目的 探討益腎健骨膠囊聯(lián)合阿法骨化醇治療肝腎不足型骨質(zhì)疏松癥的臨床療效。方法 選取2021年9月—2023年10月武漢市中醫(yī)醫(yī)院骨科收治的200例肝腎不足型骨質(zhì)疏松癥患者，依據(jù)用藥情況將所有患者分為對(duì)照組和治療組，每組各100例。對(duì)照組口服阿法骨化醇片，0.25 µg/次，1次/d。治療組在對(duì)照組的治療基礎(chǔ)上口服益腎健骨膠囊，4粒/次，3次/d。兩組用藥12周。觀察兩組患者的臨床療效和癥狀緩解時(shí)間，比較兩組治療前后疼痛數(shù)字評(píng)價(jià)量表（NRS）評(píng)分、腰椎Oswetry功能障礙指數(shù)（ODI）評(píng)分、骨鈣素（BGP）、骨保護(hù)素（OPG）、β-膠原降解產(chǎn)物（β-CTX）、Ｉ型前膠原氨基端前肽（s-PINP）、Ｉ型膠原羧基端交聯(lián)肽（s-CTX）、腫瘤壞死因子-α（TNF-α）、促生長(zhǎng)因子-1（IGF-1）、白細(xì)胞介素-6（IL-6）的變化情況。結(jié)果 治療后，治療組總有效率是96.00%，顯著高于對(duì)照組的88.00%（P＜0.05）。治療后，治療組腰痛、乏力、肌肉痙攣、脊柱變形緩解時(shí)間均短于對(duì)照組（P＜0.05）。治療后，兩組NRS評(píng)分、ODI評(píng)分均顯著降低（P＜0.05）；治療后，治療組NRS評(píng)分、ODI評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組患者BGP、OPG顯著升高，而β-CTX、s-PINP顯著降低（P＜0.05）；治療后，治療組骨代謝指標(biāo)改善優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組血清s-CTX、TNF-α、IL-6均顯著降低，而IGF-1水平顯著升高（P＜0.05）；治療后，治療組血清學(xué)指標(biāo)改善優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 益腎健骨膠囊聯(lián)合阿法骨化醇治療骨質(zhì)疏松癥具有較好的臨床療效，患者臨床癥狀好轉(zhuǎn)顯著，較好糾正骨代謝，降低機(jī)體炎性因子水平，值得借鑒與應(yīng)用。

Objective To explore the therapeutic effect of Yishen Jiangu Capsules combined with alfacalcidol in treatment of osteoporosis of liver and kidney deficiency type. Methods A total of 200 patients with hepatorenal deficiency osteoporosis admitted to the Orthopedics Department of Wuhan Hospital of Traditional Chinese Medicine from September 2021 to October 2023 were selected and divided into control group and treatment group according to drug use, with 100 patients in each group. Patients in the control group were po administered with Alfacalcidol Tablets, 0.25 µg/time, once daily. Patients in the treatment group were po administered with Yishen Jiangu Capsules on the basis of the control group, 4 grains/time, three times daily. Both groups were treated for 12 weeks. The clinical efficacy and symptom remission time of the two groups were observed. The changes of NRS score, Lumbar Oswetry Dysfunction Index (ODI) score, BGP, OPG, β-CTX, s-PINP, s-CTX, TNF-α, IGF-1, and IL-6 were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 96.00%, which was significantly higher than that of the control group (88.00%, P < 0.05). After treatment, the relief time of low back pain, fatigue, muscle spasm and spinal deformation in the treatment group was shorter than that in the control group (P < 0.05). After treatment, NRS score and ODI score were significantly decreased in both groups (P < 0.05). After treatment, NRS scores and ODI scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, BGP and OPG were significantly increased, while β-CTX and s-PINP were significantly decreased (P < 0.05). After treatment, the improvement of bone metabolism indexes in treatment group was better than that in control group (P < 0.05). After treatment, serum s-CTX, TNF-α and IL-6 were significantly decreased in both groups, while the level of IGF-1 was significantly increased (P < 0.05). After treatment, the improvement of serological indexes in treatment group was better than that in control group (P < 0.05). Conclusion Yishen Jiangu Capsules combined with alfacalcidol has good clinical effect in treatment of osteoporosis of liver and kidney deficiency type, and the clinical symptoms of the patients improved significantly, bone metabolism was better corrected, the level of inflammatory factors was reduced, which is worthy of reference and application.

R977

湖北省衛(wèi)生計(jì)生委中醫(yī)藥科研項(xiàng)目資助項(xiàng)目（ZY2019Z009）