万六妹

【摘要】 目的：探究藤黃健骨胶囊联合碳酸钙D3片、唑来膦酸注射液治疗老年骨质疏松症（0P）的临床效果。方法：选取2020年1月—2022年12月在南昌市第三医院收治的60例老年OP患者，随机分为对照组及观察组，各30例。给予两组相应的常规治疗，对照组采用碳酸钙D3片、唑来膦酸注射液治疗，观察组在对照组给药基础上另给予藤黄健骨胶囊治疗。评价对比两组临床效果、骨密度（BMD）、疼痛程度、骨代谢标志物水平及骨折发生率。结果：观察组的总有效率（96.67%）显著高于对照组（80.00%）（P<0.05）。治疗后，两组腰椎、股骨颈、Wards三角区的BMD均升高，且观察组均高于对照组（P<0.05）。治疗3、6个月后，两组视觉模拟评分法（VAS）评分均下降，且观察组均低于对照组（P<0.05）。治疗后，两组血清Ⅰ型前胶原氨基端延长肽（PⅠNP）、血清I型胶原交联C末端肽（CTX）水平均降低，且观察组均低于对照组（P<0.05）。观察组骨折发生率（6.67%）显著低于对照组（30.00%）（P<0.05）。结论：藤黄健骨胶囊联合碳酸钙D3片、唑来膦酸注射液治疗老年OP疗效良好，提高患者的BMD，减轻疼痛感，降低骨代谢标志物水平及骨折发生。

【关键词】 藤黄健骨胶囊 老年骨质疏松症 碳酸钙D3片 唑来膦酸注射液

Clinical Effect of Tenghuang Jiangu Capsules Combined with Calcium Carbonate D3 Tablets and Zoledronic Acid Injection in the Treatment of Senile Osteoporosis/WAN Liumei. //Medical Innovation of China， 2024， 21（07）： 0-066

[Abstract] Objective： To investigate the clinical effect of Tenghuang Jiangu Capsules combined with Calcium Carbonate D3 Tablets and Zoledronic Acid Injection in the treatment of senile osteoporosis （OP）. Method： A total of sixty elderly patients with OP admitted to the Third Hospital of Nanchang from January 2020 to December 2022 were selected， and randomly divided into the control group and the observation group， with 30 cases in each group. Two groups were given corresponding conventional treatment， the control group was treated with Calcium Carbonate D3 Tablets and Zoledronic Acid Injection， while the observation group was treated with Tenghuang Jiangu Capsules based on the the control group. Clinical efficacy， bone mineral density （BMD）， pain degree， the levels of bone metabolism markers， and the incidence of fracture were compared between the groups. Result： The total effective rate in the observation group （96.67%） was significantly higher than that in the control group （80.00%） （P<0.05）. After treatment， BMD of lumbar vertebra， femoral neck and Wards triangle area in both groups were increased， and those in the observation group were significantly higher than those in the control group （P<0.05）. After 3， 6 months of treatment， the visual analogue scale （VAS） scores of both groups were decreased， and those in the observation group were significantly lower than those in the control group （P<0.05）. After treatment， serum procollagen type ⅠN-terminal propeptide （PⅠNP）， carboxy-terminal cross-linked telopeptide of type Ⅰ collagen （CTX） levels in both groups decreased， and the those in the observation group were significantly lower than those in the control group （P<0.05）. The incidence of fractures in the observation group （6.67%） was significantly lower than that in the control group （30.00%） （P<0.05）. Conclusion： Tenghuang Jiangu Capsules combined with Calcium Carbonate D3 Tablets and Zoledronic Acid Injection is effective in the treatment of senile OP， can improve the patients' BMD， alleviate pain， lower the levels of bone metabolism markers， and reduce the incidence of fracture.

[Key words] Tenghuang Jiangu Capsules Senile osteoporosis Calcium Carbonate D3 Tablets Zoledronic Acid Injection

First-author's address： Medical Record Room， the Third Hospital of Nanchang， Nanchang 330000， China

doi：10.3969/j.issn.1674-4985.2024.07.015

骨质疏松症（OP）是一种常见的老年骨科代谢性疾病，会出现骨量减少，骨微结构退化及破坏，从而导致骨脆性增加，发生骨折，它是临床上常见的导致老年骨折的原因[1]。临床上治疗OP主要是通过药物治疗，补充钙剂、抑制骨吸收及促进骨形成[2]。唑来膦酸是一种双磷酸盐制剂，常用于治疗OP，它可以选择性作用于骨组织，抑制骨吸收，诱导破骨细胞凋亡，提高骨密度（BMD），治疗骨质疏松[3]。一般采用唑来膦酸治疗OP需要为患者补充钙质，临床上常用的钙剂是碳酸钙D3片，能有效补充患者机体的钙质，缓解骨质疏松症，但不能抑制或减少骨质吸收[4]。单一的药物治疗OP效果有限，联合用药已成为临床治疗OP的趋势。藤黄骨胶囊是复方中药制剂，具有活血止痛、通经活络、补肾健骨之效，常用于颈椎病、大骨节病、脊柱炎等疾病[5]。本研究将合使用探究藤黄健骨胶囊联合碳酸钙D3片、唑来膦酸注射液治疗，探究其治疗老年OP的临床效果，以便为临床用药与实践提供指导与依据。……