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目的:探讨3种不同方案治疗绝经后妇女骨质疏松的临床疗效。方法:将绝经后伴骨量减少妇女110例,随机分成3组。A组36例,钙尔奇D 1 200 mg/d+骨化三醇0.25μg/bid;B组39例,钙尔奇D 1 200 mg/d+骨化三醇0.25μg/bid+替勃龙1.25 mg/d;C组35例,钙尔奇D 1200 mg/d+骨化三醇0.25μg/bid+盐酸雷洛昔芬60 mg/d。3组妇女连续治疗1年。治疗前后测定腰椎第1~4节(L1~4)及股骨骨密度(BMD);同时检测血清骨碱性磷酸酶(BALP)及血清Ⅰ型前胶原肽(CTX)评价骨代谢指标。结果:①骨痛症状改善。3组妇女治疗1年后骨痛症状均得到改善,A、B、C组改善率分别为83%、92%、95%。②骨密度升高。3组妇女治疗后骨密度明显升高,分别与治疗前比较,差异均有统计学意义(P<0.05);治疗后1年B、C组妇女BMD均较A组显著升高,差异有统计学意义(P<0.01),但B、C两组间比较,差异无统计学意义(P>0.05)。③骨代谢指标。3组妇女治疗后BALP及CTX水平均较治疗前降低,差异有统计学意义(P<0.05);3组间比较,治疗1年后血清CTX水平,B组较C组显著下降,差异有统计学意义(P<0.01),B组较A组下降更为显著,差异有统计学意义(P<0.000 1)。结论:3种方案均可用于骨质疏松的治疗,降低骨转换、增加BMD、减少骨吸收。
Objective: To investigate the clinical effects of three different regimens in treating postmenopausal women with osteoporosis. Methods: One hundred and ten women with postmenopausal reduction of bone mass were randomly divided into three groups. A group of 36 cases, Calcium D 200 mg / d + calcitriol 0.25 μg / bid, B group 39 cases, Calcium D 200 mg / d, Calcitriol 0.25 μg / bid + Tibolone 1.25 mg / d; C group 35 cases, Calcium D 1200 mg / d + calcitriol 0.25 μg / bid + raloxifene hydrochloride 60 mg / d. Three groups of women for 1 year of continuous treatment. The lumbar spine 1 ~ 4 (L1 ~ 4) and femoral bone mineral density (BMD) were measured before and after treatment. Serum bone alkaline phosphatase (BALP) and serum type Ⅰ procollagen peptide (CTX) Results: ① The symptoms of bone pain improved. The symptoms of bone pain were improved in 3 groups of women after 1 year of treatment, and the improvement rates in group A, B and C were 83%, 92% and 95% respectively. ② increased bone mineral density. The bone mineral density of three groups of women after treatment was significantly higher than that before treatment, the difference was statistically significant (P <0.05); after 1 year of treatment, the BMD of women in group B and C were significantly higher than that of group A (P <0.01). However, there was no significant difference between B and C groups (P> 0.05). ③ bone metabolism indicators. The levels of BALP and CTX in three groups of women after treatment were lower than those before treatment (P <0.05). The levels of CTX in the three groups after treatment for one year were significantly lower than those in the C group (P <0.01). The decrease of B group was more significant than that of A group (P <0.000 1). CONCLUSION: All the three protocols can be used to treat osteoporosis, reduce bone turnover, increase BMD and decrease bone resorption.