目的 探讨续断壮骨胶囊联合依降钙素治疗骨质疏松的临床疗效。方法 选取2020年9月—2022年5月秦皇岛市第一医院收治的128例骨质疏松症患者,随机分为对照组(64例)和治疗组(64例)。对照组患者肌肉注射依降钙素注射液,10 U/次,2次/周。在对照组的基础上,治疗组口服续断壮骨胶囊,2粒/次,3次/d。两组患者用药24周。观察两组患者临床疗效,比较治疗前后两组患者患者症状缓解时间,视觉模拟疼痛评分法(VAS)评分,腰椎L2、腰椎L4、股骨颈的骨密度(BMD),血清炎性因子胰岛素样生长因子-1(IGF-1)、抗酒石酸酸性磷酸酶-5b(TRACP-5b)、白细胞介素-6(IL-6)和骨碱性磷酸酶(BSAP)水平,及不良反应情况。结果 治疗后,治疗组患者临床有效率为(98.43%),明显高于对照组(84.38%,P<0.05)。治疗后,治疗组症状缓解时间均早于对照组(P<0.05)。治疗后,两组患者VAS评分明显降低,而腰椎L2、腰椎L4、股骨颈的骨密度(BMD)均高于治疗前(P<0.05),且治疗组骨疼痛程度及骨密度均明显好于对照组(P<0.05)。治疗后,两组血清炎性因子IL-6、TRACP-5b水平均低于治疗前,而IGF-1和BSAP水平高于治疗前(P<0.05),且治疗组明显好于对照组(P<0.05)。治疗后,治疗组不良反应发生率(7.81%)明显低于对照组(12.50%,P<0.05)。结论 依降钙素联合续断壮骨胶囊治疗效果确切,对骨质疏松临床症状缓解明显,骨疼痛状态减弱,血清标志物水平显著改善。

Objective To explore the therapeutic effect of Xuduan Zhuanggu Capsules combined with calcitonin in treatment of osteoporosis.Methods Patients(128 cases) with osteoporosis in First Hospital of Qinhuangdao from September 2020 to May 2022were randomly divided into control(64 cases) and treatment(64 cases) group. Patients in the control group was intramuscular injection administered with Elcatonin Injection, 10 U/time, twice weekly. Patients in the treatment group were po administered with Xuduan Zhuanggu Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 24 weeks.After treatment, the clinical evaluation was evaluated, and the relief time of symptom, VAS scores, the BMD of lumbar L2, lumbar L4, neck of femur, and the levels of serum IL-6, TRACP-5b, IGF-1 and BSAP, and adverse reaction in two groups before and after treatment were compared.Results After treatment, the clinical effective rate of the treatment group was(98.43%), which was significantly higher than that of the control group(84.38%, P<0.05). After treatment, the time of symptom relief in the treatment group was earlier than that in the control group(P<0.05). After treatment, the VAS score in two groups were significantly decreased,while the bone mineral density(BMD) of lumbar L2, lumbar L4 and femoral neck were higher than those before treatment(P<0.05),and the degree of bone pain and bone mineral density in the treatment group were significantly better than those in the control group(P<0.05). After treatment, the levels of serum inflammatory factors IL-6 and TRACP-5b in two groups were lower than those before treatment, while the levels of IGF-1 and BSAP were higher than those before treatment(P<0.05), and which in the treatment group was significantly better than those in the control group(P<0.05). After treatment, the incidence of adverse reactions in the treatment group(7.81%) was significantly lower than that in the control group(12.50%, P<0.05).Conclusion The therapeutic effect of calcitonin combined with Xuduan Zhuanggu Capsules is definite, the clinical symptoms of osteoporosis are relieved obviously, the state of bone pain is weakened, and the level of serum markers is significantly improved.

R977

河北省医学科学研究课题计划(20221612)