目的 探讨仙灵骨葆胶囊联合阿仑膦酸钠对骨质疏松症患者骨代谢及骨转换指标的影响。方法 选取2015年9月—2018年9月西宁市第一人民医院92例骨质疏松症患者作为研究对象，按照随机数字法将患者分为对照组和观察组，每组各46例。对照组患者口服阿仑膦酸钠片，10 mg/次，1次/d。观察组在对照组的基础上口服仙灵骨葆胶囊，2粒/次，3次/d，两组均持续治疗3个月。观察两组患者的临床疗效，同时比较两组治疗前后的骨代谢、骨转换指标及腰椎L_2-4和股骨颈骨密度。结果 治疗后，观察组总有效率为93.48%，对照组总有效率为78.26%，两组总有效率比较差异具有统计学意义（P<0.05）。治疗后，两组患者骨源性碱性磷酸酶（BAP）、骨钙素（BGP）和碱性磷酸酶（ALP）水平均显著升高，24 h尿钙（U-Ca）水平显著降低（P<0.05），且观察组骨代谢各指标水平显著优于对照组（P<0.05）。治疗后，两组患者的核因子κB受体活化因子配基（RANKL）及Ⅰ型胶原交联C-末端肽（CTX-1）水平均显著降低，骨保护素（OPG）水平显著升高（P<0.05），且观察组各骨转换指标水平显著优于对照组（P<0.05）。两组治疗后腰椎L_2-4和股骨颈骨密度均显著增加（P<0.05），且观察组腰椎L_2-4和股骨颈骨密度显著高于对照组（P<0.05）。结论 仙灵骨葆胶囊联合阿仑膦酸钠可有效改善患者的骨代谢、骨转换指标及骨密度水平，疗效确切，在骨质疏松症患者治疗中具有较高的应用价值。

Objective To investigate the effects of Xianling Gubao Capsules combined with alendronate sodium on bone metabolism and bone conversion indexes in osteoporosis patients. Methods A total of 92 patients with osteoporosis in the First People's Hospital of Xining from September 2015 to September 2018 were selected as the research subjects. Patients were randomly divided into control group and observation group, with 46 patients in each group. Patients in the control group were po administered with Alendronate Sodium Tablets, 10 mg/time, once daily. Patients in the observation group were po administered with Xianling Gubao Capsules on the basis of control group, two capsules/time, three times daily. Patients in two groups were treated for three months. The clinical efficacy in two groups was observed, and the bone metabolism, bone conversion indexes and lumbar L_2-4 and femoral neck bone densityof two groups before and after treatment were compared. Results After treatment, the total effective rate was 93.48% in the observation group and 78.26% in the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, BAP, BGP and ALP levels in two groups were significantly increased, while U-CA levels were significantly decreased (P<0.05), and bone metabolism indexes in the observation group were significantly better than those in the control group (P<0.05). After treatment, RANKL and CTX-1 levels in two groups were significantly decreased, OPG levels were significantly increased (P<0.05), and the levels of bone transformation indicators in the observation group were significantly better than those in the control group (P<0.05). After treatment, the bone mineral density of L_2-4 and femoral neck in two groups was significantly increased (P<0.05), and the bone mineral density of L_2-4 and femoral neck in the observation group was significantly higher than those in the control group (P<0.05). Conclusion Xianling Gubao Capsules combined with alendronate sodium can effectively improve the level of bone metabolism, bone conversion indicators and bone mineral density in patients, with an exact curative effect, and has a high application value in the treatment of osteoporosis patients.

R982

西宁市科技项目（2015-K-25）