摘要
目的探究硫辛酸联合阿仑膦酸钠对绝经后骨质疏松症(PMOP)患者骨密度、骨代谢指标及疼痛程度的影响。方法选取2022年1月至2022年12月滁州市第一人民医院收治的106例PMOP患者作为研究对象。经随机数字表法分为试验组(53例)和对照组(53例),试验组口服硫辛酸及阿仑膦酸钠治疗,对照组仅接受阿仑膦酸钠治疗。比较治疗前后临床疗效、炎性因子[肿瘤坏死因子α(TNF-α)、胰岛素样生长因子1(IGF-1)和白细胞介素6(IL-6)]、骨密度[右股骨颈、腰椎(L_(1)~L_(4))骨]、骨代谢指标[骨钙素(BGP)、I型胶原交联的水平C-末端肽(CTX-1)、核因子кB受体激活因子配体(RANKL)和骨保护素(OPG)]及疼痛程度变化情况。结果治疗后,试验组临床有效率为94.34%,高于对照组的81.13%(χ^(2)=4.296,P<0.05)。治疗后3、6个月,TNF-α、IL-6水平均有所降低,IGF-1水平均有所升高,且试验组TNF-α、IL-6水平分别为(242.32±40.31)pg·mL^(-1)、(3.45±1.31)pg·mL^(-1),低于对照组的(274.53±41.32)pg·mL^(-1)、(4.13±1.22)pg·mL^(-1)(t=4.062、2.765,均P<0.05);IGF-1水平为(276.42±75.31)pg·mL^(-1),高于对照组的(167.32±41.43)pg·mL^(-1),差异有统计学意义(t=9.241,P<0.05)。治疗12个月后,均有所提高,且试验组右股骨颈骨和腰椎(L_(2~4))骨密度分别为(0.83±0.12)g·cm^(-1)、(0.94±0.15)g·cm^(-1),高于对照组的(0.75±0.09)g·cm^(-1)、(0.87±0.13)g·cm^(-1),差异有统计学意义(t=3.883、2.329,均P<0.05)。治疗12个月后,两组患者水平均有所降低,且试验组CTX-1、RANKL水平分别为(0.18±0.05)ng·mL^(-1)、(6.32±0.85)ng·mL^(-1),低于对照组的(0.24±0.08)ng·mL^(-1)、(8.53±1.31)ng·mL^(-1),差异有统计学意义(t=4.258、9.468,均P<0.05);治疗12个月后,两组患者均有所升高,且试验组BGP、OPG水平分别为(27.57±5.32)g·L^(-1)、(265.77±36.65)ng·mL^(-1),均高于对照组的(21.49±5.31)g·L^(-1)、(240.67±43.55)ng·mL^(-1),差异有统计学意义(t=5.360、2.934,均P<0.05);治疗6个月后,两组患者VAS评分均有所降低,且试验组VAS评分为(2.02±0.77)分,低于对照组的(2.82±1.81)分,差异有统计学意义(t=2.740,P<0.05)。试验组不良反应发生率(9.43%)与对照组(5.66%)比较,差异无统计学意义(P>0.05)。结论硫辛酸联合阿仑膦酸钠治疗PMOP患者能够降低机体炎症,提高患者骨密度,改善骨代谢情况,缓解患者疼痛程度,且安全性高。
Objective To investigate the effect of lipoic acid(LA)combined with alendronate sodium on bone mineral density,bone metabolism indexes and pain degree in patients with postmenopausal osteoporosis(PMOP).Methods A total of 106 patients with PMOP admitted to Chuzhou First People's Hospital from January to December 2022 were enrolled as the research objects.According to random number table method,they were divided into the experimental group(n=53,oral LA and alendronate sodium)and the control group(n=53,alendronate sodium).The clinical curative effect,changes in inflammatory factors(tumor necrosis factor-α(TNF-α),insulin-like growth factor-1(IGF-1),interleukin-6(IL-6)),bone mineral density(right femoral neck,lumbar vertebra(L1-L4)bone),bone metabolism indexes(osteocalcin(BGP),type I C-tenninal cross linked peptide(CTX-I),receptor activator of NF-кB ligand(RANKL),osteoprotectin(OPG))and pain degree before and after treatment were compared between the two groups.Results After treatment,the clinical response rate was higher in the experimental group than in the control(94.34%vs 81.13%,χ^(2)=4.296,P<0.05).The levels of TNF-αand IL-6 were decreased in both groups and they were lower in the experimental group than in the control((242.32±40.31)pg·mL^(-1),(3.45±1.31)pg·mL^(-1) vs(274.53±41.32)pg·mL^(-1),(4.13±1.22)pg·mL^(-1),t=4.062,2.765,both P<0.05).The IGF-1 level was increased after treatment and it was higher in the experimental group than in the control ((276.42±75.31) pg·mL^(-1) vs (167.32±41.43) pg·mL^(-1)), showing significant difference (t=9.241, P<0.05). The bone mineral density values of right femoral neck and lumbar vertebra (L2~4) were increased in both groups and they were higher in the experimental group than in the control ((0.83±0.12) g·cm-1, (0.94±0.15) g·cm-1 vs (0.75±0.09) g·cm-1, (0.87±0.13) g·cm-1), demonstrating significant difference (t=3.883, 2.329, both P<0.05). The levels of CTX-1 and RANKL were decreased in both groups and they were lower in the experimental group than in the control ((0.18±0.05) ng·mL^(-1), (6.32±0.85) ng·mL^(-1) vs (0.24±0.08) ng·mL^(-1), (8.53±1.31) ng·mL^(-1), t=4.258, 9.468, both P<0.05). However, the levels of BGP and OPG were increased and they were higher in the experimental group than in the control ((27.57±5.32) g·L^(-1), (265.77±36.65) ng·mL^(-1) vs (21.49±5.31) g·L^(-1), (240.67±43.55) ng·mL^(-1)), revealing statistically significant difference (t=5.360, 2.934, both P<0.05). After treatment, the VAS scores were decreased in both groups and they were remarkably lower in the experimental group than in the control ((2.02±0.77) points vs (2.82±1.81) points, t=2.740, P<0.05). The difference in incidence of adverse reactions was not statistically significant between the two groups (9.43% vs 5.66%, P>0.05). Conclusion LA combined with alendronate sodium can reduce inflammation, increase bone mineral density, improve bone metabolism and relieve pain in PMOP patients. Furthermore, it is of high safety.
作者
姚慧妤
冯小凤
赵敏
谢丹丹
Yao Hui-yu;Feng Xiao-feng;Zhao Min;Xie Dan-dan(Department of Gynaecology and Obstetrics,Chuzhou First People's Hospital,Chuzhou 239000,China)
出处
《中国药物应用与监测》
CAS
2024年第5期626-630,共5页
Chinese Journal of Drug Application and Monitoring
基金
安徽省科技厅临床医学研究转化专项(202204295107020048)。
关键词
绝经
骨密度
硫辛酸
骨代谢指标
炎症因子
阿仑膦酸钠
Menopause
Bone mineral density
Lipoic acid
Bone metabolism index
Inflammatory factor
Alendronate sodium
