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[1]梁博程,史曉林,施振宇,等.強(qiáng)骨膏方對(duì)絕經(jīng)后骨質(zhì)疏松性椎體骨折患者經(jīng)皮椎體后凸成形術(shù)后骨代謝及生活質(zhì)量的影響[J].中醫(yī)正骨,2020,32(05):6-10.
　LIANG Bocheng,SHI Xiaolin,SHI Zhenyu,et al.Influence of Qianggu(強(qiáng)骨)paste on bone metabolism and life quality of patients who received percutaneous kyphoplasty for postmenopausal osteoporotic vertebral fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(05):6-10.
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強(qiáng)骨膏方對(duì)絕經(jīng)后骨質(zhì)疏松性椎體骨折患者經(jīng)皮椎體后凸成形術(shù)后骨代謝及生活質(zhì)量的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年05期
頁碼:
6-10
欄目:
臨床研究
出版日期:
2020-05-20

文章信息/Info

Title:
Influence of Qianggu(強(qiáng)骨)paste on bone metabolism and life quality of patients who received percutaneous kyphoplasty for postmenopausal osteoporotic vertebral fractures
作者:
梁博程1; 史曉林1; 施振宇2; 吳連國(guó)1; 涂冬鵬3; 李敏1
(1.浙江中醫(yī)藥大學(xué)附屬第二醫(yī)院,浙江 杭州 310005; 2.浙江中醫(yī)藥大學(xué)第一臨床醫(yī)學(xué)院,浙江 杭州 310053; 3.浙江中醫(yī)藥大學(xué)第二臨床醫(yī)學(xué)院,浙江 杭州 310053)
Author(s):
LIANG Bocheng1; SHI Xiaolin1; SHI Zhenyu2; WU Lianguo1; TU Dongpeng3; LI Min1
1.The Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,Zhejiang,China 2.The First Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China3.The Second Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China
關(guān)鍵詞:
骨質(zhì)疏松; 絕經(jīng)后;  骨質(zhì)疏松性骨折;  脊柱骨折;  椎體后凸成形術(shù);  強(qiáng)骨膏方;  骨密度;  生活質(zhì)量;  骨代謝;  臨床試驗(yàn)
Keywords:
osteoporosis; postmenopausal;  osteoporotic fractures;  spinal fractures;  kyphoplasty;  Qianggu paste;  bone density;  quality of life;  bone metabolism;  clinical trial
摘要:
目的:觀察強(qiáng)骨膏方對(duì)絕經(jīng)后骨質(zhì)疏松性椎體骨折患者經(jīng)皮椎體后凸成形術(shù)(percutaneous kyphoplasty,PKP)后骨代謝及生活質(zhì)量的影響。方法:選擇2018年9—12月因骨質(zhì)疏松性椎體骨折接受了PKP治療的患者為研究對(duì)象。采用隨機(jī)數(shù)字表將符合要求的患者隨機(jī)分為2組。常規(guī)治療組自術(shù)后第2天開始口服碳酸鈣D3片(每天1次,每次600 mg)和阿法骨化醇軟膠囊(每天1次,每次1 μg),強(qiáng)骨膏方組在常規(guī)治療組治療方案的基礎(chǔ)上自術(shù)后第2天開始口服強(qiáng)骨膏方(每次15 mL,每天早晚各1次)。所有藥物每服用3個(gè)月,停藥1個(gè)月,共治療1年。分別于入組時(shí)和治療結(jié)束時(shí),測(cè)定患者的血清總Ⅰ型原膠原氨基端前肽(total procollagen typeⅠN-terminal propeptide,T-PⅠNP)含量、Ⅰ型膠原羧基端肽β特殊序列(β-C-terminal telopeptide of typeⅠcollagen,β-CTX)含量、腰椎和髖部骨密度及簡(jiǎn)明健康狀況調(diào)查表(short form 36 health survey questionnaire,SF-36)評(píng)分。結(jié)果:①分組結(jié)果。共納入109例患者,強(qiáng)骨膏方組57例、常規(guī)治療組52例。至試驗(yàn)結(jié)束時(shí),強(qiáng)骨膏方組3例因出現(xiàn)藥物性胃腸道不良反應(yīng)退出、2例主動(dòng)要求退出、1例因再次發(fā)生骨折退出; 常規(guī)治療組2例因出現(xiàn)藥物性胃腸道不良反應(yīng)退出、1例主動(dòng)要求退出、2例因再次發(fā)生骨折退出。出現(xiàn)藥物性胃腸道不良反應(yīng)患者改用抗骨質(zhì)疏松針劑治療,再次出現(xiàn)骨折患者均再次行PKP和抗骨質(zhì)疏松治療,預(yù)后良好。②骨轉(zhuǎn)換標(biāo)志物及骨密度測(cè)定結(jié)果。