首页> 中文期刊> 《世界中医药》 >独活寄生汤与强骨活血汤联合钙尔奇 D、仙灵骨葆治疗老年骨质疏松性骨折的临床疗效比较研究

独活寄生汤与强骨活血汤联合钙尔奇 D、仙灵骨葆治疗老年骨质疏松性骨折的临床疗效比较研究

         

摘要

Objective:To compare the effect of Duhuojisheng Decoction (DHJSD)and Qiangguhuoxue Decoction (QGHXD),com-bined with Caltrate D and Xianlinggubao ,on senile osteoporosis fracture .Methods:A total of 150 cases who were hospitalized from January 2013 to January 2015 were confirmed as senile osteoporosis thoracolumbar compression fractures .They were separated into three groups randomly .Group 1 were treated with Duhuojisheng decoction combined with Caltrate D and xianlinggubao ; Group 2 were treated with Qiangguhuoxue decoction combined with Caltrate D and xianlinggubao ;Group 3 were treated with Caltrate D and xianlinggubao .The anterior height of the 3 groups were observed before and after 2,4,8 months of treatment;the Cobb angle in the 3 groups were observed before and after 2,4,8 months of treatment; VAS score in the 3 groups were evaluated after 1,2,3,4, months of treatment;osteocalcin and bone alkaline phosphatase in group 1 and group 2 were tested before and after 2 and 4 months of treatment .The efficacy on group 3 was evaluated after 8 months of treatment .Results:In the comparison of anterior height of 3 groups,there was no obvious difference nor statistical significance before treatment (P<0.05);after 2 months of treatment,the al-titude lip of Group 1 was slightly lower than that of Group 2,and there was difference between the two groups ( t2 =2.0239,P<0.05);after 4 and 8 months of treatment,there was no significant difference in the two groups (t4 =0.7538,t8 =0.5047,P>0.05);after 2,4,8 months of treatment,the altitude of lip of group 3 was much higher than that of Group 1 and Group 2,thus there was significant difference(P<0.05).The Cobb angle measurement showed no significant difference before and after 4 months of treatment(P<0.05)After 2 month of treatment,the Cobb angle measurement of group 1 is significantly larger than that of group 2 and 3(P<0.05);before treatment,VAS of 3 groupsshowed no significant difference (P>0.05); while after 1,2,3,4 months of treatment in Group 1,VAS was much larger than that of Group 2(P<0.05),and almost the same as that of group 3(P>0.05). Conclusion:Duhuojisheng decoction and Qiangguhuoxue decoction combined with Caltrate D and Xianlinggubao had positive effect on senile osteoporosis fracture ,clinically .However ,the latter onereduced the pain ,induced the osteocalcin and bone alkaline phos-phatase,promoted the fracture healing ,inhibited bone loss and absorption and strengthened the bone .%目的:比较研究独活寄生汤与强骨活血汤联合钙尔奇D、仙灵骨葆治疗治疗老年骨质疏松性骨折的临床疗效。方法:选取本院2013年1月至2015年1月收治并确诊的老年骨质疏松胸腰椎压缩性骨折患者150例,治疗医师根据数字表法将所有患者随机平分为3组,其中中药1组采用独活寄生汤联合钙尔奇D、仙灵骨葆治疗,中药2组采用强骨活血汤治疗联合钙尔奇D、仙灵骨葆治疗,对照组行单纯钙尔奇D联合仙灵骨葆进行治疗。观察3组治疗前、治疗后2、4、8个月的伤椎前缘高度变化;3组治疗前、治疗后2、4个月的伤椎Cobb角测量值;3组治疗前、治疗后1、2、3、4个月的视觉疼痛模拟评分( VAS);中药1组和中药2组的治疗前、治疗后2、4个月的骨钙素和血清骨碱性磷酸酶的检测值;对3组患者治疗后8个月的临床疗效评估。结果:伤椎前缘高度变化组间比较中,3组治疗前伤椎前缘高度无统计学意义(P>0.05),治疗后2个月,中药1组伤椎前缘高度略小于中药2组,比较差异有统计学意义(t2=2.0239,P<0.05);治疗后4、8个月,2组治疗后伤椎前缘高度比较无统计学意义(t4=0.7538,t8=0.5047,P>0.05)。对照组在治疗后2、4、8个月的伤椎前缘高度明显高于中药1组和中药2组,比较差异有统计学意义( P<0.05)。3组治疗前、治疗后4个月的伤椎Cobb角测量值差异比较无统计学意义( P>0.05);中药1组治疗后2个月的伤椎Cobb角测量值明显大于中药2组和对照组,比较差异有统计学意义(P<0.05);3组治疗前的视觉疼痛模拟评分(VAS)差异比较无统计学意义(P>0.05);中药1组治疗后1、2、3、4个月的VAS评分明显大于中药2组(P<0.05),而中药1组治疗后1、2、3、4个月的VAS评分与对照组无统计学意义(P>0.05)。结论:采用独活寄生汤或强骨活血汤联合钙尔奇D、仙灵骨葆治疗老年骨质疏松性胸腰椎压缩性骨折均可取得较好的临床疗效,但本研究认为强骨活血汤联合钙尔奇D、仙灵骨葆可更有效的降低患者治疗过程中的疼痛、提高恢复过程中体内骨钙素、血清骨碱性磷酸酶的水平值,促进骨折愈合,抑制骨质流失及吸收,增强骨强度,达到了治疗与强化的双层目的。

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