目的 探讨骨松康合剂联合地诺单抗治疗绝经后骨质疏松症的临床疗效。方法 选取2017年3月—2020年3月在陕西省中医医院治疗的86例绝经后骨质疏松症患者，根据用药的差别分为对照组和治疗组，每组各43例。对照组腹部皮下注射地舒单抗注射液，120 mg/次，1次/4周；治疗组在对照组基础上口服骨松康合剂，30 mL/次，3次/d。两组患者均治疗12个月。观察两组患者临床疗效，比较治疗前后两组患者ADL、Lysholm、VAS评分及骨代谢和骨密度指标。结果 经治疗，对照组和治疗组总有效率分别为81.40%、97.67%（P<0.05）。经治疗，两组ADL评分和Lysholm评分明显升高，而VAS评分明显下降（P<0.05），且治疗组评分项目明显好于对照组（P<0.05）。经治疗，两组血清骨碱性磷酸酶（BALP）、前脂肪细胞因子1（Pref-1）、骨钙素（BGP）、I型前胶原氨基端原肽（PINP）、组织蛋白酶K（Cathe K）和抗酒石酸酸性磷酸酶（TRACP-5b）水平显著降低（P<0.05），且治疗组比对照组更低（P<0.05）。经治疗，两组患者腰椎L_2～4、股骨颈、Ward’s三角区骨密度水平明显升高（P<0.05），且治疗组升高更明显（P<0.05）。结论 骨松康合剂联合地诺单抗治疗绝经后骨质疏松症可有效改善患者骨痛，改善骨代谢指标及骨密度，提高患者日常活动能力，改善膝关节功能。

Objective To investigate the clinical efficacy of Gusongkang Mixture combined with dinosumab in treatment of postmenopausal osteoporosis. Methods Patients (86 cases) with postmenopausal osteoporosis in Shaanxi Provincial Hospital of Chinese Medicine from March 2017 to March 2020 were divided into control and treatment groups based on different treatments, and each group had 43 cases. Patients in the control group were abdominal subcutaneous injected with Denosumab Injection, 120 mg/time, once every 4 weeks. Patients in the treatment group were po administered with Gusongkang Mixture, 30 mL/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, the scores of ADL, Lysholm and VAS, and the indexes of bone metabolism and the bone mineral density in two groups before and after treatment were compared. Results After treatment, the total effective rates of the control group and the treatment group were 81.40% and 97.67%, respectively (P < 0.05). After treatment, the ADL score and Lysholm score in two groups were significantly increased, while the VAS score was significantly decreased (P < 0.05), and the score items of the treatment group were significantly better than those of the control group (P < 0.05). After treatment, the serum levels of BALP, Pref-1, BGP, PINP, Cathe K, and TRACP-5b in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the BMD of lumbar vertebrae L_2-4, femoral neck, and Ward's triangle in two groups were significantly increased (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Gusongkang Mixture combined with dinosumab in treatment of postmenopausal osteoporosis can effectively improve the bone pain, bone metabolic index and bone mineral density, ameliorate the daily activity and the function of knee joint

R977

陕西省名中医传承工作室建设项目（陕中医药发2019019）