入組時(shí)2組患者的血清T-PⅠNP含量、血清β-CTX含量、腰椎骨密度及髖部骨密度比較,組間差異均無統(tǒng)計(jì)學(xué)意義(t=-1.335,P=0.185; t=0.471,P=0.693; t=-1.734,P=0.086; t=-1.190,P=0.237)。治療結(jié)束時(shí)2組患者的血清T-PⅠNP和β-CTX含量均較入組時(shí)降低[T-PⅠNP:(60.83±4.57)ng·mL-1,(39.26±4.06)ng·mL-1,t=26.460,P=0.000;(62.14±5.11)ng·mL-1,(31.32±2.49)ng·mL-1,t=38.692,P=0.000; β-CTX:(0.77±0.08)ng·mL-1,(0.44±0.05)ng·mL-1,t=25.880,P=0.000;(0.76±0.10)ng·mL-1,(0.52±0.06)ng·mL-1,t=14.961,P=0.000],腰椎和髖部骨密度均較入組時(shí)升高[腰椎骨密度:(0.758±0.011)g·cm-2,(0.786±0.024)g·cm-2,t=-10.238,P=0.000;(0.761±0.006)g·cm-2,(0.779±0.028)g·cm-2,t=-4.239,P=0.000; 髖部骨密度:(0.528±0.008)g·cm-2,(0.567±0.036)g·cm-2,t=-7.550,P=0.000;(0.530±0.010)g·cm-2,(0.556±0.024)g·cm-2,t=-8.039,P=0.000]; 治療結(jié)束時(shí)強(qiáng)骨膏方組的血清T-PⅠNP含量高于常規(guī)治療組(t=11.754,P=0.000),血清β-CTX含量低于常規(guī)治療組(t=-6.901,P=0.000),腰椎和髖部骨密度的組間差異均無統(tǒng)計(jì)學(xué)意義(t=1.355,P=0.179; t=1.770,P=0.080)。③SF-36評(píng)分。入組時(shí)2組患者的SF-36評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義(t=-1.212,P=0.229)。治療結(jié)束時(shí),2組患者的SF-36評(píng)分均較入組時(shí)升高[(102.22 1.69)分,(124.55±2.56)分,t=-98.085,P=0.000;(102.68±2.03)分,(115.34±2.29)分,t=-80.066,P=0.000],強(qiáng)骨膏方組的SF-36評(píng)分高于常規(guī)治療組(t=18.702,P=0.000)。結(jié)論:絕經(jīng)后骨質(zhì)疏松性椎體骨折患者PKP術(shù)后應(yīng)用強(qiáng)骨膏方,可以改善骨代謝、改善生活質(zhì)量。
Abstract:
Objective:To observe the influence of Qianggu(強(qiáng)骨,QG)paste on bone metabolism and life quality of patients who received percutaneous kyphoplasty(PKP)for postmenopausal osteoporotic vertebral fractures.Methods:One hundred and nine patients with osteoporotic vertebral fractures who were treated with PKP from September 2018 to December 2018 were selected as the subjects,and were randomly divided into conventional therapy group(52 cases)and QG paste group(57 cases)by using random digits table.All patients in the 2 groups were treated with oral applications of calcium carbonate and Vitamin D3 tablets(once a day,600 mg at a time)and alfacalcidol soft capsules(once a day,1 μg at a time)since the postoperative day 2.Moreover,the patients in QG paste group were treated with oral application of QG paste(twice a day in the morning and evening respectively,15 mL at a time)since the postoperative day 2.All the medicines were taken for 1 year with a 1-month rest-insertion between every 3 months.The serum contents of total procollagen typeⅠN-terminal propeptide(T-PⅠNP)and β-C-terminal telopeptide of typeⅠcollagen(β-CTX),the bone mineral density(BMD)of lumbar spine and hip and the short form 36 health survey questionnaire(SF-36)scores were measured at the enrollment and the end of the treatment respectively.Results:By the end of the trial,6 patients in QG paste group dropped