目的 探讨维D钙咀嚼片联合依替膦酸二钠治疗骨质疏松症的临床疗效。方法 选取2018年1月-2021年12月南通大学附属南通第三医院骨科诊疗的120例骨质疏松患者,按照随机数字表法分为对照组和治疗组,每组各60例。对照组患者口服依替膦酸二钠片,0.2 g/次,2次/d。治疗组在对照组的治疗基础上口服维D钙咀嚼片,1片/次,2次/d。两组用药8周。观察两组的临床疗效,比较两组症状改善时间、骨代谢指标和血清炎性因子水平。比较两组不良反应情况。结果 治疗后,治疗组总有效率为98.33%,显著高于对照组的85.00%(P<0.05)。经治疗,治疗组出现腰痛、背痛、胸闷、肌肉痛改善时间均显著短于对照组(P<0.05)。治疗后,两组患者碱性磷酸酶(BAP)、骨钙素(N-MID)均显著升高,而β-胶原片段(β-CTX)显著降低(P<0.05);治疗后,治疗组骨代谢指标改善优于对照组(P<0.05)。治疗后,两组血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β(TGF-β1)水平均较治疗前显著降低,而血管内皮生长因子(VEGF)升高(P<0.05);治疗后,治疗组血清学指标改善优于对照组(P<0.05)。治疗后,治疗组不良发生发生率是5.02%,显著低于对照组的11.67%(P<0.05)。结论 维D钙咀嚼片联合依替膦酸二钠治疗骨质疏松症效果确切,能有效改善患者症状,改善机体骨代谢,调节机体血清学指标,值得借鉴和推广。

Objective To investigate the effect of Calcium Supplement with Vitamin D Chewable Tablets combined with etidronate disodium in treatment of osteoporosis. Methods A total of 120 patients with osteoporosis treated in the Department of Orthopedics of Nantong Third Hospital Affiliated to Nantong University from January 2018 to December 2021 were selected and divided into control group and treatment group according to random number table method, with 60 cases in each group. Patients in the control group were po administered with Etidronate Disodium Tablets, 0.2 g/time, twice daily. Patients in the treatment group were po administered with Calcium Supplement with Vitamin D Chewable Tablets on the basis of the control group, 1 tablet/time, twice daily. Both groups were treated for 8 weeks. The clinical efficacy of the two groups was observed, and the improvement time of symptoms, bone metabolism indexes and serum inflammatory factors were compared between the two groups. The adverse reactions of the two groups were compared. Results After treatment, the total effective rate of the treatment group was 98.33%, which was significantly higher than that of the control group 85.00% (P＜0.05). After treatment, the improvement time of lumbago, back pain, chest tightness, muscle pain and other symptoms in the treatment group was significantly shorter than that in the control group (P＜0.05). After treatment, alkaline phosphatase (BAP) and osteocalcin (N-MID) were significantly increased in two groups, but β-collagen fragment (β-CTX) were significantly decreased (P＜0.05). After treatment, the improvement of bone metabolism indexes in treatment group was better than that in control group (P＜0.05). After treatment, serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and transforming growth factor-β (TGF-β1) in two groups were significantly decreased compared with before treatment, while vascular endothelial growth factor (VEGF) was increased (P＜0.05). After treatment, the improvement of serological indexes in treatment group was better than that in control group (P＜0.05). After treatment, the incidence of adverse events in the treatment group was 5.02%, which was significantly lower than that in the control group (11.67%, P＜0.05). Conclusion Calcium Supplement with Vitamin D Chewable Tablets combined with etidronate disodium has exact effect in treatment of osteoporosis, and can effectively improve the patients’ symptoms and the bone metabolism, and can regulate the serological indicators, which is worth learning and promoting.

R9285.5

南通市科技局民生科技计划项目(MSZ19181)