目的 探討補(bǔ)腎健骨膠囊聯(lián)合唑來膦酸注射液和碳酸鈣D3片治療老年骨質(zhì)疏松癥的臨床療效。方法 選擇2012年5月-2015年1月在郫縣人民醫(yī)院骨科接受醫(yī)治的114例骨質(zhì)疏松癥患者為研究對(duì)象,所有患者按照治療方法的不同分為對(duì)照組和治療組,每組各57例。所有患者均口服碳酸鈣D3片,1片/次,1次/d。在此基礎(chǔ)上對(duì)照組靜脈滴注唑來膦酸注射液,5 mg加入生理鹽水250 mL中,1次/月,每次滴注不少于15 min。治療組在對(duì)照組基礎(chǔ)上口服補(bǔ)腎健骨膠囊,4粒/次,3次/d。兩組患者均連續(xù)治療12個(gè)月。觀察兩組患者的臨床療效,比較骨代謝指標(biāo)以及骨密度(BMD)、骨鈣素(BGP)、骨形態(tài)發(fā)生蛋白(BMP-2)及視覺模擬(VAS)評(píng)分。結(jié)果 治療后,對(duì)照組和治療組總有效率分別為82.46%、94.74%,兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組血鈣(S-Ca)、血磷(S-P)明顯增高,堿性磷酸酶(ALP)顯著降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者L2-L4 BMD、股骨頸BMD、BGP、BMP-2均明顯增加,VAS評(píng)分明顯降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。對(duì)照組、治療組的不良反應(yīng)發(fā)生率分別為7.02%、8.77%,兩組不良反應(yīng)發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 補(bǔ)腎健骨膠囊聯(lián)合唑來膦酸注射液和碳酸鈣D3片治療老年骨質(zhì)疏松癥具有較好的臨床效果,可有效增加患者BMD,明顯改善骨代謝,減少骨量流失,值得臨床推廣應(yīng)用。

Objective To investigate the clinical effect of Bushen Jiangu Capsules combined with Zoledronic Acid Injection and Calcium Carbonate D3 Tablets in treatment of aged osteoporosis.Methods Patients (114 cases) with aged osteoporosis in the Department of Orthopedics of Pixian County People's Hospital from May 2012 to January 2015 were enrolled in this study. According to the different treatment plans, patients were divided into control group (57 cases) and treatment group (57 cases). All patients were po administrated with Calcium Carbonate D3 Tablets, 1 tablet/time, once daily. The patients in the control group were iv administered with Zoledronic Acid Injection, 5 mg Zoledronic Acid Injection added into normal saline 250 mL, once monthly, and the infusion times were not less than 15 min. The patients in the treatment group were poadministered with Bushen Jiangu Capsules on the basis of the control group, 4 capsules/time, three times daily. The patients in two groups were treated for 12 months. After treatment, the efficacy was observed, and bone metabolic markers, BMD, BGP, BMP-2, and VAS scores in two groups before and after treatment were compared.Results After treatment, the efficacies in the control and treatment groups were 82.46% and 94.74%, respectively, and there were differences between two groups (P < 0.05). After treatment, S-P and S-Ca in two groups were significantly increased, but ALP was obviously decreased, and the differences were statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, L2-L4 BMD, femoral neck BMD, BGP, and BMP-2 in two groups were significantly increased, but VAS scores were obviously decreased, and the differences were statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). The incidences of adverse reactions in the control and treatment groups were 8.77% and 7.02%, , respectively, but there was no significant difference between two groups.Conclusion Bushen Jiangu Capsules combined with Zoledronic Acid Injection and Calcium Carbonate D3 Tablets has clinical curative effect in treatment of aged osteoporosis, can effectively increase BMD, significantly improve the bone metabolism, and reduce the loss of bone mass, which has a certain clinical application value.