out of the trial for drug-induced gastrointestinal adverse reactions(3),initiative request(2)and refracture(1)respectively,while 5 patients in conventional therapy group dropped out of the trial for drug-induced gastrointestinal adverse reactions(2),initiative request(1)and refracture(2)respectively.The patients with drug-induced gastrointestinal adverse reactions were treated with anti-osteoporosis injection,and the patients with refractures were treated with another PKP and anti-osteoporosis therapy,and they all got a good prognosis.There was no statistical difference in serum contents of T-PⅠNP and β-CTX and BMD of lumbar spine and hip between the 2 groups at the enrollment(t=-1.335,P=0.185; t=0.471,P=0.693; t=-1.734,P=0.086; t=-1.190,P=0.237).The serum contents of T-PⅠNP and β-CTX decreased,while the BMD of lumbar spine and hip increased in the 2 groups at the end of the treatment compared to those at the enrollment(T-PⅠNP:60.83+/-4.57 vs 39.26+/-4.06 ng/mL,t=26.460,P=0.000; 62.14+/-5.11 vs 31.32+/-2.49 ng/mL,t=38.692,P=0.000; β-CTX:0.77+/-0.08 vs 0.44+/-0.05 ng/mL,t=25.880,P=0.000; 0.76+/-0.10 vs 0.52+/-0.06 ng/mL,t=14.961,P=0.000; lumbar BMD:0.758+/-0.011 vs 0.786+/-0.024 g/cm(2),t=-10.238,P=0.000; 0.761+/-0.006 vs 0.779+/-0.028 g/cm(2),t=-4.239,P=0.000; Hip BMD:0.528+/-0.008 vs 0.567+/-0.036 g/cm(2),t=-7.550,P=0.000; 0.530+/-0.010 vs 0.556+/-0.024 g/cm(2),t=-8.039,P=0.000).At the end of the treatment,the serum content of T-PⅠNP was higher while the serum content of β-CTX was lower in QG paste group compared to conventional therapy group(t=11.754,P=0.000; t=-6.901,P=0.000),and there was no statistical difference in BMD of lumbar spine and hip between the 2 groups(t=1.355,P=0.179; t=1.770,P=0.080).There was no statistical difference in SF-36 scores between the 2 groups at the enrollment(t=-1.212,P=0.229).The SF-36 scores increased in the 2 groups at the end of the treatment compared to those at the enrollment,and were higher in QG paste group compared to conventional therapy group(102.22+/-1.69 vs 124.55+/-2.56 points,t=-98.085,P=0.000; 102.68+/-2.03 vs 115.34+/-2.29 points,t=-80.066,P=0.000; t=18.702,P=0.000).Conclusion:QG paste can improve bone metabolism and life quality of patients with postmenopausal osteoporotic vertebral fractures after PKP.

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備注/Memo

備注/Memo:
(收稿日期:2020-03-08 本文編輯:李曉樂)基金項(xiàng)目:浙江省中醫(yī)藥科技計(jì)劃項(xiàng)目(2019ZQ026); 浙江中醫(yī)藥大學(xué)附屬第二醫(yī)院“186”人才培養(yǎng)項(xiàng)目; 浙江省“十三五”中醫(yī)藥重點(diǎn)專科建設(shè)項(xiàng)目; “十三五”浙江省中醫(yī)藥(中西醫(yī)結(jié)合)重點(diǎn)學(xué)科建設(shè)項(xiàng)目通訊作者:李敏 E-mail:[email protected]
更新日期/Last Update: 2020-08-15