乙胜 付琳 李占明 桑明中 孙晓栋

[摘要] 目的 探討益精调血法治疗绝经后骨质疏松症（PMOP）的临床效果。方法 方便选择2017年1—12月该院收治的绝经后PMOP患者，共计90例。90例患者以简单随机化方法分为3组，即空白组、对照组与治疗组各30例。空白组采用钙剂与骨化三醇软胶囊治疗，对照组采用钙剂、骨化三醇软胶囊与阿仑膦酸钠治疗，治疗组采用钙剂、骨化三醇软胶囊与益精调血方治疗。评价3组患者的临床疗效，治疗前与治疗后（治疗1年时）骨密度、骨钙素与人1，25 二羟基维生素D（1，25-（OH）2VD）指标的变化，以及药物不良反应。结果 3组临床疗效对比中，治疗组治疗的总有效率96.67%高于对照组73.33%与空白组的60.00%（P<0.05）。治疗后治疗组骨密度与1，25-（OH）2VD高于对照组与空白组（P<0.05）;骨钙素低于对照组与空白组（P<0.05）。在药物不良反应发生率对比中，3组差异无统计学意义（χ2=0.000，P>0.05）。结论 益精调血法治疗绝经后PMOP疗效确切，可以有效调节患者的骨密度、骨钙素等指标，改善临床症状，且安全性佳，值得临床推广。

[关键词] 中医;益精调血法;绝经后骨质疏松症

[中图分类号] R259          [文献标识码] A          [文章编号] 1674-0742（2019）11（a）-0006-03

Clinical Study on Treatment of Postmenopausal Osteoporosis with Yijing Tiaoxue Method

YI Sheng， FU Lin， LI Zhan-ming， SANG Ming-zhong， SUN Xiao-dong

Department of Orthopaedics， Section Two， Shouguang City Hospital of Traditional Chinese Medicine， Weifang， Shandong Province， 262700 China

[Abstract] Objective To investigate the clinical effect of Yijing Tiaoxue therapy on postmenopausal osteoporosis （PMOP）. Methods A total of 90 postmenopausal PMOP patients admitted to our hospital from January to December 2017 were convenient selected. 90 patients were divided into three groups by simple randomization method， namely， 30 patients in the blank group， the control group and the treatment group. The blank group was treated with calcium and calcitriol soft capsules， the control group was treated with calcium， calcitriol soft capsule and alendronate. The treatment group was treated with calcium， calcitriol and capsules of Yijing Tiaoxue therapy. To evaluate the clinical efficacy of the three groups of patients， before and after treatment （1 year of treatment）， bone mineral density， osteocalcin and human 1，25 dihydroxyvitamin D （1，25-（OH）2VD） indicators， and drugs adverse reactions. Results In the comparison of the clinical efficacy of the three groups， the total effective rate of the treatment group was 96.67% higher than that of the control group （73.33%） and the blank group （60.00%） （P<0.05）. After treatment， the bone mineral density and 1，25-（OH）2VD in the treatment group were higher than those in the control group and the blank group （P<0.05）. The osteocalcin was lower than the control group and the blank group （P<0.05）. In the comparison of the incidence of adverse drug reactions， there was no significant difference between the three groups （χ2=0.000， P>0.05）. Conclusion Yijing Tiaoxue therapy is effective in the treatment of postmenopausal PMOP. It can effectively regulate the bone mineral density， osteocalcin and other indicators， improve clinical symptoms， and has good safety. It is worthy of clinical promotion.

[Key words] Chinese medicine; Yijing Tiaoxue method; Postmenopausal osteoporosis

绝经后骨质疏松症（PMOP）是绝经后女性的常见病之一，主要由雌激素缺乏所致的骨组织结构变化与骨量减少所致[1]。目前，PMOP尚无特效的治疗方案，其中西医主要以激素替代疗法、维生素D、补钙、双膦酸盐二磷酸盐、选择性雌激素受体调节剂、降钙素与甲状旁腺素等方法治疗，但整体收效参差不齐，且长期用药不良反应较多[2]。中医对PMOP有着独到的见解，其认为肾主骨生髓，肾脏与骨质坚硬程度关系密切，其中肾精亏虚是 PMOP 基础，精血同源，精亏血少，而瘀血是其病理产物[3]。以此，立益精调血之法，旨在观察益精调血法对绝经后PMOP 患者骨密度、骨钙素等指标变化的影响。……