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每日米诺膦酸和每周阿仑膦酸钠对绝经后骨质疏松症患者上消化道症状、骨吸收和背痛影响的对比研究。

A comparative study of the effects of daily minodronate and weekly alendronate on upper gastrointestinal symptoms, bone resorption, and back pain in postmenopausal osteoporosis patients.

机构信息

Department of Orthopaedics, Sakamidorii Hospital, 6-28-1 Midorii, Asaminami-ku, Hiroshima, Hiroshima, 731-0103, Japan.

出版信息

J Bone Miner Metab. 2013 Mar;31(2):153-60. doi: 10.1007/s00774-012-0393-x. Epub 2012 Oct 19.

Abstract

The purpose of the present study was to precisely compare both the efficacy and abdominal symptom-related quality of life after treatment with daily minodronate and weekly alendronate in patients with primary postmenopausal osteoporosis. The efficacy of the two drugs was assessed based on improvements in a bone turnover marker, back pain, and gastrointestinal symptoms that impair quality of life, which was assessed using the Izumo scale questionnaire. In the minodronate group, there were no significant changes during the treatment period in the specific scores for heartburn, epigastralgia and epigastric fullness, whereas all of the scores were significantly elevated at some time point after drug administration in the alendronate group. Urinary N-telopeptide of type I collagen (uNTX), a bone resorption marker, and bone-specific alkaline phosphatase, a bone formation marker, significantly decreased in both groups, but decreases in uNTX in the minodronate group was observed significantly earlier compared with those in the alendronate group. The back pain scores, which were obtained using a visual analog scale, were significantly reduced in both groups. However, analgesic effects were detected earlier in the minodronate group. In conclusion, compared with weekly alendronate, daily minodronate improved bone turnover and back pain more promptly without causing upper gastrointestinal symptoms.

摘要

本研究旨在精确比较每日米诺膦酸盐和每周阿仑膦酸盐治疗原发性绝经后骨质疏松症患者的疗效和与腹部症状相关的生活质量。根据骨转换标志物、背痛和影响生活质量的胃肠道症状的改善来评估两种药物的疗效,生活质量采用 Izumo 量表问卷进行评估。在米诺膦酸盐组,在治疗期间,烧心、上腹痛和上腹胀的特定评分没有明显变化,而在阿仑膦酸盐组,所有评分在给药后某个时间点均显著升高。I 型胶原尿 N-末端肽(uNTX),一种骨吸收标志物,和骨特异性碱性磷酸酶,一种骨形成标志物,在两组中均显著降低,但米诺膦酸盐组的 uNTX 降低较阿仑膦酸盐组更早。使用视觉模拟评分法获得的背痛评分在两组中均显著降低。然而,米诺膦酸盐组更早出现镇痛效果。总之,与每周阿仑膦酸盐相比,每日米诺膦酸盐在不引起上胃肠道症状的情况下,更迅速地改善了骨转换和背痛。

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