辨证取穴埋线联合药物治疗绝经后骨质疏松症临床对照研究

作者	单位
徐敏	广西柳州市中医院脊柱外科
王继	广西柳州市中医院脊柱外科
唐汉武	广西柳州市中医院脊柱外科
唐福宇	广西柳州市中医院脊柱外科
娄宇明	广西柳州市中医院脊柱外科
刘保新	广西柳州市中医院脊柱外科
梁柱	广西柳州市中医院脊柱外科
梁冬波	广西柳州市中医院脊柱外科
黄承军	广西柳州市中医院脊柱外科

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中文摘要:

目的探讨分期整体辨证取穴埋线疗法对绝经后骨质疏松症的疗效及相关指标的影响。方法 135例绝经后骨质疏松症患者随机分为3组:对照A、B组及治疗组,每组45例,对照A组采用碳酸钙D3咀嚼片治疗,对照B组采用碳酸钙D3咀嚼片加仙灵骨葆胶囊口服治疗,治疗组采用碳酸钙D3咀嚼片口服加分期辨证取穴埋线治疗。评价治疗前、治疗3、6个月后的腰背疼痛、生活质量与中医证候积分,治疗前及治疗6个月后腰椎骨密度(BMD)与血清雌二醇(E2)的改变与各组6个月后的疗效。结果治疗前3组患者的疼痛评分(VAS)、BMD、E2、生活质量评分与中医证候积分比较,差异无统计学意义(均P>0.05)。3组治疗3个月后VAS积分、中医证候积分及生活质量评分与本组治疗前比较,差异均有统计学意义(均P<0.01)。其中,治疗组、对照B组优于对照A组(P<0.05,P<0.01),治疗组VAS积分优于对照B组(P<0.01),而中医证候积分与生活质量评分比较,差异无统计学意义。3组经过6个月治疗后,VAS、中医证候积分、生活质量评分与本组治疗前、治疗3个月后比较,差异均有统计学意义(P<0.01),其中,治疗组、对照B组优于对照A组(P<0.01),治疗组优于对照B组(P<0.05,P<0.01)。治疗组与对照B组腰椎BMD、血清E2含量与本组治疗前比较,差异均有统计学意义(均P<0.01),但对照A组治疗前后比较,差异无统计学意义,治疗后治疗组与对照B组优于对照A组,治疗组E2优于对照B组(P<0.01),但BMD方面无差别。3组治疗6个月后的疗效差异显著(P<0.01),治疗组与对照B组优于对照A组(P<0.01,P<0.05),对照B组与治疗组无差别。结论分期整体辨证取穴埋线疗法可减轻绝经后骨质疏松症患者疼痛程度,减少中医证候积分,提高患者的BMD、E2与生活质量,是一种有效的治疗方法。

英文摘要:

Objective To study the therapeutic efficacy of embedding thread according to staging and wholism syndrome differentiation and its effect on correlated indices of patients with postmenopausal osteoporosis.Methods 135 patients with postmenopausal osteoporosis were randomly assigned to the control group A(treated with Calcichew D3 Tablet),the control group B(treated with Calcichew D3 Tablet and Xianling Gubao Capsule),and the treatment group(treated with Calcichew D3 Tablet and embedding thread according to staging and wholism syndrome differentiation).The visual analogue scale(VAS),Chinese medicine syndrome integral,and the quality of life scale before treatment,3 months after treatment,and 6 months after treatment were assessed.Changes of the lumbar bone mineral density(BMD) and the serum level of estradiol(E2) were also assessed before and after six-month treatment.And the therapeutic efficacy of each group was also assessed after 6 months of treatment.Results Before treatment,there was no significant difference in scores of VAS,Chinese medicine syndrome integral and the quality of life scale,the serum level of E2,and the lumbar BMD of the patients in three groups(all P>0.05).After three months of treatment,there was significant difference in scores of VAS,Chinese medicine syndrome integral and the quality of life scale of the patients in the three groups(all P<0.01).Of them,the improvement of the three indices in the control group A was the worst in three groups(P<0.05,P<0.01).The VAS in the treatment group was superior to those in control group B(P<0.01).But the difference of Chinese medicine syndrome integral and the quality of life scale was insignificant in the three groups.After six months of treatment,significant difference was shown in the scores of VAS,Chinese medicine syndrome integral,or the quality of life scale of the patients in the three groups when compared with the corresponding index before treatment and after three months of treatment(all P<0.01).Of them the improvement of the three indices of patients in the treatment group and the control group B was better than that in the control group A(all P<0.01),and the improvement in the treatment group were superior to that in the control group B(P<0.05,P<0.01).Significant difference was shown in the serum level of E2 and the lumbar BMD of the patients in the treatment group and the control group B when compared with before treatment of the same group(both P<0.01).But there was no difference in the control group A between before and after treatment,with better effects obtained in the treatment group and the control group B.And the serum level of E2 of the patients in the treatment group after treatment was higher than that in the control group B(P<0.01),but there was no difference in the lumbar BMD.The therapeutic efficacy in the treatment group and the control group B were superior to that in the control group A(P<0.01,P<0.05),but no difference existed between the treatment group and the control group B.Conclusions The therapy of embedding thread according to staging and wholism syndrome differentiation could reduce the scores of VAS and Chinese medicine syndrome integral,enhance the serum lever of E2,the quality of life scale and the lumbar BMD of patients with postmenopausal osteoporosis.So it was an effective method.

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