,P=0.777)。结论对老年女性OP患者应用杜仲健骨颗粒联合特立帕肽治疗,可提高抗OP效果,使患者症状明显减轻,骨密度显著增大,骨代谢指标及血清趋化素水平有效降低,且安全性较高。
Objective To explore the therapeutic effect of Duzhong Jiangu granules combined with teriparatide on osteoporosis(OP)in elderly women.Methods Totally 100 elderly female OP patients who were treated in Tangshan Central Hospital,Hebei Province from June 2021 to October 2022 were selected as research subjects.According to the random number table method,they were divided into western medicine group and traditional Chinese and western medicine group,with 50 cases in each group.All patients were treated with basic treatment,and the western medicine group was treated with teriparatide subcutaneous injection on the basis of basic treatment,and the traditional Chinese and western medicine group was treated with oral Duzhong Jiangu granules on the basis of the western medicine group.The bone density,bone metabolism indicators[C-telopeptide of typeⅠcollagen(CTX-Ⅰ),intact parathyroid hormone(iPTH),tartrate resistant acid phosphatase 5b(TRACP-5b)],traditional Chinese medicine syndrome scores,and serum chemerin levels before treatment and 6 months after treatment were compared between the two groups.At the same time,the efficacy and occurrence of adverse drug reactions(ADR)were compared between the two groups.Results During the study period,2 and 3 cases dropped out in the western medicine group and the traditional Chinese and western medicine group,respectively,48 and 47 cases were finally included in the evaluation,respectively.After 6 months of treatment,the bone density of the 2nd to 4th lumbar vertebrae,femoral neck,and greater trochanter in both groups were higher than those before treatment,and those in the traditional Chinese and western medicine group were significantly higher than those in the western medicine group;the levels of CTX-Ⅰ,iPTH,TRACP-5b,traditional Chinese medicine syndrome scores and serum chemerin level were lower than those before treatment,and those in the traditional Chinese and western medicine group were significantly lower than those in the western medicine group(all P<0.05).The total effective rate of the traditional Chinese and western medicine group was significantly higher than that of the western medicine group[95.7%(45/47)vs 81.2%(39/48)](χ2=4.873,P=0.027).There was no significant difference in the total incidence of ADR between the two groups(χ2=0.080,P=0.777).Conclusion The application of Duzhong Jiangu granules combined with teriparatide in the treatment of elderly female OP patients can improve the anti-OP effect,obviously alleviate symptoms,increase bone density,effectively reduce bone metabolism indicators and serum chemerin level,and has high safety.
作者
才蕊
杨光
Cai Rui;Yang Guang(First Department of Endocrinology,Tangshan Central Hospital,Hebei Province,Tangshan 063000,China;Second Department of Neurology,Tangshan Union Medical College Hospital,Hebei Province,Tangshan 063000,China)
出处
《中国医药》
2024年第5期728-732,共5页
China Medicine
基金
河北省医学科学研究课题计划(20231847)。
