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目的:观察补肾活血通络汤治疗糖皮质激素致骨质疏松症(GIOP)的效果,并探讨其作用机制。方法:将120例GIOP患者随机分为观察组和对照组,各60例。观察组给予强的松激素和补肾活血汤,对照组给予糖皮质激素和骨化三醇胶囊和碳酸钙D3片,治疗6个月。评价两组患者的疗效,治疗前后中医证候积分,血钙、血磷、尿钙、尿磷、血清碱性磷酸酶(ALP),血清骨钙素(BGP)和血甲状腺旁激素(PTH)水平,骨密度(BMD)值和不良反应。结果:观察组显效率(53.3%)高于对照组(30.0%)(P<0.05),两组总有效率无明显差异。与治疗前比较,两组患者治疗后中医证候总积分降低,血钙、血磷升高,BMD值增加,均有统计学差异(P<0.05)。与对照组比较,观察组治疗后腰膝酸软、腰背疼痛、下肢疼痛、步履艰难症状和总积分明显下降(P<0.05),PTH水平明显降低,BMD值明显升高(P<0.05)。观察组不良反应发生率为0%,对照组为10.0%,观察组低于对照组(P<0.05)。结论:补肾活血通络汤治疗GIOP的效果好,能减轻激素和副作用,降低骨折的发生率,安全性良好。
Objective: To observe the effect of Bushen Huoxue Tongluo Decoction on glucocorticoid-induced osteoporosis (GIOP) and its mechanism of action. Methods: 120 cases of GIOP patients were randomly divided into observation group and control group, 60 cases each. The observation group was given prednisone and Bushen Huoxue Decoction. The control group was given glucocorticoid and calcitriol capsule and calcium carbonate D3 tablets for 6 months. The curative effect of the two groups of patients was evaluated. The scores of TCM syndromes, serum calcium, phosphorus, urinary calcium, urinary phosphorus, serum alkaline phosphatase (ALP), serum BGP and PTH, Level, bone mineral density (BMD) values and adverse reactions. Results: The markedly effective rate (53.3%) in the observation group was significantly higher than that in the control group (30.0%) (P <0.05). There was no significant difference in the total effective rate between the two groups. Compared with those before treatment, the total score of TCM syndrome decreased, serum calcium and phosphorus increased, and BMD increased after treatment in both groups (P <0.05). Compared with the control group, the patients in the observation group showed weakness of the knees, low back pain, lower extremity pain, difficulty walking symptoms and total score (P <0.05). The PTH level and the BMD in the observation group were significantly increased (P <0.05). The incidence of adverse reactions in the observation group was 0%, in the control group was 10.0%, the observation group was lower than the control group (P <0.05). Conclusion: Bushen Huoxue Tongluo Decoction is effective in treating GIOP, which can reduce hormones and side effects, reduce the incidence of fractures and has good safety.