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| 益肾壮骨法治疗系统性红斑狼疮患者继发的激素性骨质疏松症48例的临床研究 |
| Clinical study of the treatment of steroid-induced secondary osteoporosis with tonifying kidney and strong bone method in 48-case of systemic lupus erythematosus |
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| DOI：10.3969/j.issn.1006.7108.2018.09.018 |
| 中文关键词: 益肾壮骨法 系统性红斑狼疮 糖皮质激素性骨质疏松症 临床研究 |
| 英文关键词:tonifying kidney and strong bone method SLE GIOP clinical study |
| 基金项目:教育部“春晖计划”合作科研项目（E2008-1-15021） |
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| 中文摘要: |
| 目的 观察益肾壮骨法治疗系统性红斑狼疮（systemic lupus erythematosus ,SLE）合并糖皮质激素性骨质疏松（Glucocorticoid osteoporosis,GIOP）患者的影响，客观评价其疗效。方法 将48例患者采用随机分组方法分为治疗组和对照组各24例。两组均予以西医常规治疗+一定剂量的糖皮质激素继续控制病情+调节骨骼代谢药物（碳酸钙 D3、骨化三醇等），治疗组在西医治疗基础上加用我院自制剂生髓健骨胶囊（由山药、杜仲、熟地、淫羊藿、枸杞、蛤蚧、山茱萸、鹿角霜等组成）。治疗时间以6个月作为1个疗程，在治疗过程中，停止应用导致骨质疏松症发生及治疗相关的各种药物、和理疗方法。治疗1个疗程后，治疗前、治疗后进行比较2组的临床疗效、骨密度值、中医证候积分的变化、骨代谢相关生化指标血钙、血磷和血清碱性磷酸酶水平的变化情况。结果（1）治疗1个疗程后，比较得出治疗组相对于对照组的疗效显著，（P＜0.01），差异有统计学意义。（2）两组治疗后中医证候评分和总分，较治疗前相比显著降低（均 P＜0.05）；治疗后比较两组，得出治疗组的主症证候单项评分及总积分均较对照组下降更为明显（均 P＜0.05）。（3）治疗组的腰椎（L2-4）、左、右髋骨3个部位的骨密度( bone mineral density BMD)值在治疗1个疗程后，无显著的变化（均 P＞0．05），而治疗后的对照组腰椎（L2-4）、左、右髋骨的骨密度值均较治疗前显著下降（ P＜0.05）。治疗后2组比较，治疗组的骨密度值均明显高于对照组（P＜0.05）。（4）有关骨代谢生化指标方面，治疗组在治疗后呈下降趋势（ P＞0.05），而对照组生化指标值则显著上升（ P＜0.05），治疗后的2组进行对比，发现对照组各生化指标值显著高于治疗组（ P＜0.05）。（5）治疗过程中，患者无任何不良症状，也无脱落病例。结论 益肾壮骨法对于系统性红斑狼疮合并GIOP的患者缓解症状，改善病情有很好的效果。 |
| 英文摘要: |
| Objective To observe the effect of tonifying kidney and strong bone method on patients with systemic lupus erythematosus (SLE) complicated with glucocorticoid-induced osteoporosis (GIOP) and to evaluate its efficacy objectively. Methods Forty-eight patients were randomly divided into treatment group (24 cases) and control group (24 cases). Patients in 2 groups received conventional Western medicine + a certain dose of glucocorticoid to continue to control the disease + regulate bone metabolism drugs (calcium D3, calcitriol, etc.). In addition, patients in the treatment group received our hospital homemade producing marrow and strong bone capsules (composed of yam, eucommia, rehmannia, epimedium, medlar, gecko, dogwood, antler cream, etc.). Six-month was a treatment course. During the treatment, the application of various drugs that led to the occurrence and treatment of osteoporosis and physical therapy were stopped. After a course of treatment, the clinical efficacy, bone mineral density, TCM syndrome score changes, bone metabolism related serum calcium, serum phosphorus and serum alkaline phosphatase levels were compared before treatment and after treatment. Results (1) After a course of treatment, the curative effect of the treatment group was more obvious than that of the control group (P<0.01), and the difference was statistically significant. (2) TCM syndrome scores and total scores after treatment in both groups were significantly lower than those before treatment (all P<0.05). After treatment, the two groups were compared. The main syndrome score and total score were lower in the treatment group than in the control group (P<0.05). (3) The bone mineral density (BMD) values of the lumbar spine (L2-4) and the left and right hip in the treatment group did not change significantly after treatment in one course of treatment (all P>0.05), whereas BMD in the control group was significantly lower than that before the treatment (P<0.05). After treatment, BMD in the treatment group was significantly higher than that in the control group (P<0.05). (4) Metabolic biochemical indicators in the treatment group showed a downward trend after treatment (P>0.05), while the biochemical indicators in the control group increased significantly (P<0.05). The biochemical indicators in the control group were significantly higher than those in the treatment group after treatment (P<0.05). (5) During the course of treatment, the patients had no any adverse symptoms and no shedding cases. Conclusion The tonifying kidney and strong bone method relieves symptoms and improves the condition in patients with SLE complicated with GIOP. |
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