密固达对骨质疏松患者中短期生存质量的影响
Effect of Aclasta on mid-short term quality of life in patients with osteoporosis
  
DOI:10. 3969/j. issn. 1006-7108. 2012. 12. 009
中文关键词:  骨质疏松  密固达  疼痛  生存质量
英文关键词:Osteoporosis  Aclasta  Pain  Quality of life
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作者单位
黄永明 徐逸生 肖春生 苏海涛 罗明海 徐旭 510006广州广东省中医院骨科 
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中文摘要:
      目的 我国老年人数量居于世界首位,骨质疏松是老年人常见的疾病,骨质疏松症的发病率呈上升趋势,使用疗效确切、迅速起效的抗骨质疏松药物减轻疼痛,恢复生活自理能力,提高生活质量尤为必要。方法 回顾分析2010年5月~2012年5月骨质疏松患者52例,随机分为密固达组和福善美组各26例,密固达组每年静脉滴注密固达注射液(诺华公司)5 mg;福善美组口服福善美,1片/次,每周1次,分析治疗前、治疗后1周、2周、1月、6月、1年VAS疼痛指数和诺丁汉健康量表变化。结果 52例患者治疗后VAS疼痛指数均有改善,半年治疗后,VAS改善比较明显,与治疗前比较差异有统 计学意义(P<0.01 ),密固达组的VAS评分改善更为迅速,治疗后1周内VAS指数已有明显的下降 (P<0.05 )。在诺丁汉健康量表分析方面,52例患者经治疗后指数均有不同程度的下降,尤其是在躯 体活动、精力、疼痛这3个条目方面(P<0.01 ),而密固达组下降更为迅速,治疗后1周已有显著性差 异(P<0. 05 );密固达组在治疗后1年社会联系条目指数较治疗前也有明显下降(P<0. 05 );两组在睡眠与情感反应条目治疗前后未见明显变化(P>0. 05 );密固达组治疗1年后,躯体活动、精力、疼痛 条目得分较福善美组低,比较有显著差异,具有统计学意义(P<0.05 )。结论 静脉滴注唑来膦酸盐较口服阿仑膦酸盐有更好的止痛效果,其起效更为迅速,使患者更快的恢复自理,减少了卧床时间,从而减少了因疼痛长期卧床引起废用性骨质疏松的恶性循环。同时,密固达每年仅需要一次静脉滴 注,大大提高了用药的依从性,受到患者及其家属的青睐,是一种高效的人性化的抗骨质疏松药物。
英文摘要:
      Objective China has the largest population of elderly people in the world. Osteoporosis is a common disease in elderly people. As the incidence of osteoporosis in in a trend of rising, it is particularly necessary to apply effective,rapid onset anti-osteoporosis drugs to alleviate pain,to restore living skills,and to improve the quality of life. Methods Data of 52 patients with osteoporosis from May 2010 to May 2012 were analyzed retrospectively. The patients were randomly divided into 2 groups: Aclasta group ( n = 26 ) and Fosamax group ( n =26 ). Patients in Aclasta group received an intravenous injection of 5 mg Aclasta (Novartis Pharmaceuticals ) once a year. Patients in Fosamax group had an oral administration of Fosamax,1 pill each time,once a week. The whole treatment lasted for 1 year. The changes of VAS pain scores and Nottingham Health Scale on pre-treatment,1 week, 2 weeks, 1 month, 6 months, and 1 year after the treatment,were compared. Results After the treatment,the VAS pain scores of all 52 patients improved.VAS improved fairly obviously after 6-month treatment,and it had significant difference with the pre-treatment VAS (P <0.01 ). The VAS scores in Aclasta group improved more rapidly. The VAS had significant decline after one-week treatment (P< 0. 05 ). The Nottingham Health Questionnaire analysis showed that the index of 52 patients had different degree of decline after the treatment, especially in physical activity, energy and pain (P <0.01 ). The index decreased more rapidly in Aclasta group, and the significant difference was shown just one-week alter the treatment (P< 0. 05 ). The social contact item in Aclasta group decreased significantly alter an 1 -year treatment (P < 0. 05 ). No obvious change in sleep and emotional reaction items between pre-and post-treatment was shown in both groups (P> 0. 05 ). Alter 1 -year treatment, the score of physical activity, and energy and pain items in Aclasta group were significant lower than that in Fosamax group ( P < 0. 05 ). Conclusion Intravenous infusion of zoledronic bisphosphonates has a better analgesic effect compared to oral alendronate sodium. The effect appears more rapidly, giving the patients a faster recovery of self-care, reducing the time in bed, thereby blocking the vicious cycle of disuse osteoporosis caused by pain bedridden. Simultaneously, Aclasta needs an intravenous drip once a year,which greatly improves the medication compliance of patients and their families. It is considered as a highly effective and humanized anti - osteoporosis drug.
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