补肾活血方治疗肾虚血瘀型原发性骨质疏松症临床的研究.docVIP

补肾活血方治疗肾虚血瘀型原发性骨质疏松症临床的研究 　　摘要：目的 观察补肾活血方治疗肾虚血瘀型原发性骨质疏松症的临床疗效及安全性。方法 纳入肾虚血瘀型原发性骨质疏松症患者50例，予补肾活血方颗粒剂，每日2次，冲服。连续治疗12周。治疗前后测量股骨颈、Wards区、L1～4骨密度，观察治疗前及治疗4、8、12周中医症状评分、视觉模拟评分法（VAS）评分，治疗前后检测血清骨钙素（OC）、β-胶原降解产物（β-CTX）、骨保护素（OPG）含量，血、尿常规及肝、肾功能。结果 补肾活血方可提高患者左侧股骨颈及Wards区的骨密度（P=0.001，P=0.044），L1～4骨密度呈升高趋势，差异无统计学意义（P=0.172）。L1～4、股骨颈骨密度疗效总有效率均为60.870%（28/46），Wards区为58.696%（27/46）。与治疗前比较，患者治疗4、8、12周VAS评分、中医症状评分均降低（P0.01），且随着治疗时间增加，VAS评分、中医症状评分均显著降低（F=159.690，P0.001；F=163.970，P0.001）。治疗12周，中医疗效总有效率为78.26%（36/46）。治疗后血清OC、OPG有升高趋势，β-CTX有降低趋势，差异均无统计学意义（P=0.087，P=0.091，P=0.419）。血、尿常规及肝、肾功能未见异常。结论 补肾活血方临床疗效较好，可显著提高骨密度，改善骨代谢，缓解骨痛，安全性较高。 　　关键词：补肾活血方；肾虚血瘀证；原发性骨质疏松症 　　DOI：10.3969/j.issn.1005-5304.2017.09.004 　　中图分?号：R274.9 文献标识码：A 文章编号：1005-5304（2017）09-0011-04 　　Clinical Research on Bushen Huoxue Prescription in Treating Kidney Deficiency and Blood Stasis Type Primary Osteoporosis TIAN Lin， KANG Hao-chen， WANG Shu-li， YANG Ge， ZHU Jian-gui （Guang’anmen Hospital， China Academy of Chinese Medical Sciences， Beijing 100053， China） 　　Abstract： Objective To observe the efficacy and safety of Bushen Huoxue Prescription in the treatment of kidney deficiency and blood stasis type primary osteoporosis. Methods Totally 50 patients with kidney deficiency and blood stasis type primary osteoporosis were collected. They were given Bushen Huoxue Prescription granules twice a day， taking with water， for 12 weeks. Before and after treatment， the femoral neck， Wards area， L1?C4 bone mineral density （BMD） were measured. VAS and TCM syndrome integrals were evaluated before and 4， 8 and 12 week of treatment. The level of serum osteocalcin （OC）， β-C-terminal telopeptides of type I collagen （β-CTX） and osteoprotegerin （OPG） were detected before and after treatment. Hematuria routine， liver and kidney function were under safety testing before and after treatment. Results Bushen Huoxue Prescription could significantly increase BMD of left femoral neck and Ward’s triangle （P=0.001， P=0.044）. L1?C4 BMD increase