刘利群 胡俊 张莉莉 袁忠 张楚焌 谈荣珍 杨盼盼

*基金项目：江西省卫生健康委科技计划项目（202311306）

【摘要】 目的：观察脉冲电磁场联合双膦酸盐对绝经后骨质疏松症患者心理健康和生活质量的影响。方法：选取2022年10月—2023年5月南昌市洪都中医院收治的90例绝经后骨质疏松症患者为研究对象，采用随机单盲、平行对照的研究方法。将患者随机分为三组，各30例。A组给予低频脉冲电磁场联合伊班膦酸钠治疗，B组采用低频脉冲电磁场治疗，C组采用伊班膦酸钠治疗，三组均连续治疗3个月。比较三组性激素、骨密度、骨代谢指标、心理状态、疼痛程度、生活质量及不良反应发生情况。结果：治疗后三组髋部及腰椎骨密度均提高，且A组高于B组、C组（P<0.05）；治疗后三组β-胶原降解产物（β-CTX）、总Ⅰ型前胶原氨基端肽（T-PⅠNP）均降低，A组低于B组、C组，骨钙素（OCN）、25-羟维生素D均升高，A组高于B组、C组（P<0.05）；治疗后三组焦虑自评量表（SAS）、抑郁自评量表（SDS）、视觉模拟评分法（VAS）评分均降低，A组低于B组、C组（P<0.05）；治疗后，三组健康调查量表36（SF-36）各维度评分均提高，且A组高于B组、C组（P<0.05）；三组治疗期间均未见严重不良反应。结论：脉冲电磁场联合双膦酸盐治疗可调节绝经后骨质疏松症患者骨代谢指标，提高骨密度，缓解骨痛，改善心理状况，提升生活质量，且治疗安全性较高。

【关键词】 脉冲电磁场 双膦酸盐 绝经后骨质疏松症 心理健康 生活质量

Effects of Pulsed Electromagnetic Fields Combined with Bisphosphonates on Mental Health and Quality of Life in Patients with Postmenopausal Osteoporosis/LIU Liqun， HU Jun， ZHANG Lili， YUAN Zhong， ZHANG Chujun， TAN Rongzhen， YANG Panpan. //Medical Innovation of China， 2024， 21（13）： 0-024

[Abstract] Objective： To observe the effects of pulsed electromagnetic fields combined with bisphosphonates on mental health and quality of life in patients with postmenopausal osteoporosis. Method： A total of 90 patients with postmenopausal osteoporosis who were admitted to Nanchang Hongdu Hospital of TCM from October 2022 to May 2023 were selected as the study objects， and a randomized single-blind， parallel control method was adopted. Patients were randomly divided into 3 groups， 30 cases in each group. Group A was treated with low frequency pulsed electromagnetic fields combined with Sodium Ibandronate， group B was treated with low frequency pulsed electromagnetic fields， and group C was treated with Sodium Ibandronate. All three groups were treated continuously for 3 months. Sex hormones， bone density， bone metabolism indexes， mental state， pain degree， quality of life and adverse reactions were compared among the three groups. Result： After treatment， the hip and lumbar bone density of the three groups were increased， and those of group A were higher than those of group B and group C， the differences were statistically significant （P<0.05）. After treatment， β-collagen degradation products （β-CTX） and total procollagen typeⅠ N-terminal propeptide （T-PⅠNP） of the three groups were decreased， and those of group A were lower than and those of group B and group C， osteocalcin （OST） and 25-hydroxyvitamin D of the three groups were increased， and those of group A were higher than those of group B and group C， the differences were statistically significant （P<0.05）. After treatment， the scores of self-rating anxiety scale （SAS）， self-rating depression scale （SDS） and visual analogue scale （VAS） of the three groups were decreased， and those of group A were lower than those of group B and group C （P<0.05）. After treatment， all dimensions scores of short form 36 （SF-36） of the three groups were increased， and those of group A were higher than those of group B and group C （P<0.05）. No serious adverse reactions were observed in the three groups during treatment. Conclusion： Pulsed electromagnetic fields combined with bisphosphonates therapy can regulate bone metabolism indexes in patients with postmenopausal osteoporosis， improve bone density， relieve bone pain， improve mental state， and enhance quality of life， and the treatment safety is safe.

[Key words] Pulsed electromagnetic fields Bisphosphonates Postmenopausal osteoporosis Mental health Quality of life

First-author's address： Department of Osteoporosis， Nanchang Hongdu Hospital of TCM， Nanchang 330000， China

doi：10.3969/j.issn.1674-4985.2024.13.005

绝经后骨质疏松症是导致女性机体骨量减少、骨组织结构变化及骨脆性增加的一种代谢性骨病，常诱发骨痛、骨骼变形、骨折等，严重影响中老年女性患者身心健康，降低生活质量[1]。目前针对绝经后骨质疏松症的治疗以药物为主，包括维生素D、雌激素受体调节剂、双磷酸盐类等。其中双磷酸盐为焦磷酸盐的稳定类似物，是当下临床应用最为广泛的抗骨质疏松药物，可通过抑制破骨细胞活性，减少骨吸收，而伊班膦酸钠为第三代双磷酸盐类药物，可采取静脉滴注的方式给药，具有起效时间长、生物利用度高等优点[2-3]。脉冲电磁场为物理疗法，通过设定特定脉冲电流及频率，借助共振效应改变机体生物磁场及生物电，继而发挥调节骨代谢作用[4-5]。……