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补肾壮骨片联合常规方案对绝经后骨质疏松症患者骨密度改善、功能恢复及骨折风险预防的作用研究。

Study on the Effect of Bushen Zhuanggu Tablet Combined with Conventional Regimen on Bone Mineral Density Improvement, Functional Recovery and Fracture Risk Prevention in Patients with Postmenopausal Osteoporosis.

机构信息

The Second Clinical Medical College of Guangzhou University of Chinese Medicine, China.

Department of Orthopedics, Gaozhou Hospital of Traditional Chinese Medicine, China.

出版信息

Comput Math Methods Med. 2023 Jul 7;2023:4846392. doi: 10.1155/2023/4846392. eCollection 2023.

Abstract

OBJECTIVE

This case-control study was to explore the effect of Bushen Zhuanggu tablet combined with routine regimen on bone mineral density (BMD) improvement, functional recovery, and fracture prevention in postmenopausal osteoporosis (PMOP) patients.

METHODS

180 postmenopausal osteoporosis patients were randomly selected from communities A, B, and C cohorts as research subjects from January to May 2021. The study subjects were divided into three groups. The groups were in a 1 : 1 ratio according to the principles of nonrandomised, concurrent controlled trials, and methods. There were 60 participants in each group (group A, group B, and group C). Group A was treated with Bushen Zhuanggu tablet for antiosteoporosis + basic treatment (calcium supplement and vitamin D). Group C was given Bushen Zhuanggu tablet for antiosteoporosis intervention. Group B was given basic treatment (calcium supplement and vitamin D supplementation) as a control group. The follow-up time was 6 months after treatment. Finally, we compare the differences in calcium and phosphorus metabolism indexes, BMD, bone metabolism indexes, upper and lower limb muscle strength, and quality of life scores.

RESULTS

Group A, B, and C's effective rate was 98.33%, 80.00%, and 93.33%, respectively. The group A's effective rate was significantly higher than that in group B and C, and the difference was statistically significant ( < 0.05). After 6 months intervention, the levels of serum Ca, serum phosphorus (P), serum creatinine (Cr), and parathyroid hormone (PTH) in 3 groups decreased. Ca, P, Scr, and PTH levels in group A were the lowest among study groups, and the difference was statistically significant ( < 0.05). The increase in the BMD of lumbar spine, the left femoral neck, and Ward's triangle area of the three groups were observed with the highest data in group A. After 6 months of treatment, the levels of serum N-terminal propeptide of type I procollagen, PINP, and serum osteocalcin (OC) increased, while the levels of -cross-linked C-terminal telopeptide of type I collagen (-CTX) and alkaline phosphatase (ALP) decreased in the three groups. The improvement of all bone metabolic indexes in group A was significantly better than that in B and C groups, and the difference was statistically significant ( < 0.05). The enhanced upper limb muscle strength and the shorter standing-walking timing test (TUGT) time were observed after 6 months of treatment. The improvement effect of upper and lower limb muscle strength in group A was significantly better than that in B and C groups, and the difference was statistically significant ( < 0.05). There were significant differences in physiological function, life function, general health status, physical pain, mental state, emotional function, vitality, and social function among the three groups after 6 months treatment, and the difference was statistically significant ( < 0.05). The score of quality of life in group A was higher than that in B and C groups, and the difference was statistically significant ( < 0.05).

CONCLUSION

Bushen Zhuanggu tablet combined with conventional therapy is effective in the postmenopausal osteoporosis treatment, which effectively increase the BMD, regulate calcium and phosphorus metabolism, promote the recovery of limb function, prevent the recurrence of fracture, and improve the patients' quality of life. This treatment scheme is worth popularizing.

摘要

目的

本病例对照研究旨在探讨补肾壮骨片联合常规方案对绝经后骨质疏松症(PMOP)患者骨密度(BMD)改善、功能恢复和骨折预防的影响。

方法

2021 年 1 月至 5 月,从社区 A、B、C 队列中随机抽取 180 例绝经后骨质疏松症患者作为研究对象。研究对象按非随机同期对照试验原则和方法分为三组,每组按 1:1 比例分组,共 60 例(组 A、组 B、组 C)。组 A 给予补肾壮骨片抗骨质疏松+基础治疗(补钙和维生素 D)。组 C 给予补肾壮骨片抗骨质疏松干预。组 B 给予基础治疗(补钙和维生素 D 补充)作为对照组。治疗后随访 6 个月。最后,比较各组钙磷代谢指标、BMD、骨代谢指标、上下肢肌肉力量和生活质量评分的差异。

结果

组 A、B、C 的有效率分别为 98.33%、80.00%和 93.33%。组 A 的有效率明显高于组 B 和 C,差异有统计学意义(<0.05)。干预 6 个月后,3 组血清 Ca、血清磷(P)、血清肌酐(Cr)和甲状旁腺激素(PTH)水平降低。组 A 血清 Ca、P、Scr 和 PTH 水平最低,差异有统计学意义(<0.05)。三组腰椎、左侧股骨颈和 Ward 三角区 BMD 均有升高,组 A 数据最高。治疗 6 个月后,3 组血清Ⅰ型前胶原 N 端肽、PINP 和血清骨钙素(OC)水平升高,而血清Ⅰ型胶原交联 C 端肽(CTX)和碱性磷酸酶(ALP)水平降低。组 A 各项骨代谢指标改善均明显优于 B、C 组,差异有统计学意义(<0.05)。治疗 6 个月后,上肢肌肉力量增强,站立行走计时测试(TUGT)时间缩短。组 A 上下肢肌肉力量改善效果明显优于 B、C 组,差异有统计学意义(<0.05)。治疗 6 个月后,三组生理功能、生活功能、一般健康状况、躯体疼痛、精神状态、情绪功能、活力和社会功能均有显著差异,差异有统计学意义(<0.05)。组 A 生活质量评分高于 B、C 组,差异有统计学意义(<0.05)。

结论

补肾壮骨片联合常规疗法治疗绝经后骨质疏松症有效,能有效提高 BMD,调节钙磷代谢,促进肢体功能恢复,预防骨折复发,提高患者生活质量。该治疗方案值得推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/682d/10348851/560de506e909/CMMM2023-4846392.001.jpg

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