庞江娜 武永富 梁芳 王江泳 赵旭兰 范亚坤 周艳艳 张灿

摘要 目的：探讨独活寄生湯联合摩擦步训练对老年骨质疏松症患者骨密度及下肢肌力的影响。方法：选取2013年4至2015年12月石家庄市第一医院收治的老年骨质疏松症患者96例，按随机、对照原则分对照组和观察组，每组48例，对照组采用钙尔奇联合骨化三醇治疗；观察组采用独活寄生汤联合摩擦步训练治疗，治疗8周为1个疗程，治疗前后测定临床疼痛缓解和骨密度，评定下肢肌力，采血测定血清骨代谢指标，同时比较临床疗效及安全性。结果：与治疗前比较，2组治疗后静息性腰背痛、翻身痛、前屈后伸痛降低，腰椎L2-4和右股骨颈骨密度升高，慢速伸肌肌力、屈肌肌力和中速伸肌肌力、屈肌肌力升高，钙、磷水平升高，AKP水平降低（P<0.05）；与对照组比较，观察组治疗后静息性腰背痛、翻身痛、前屈后伸痛较低，腰椎L2-4和右股骨颈骨密度较高，慢速伸肌肌力、屈肌肌力和中速伸肌肌力、屈肌肌力较高，钙、磷水平较高，AKP水平较低（P<0.05）；对照组有效率为75.00%；观察组有效率为91.67%，观察组高于对照组（P<0.05）。结论：独活寄生汤联合摩擦步训练对老年骨质疏松症疗效显著，显著提高骨密度和下肢肌力，改善骨代谢指标和临床症状。

关键词 独活寄生汤；摩擦步训练；老年；骨质疏松症；骨密度；下肢肌力

Abstract Objective：To investigate the effects of Duhuo Jisheng Decoction combined with friction step training on bone density and muscle strength of lower limbs of the elderly patients with osteoporosis. Methods：Ninety-six elderly patients with osteoporosis who were admitted and treated in the First Hospital of Shijiazhuang from April 2013 to December 2015 were selected and randomly divided into control group （n=48） and study group （n=48）. The patients of control group were treated with Caltrate with ossification calcitriol treatment， and patients of study group were treated with Duhuo Jisheng Decoction combined with friction step training for 8 weeks. The clinical pain relief and bone mineral density were measured， and the lower limb muscle strength was assessed. The serum bone metabolic markers， clinical efficacy and safety were compared after the treatment. Results：Compared with the state before treatment， scores of resting pain， back pain， over flexion and extension pain decreased， and scores of bone mineral density of lumbar spine L2-4 and right femoral neck increased. Slow extensor muscle strength increased， and flexor muscle flexor muscle， extensor muscle strength and speed increased. Contents of Ca and P increased， and AKP decreased （P<0.05）； Compared with the control group， scores of resting pain， back pain， over flexion and extension pain were lower， and scores of bone mineral density of lumbar spine L2-4 and right femoral neck were higher. And slow extensor muscle strength were higher， and flexor muscle flexor muscle， extensor muscle strength and speed were higher. and content of Ca and P were higher， and AKP were lower（P<0.05）； The effective rate of the patients in the control group was 75.00%， which was lower than that of study group 91.76% （P<0.05）. Conclusion：Duhuo Jisheng Decoction combined with friction step training has significant therapeutic effect on senile osteoporosis， and significantly improve bone density and muscle strength of lower limbs， and improve bone metabolism and clinical symptoms， which was worthy of wide promotion.

Key Words Duhuo Jisheng Decoction； Friction step training； Senile； Osteoporosis； Bone density； Muscle strength of lower limbs

中图分类号：R289.5；R274.9文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.02.032

骨质疏松症属于一类代谢性疾病，具有骨折发生率高、骨强度和密度低等特点，给老年患者的生命质量带来了极大的影响[1]。临床尚缺少确切的治疗方案，仍然以药物治疗为主，然而难以在根本上改善下肢肌力和疼痛症状，具有一定的局限性。因此探讨骨质疏松症的有效治疗方法具有重要的临床意义[2]。独活寄生汤出自唐代孙思邈所著《备急千金要方》，既往临床常用于治疗痹证、腰痛。随着治疗应用的不断扩展，经多次临床研究证实，独活寄生汤加减治疗骨质疏松症疗效确切，能显著改善骨代谢指标[3]。……