本文選題：絕經(jīng)后骨質(zhì)疏松癥　切入點(diǎn)：骨代謝指標(biāo)　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過對(duì)100例絕經(jīng)后骨稀疏癥患者、20例絕經(jīng)后非骨松癥患者及20例育齡期女性的研究,來探討骨鈣素、雌二醇、尿NTx在絕經(jīng)后骨松癥中的意義;并探究骨代謝指標(biāo)在絕經(jīng)后骨松癥中醫(yī)分型上是否存在差異,為骨松癥的診斷和辨證提供一定的依據(jù)。方法:根據(jù)雙光能X線骨密度儀測(cè)定的BMD數(shù)值,選取停經(jīng)后骨質(zhì)稀疏癥(包括骨量減少者)100例,停經(jīng)后非骨質(zhì)松癥(非骨松組)及育齡期骨密度正常女性(對(duì)照組)各20例。綜合患者臨床癥狀及體征,依照中華人民共和國國家標(biāo)準(zhǔn)制訂的中醫(yī)臨床診療術(shù)語癥候部分,以國內(nèi)中醫(yī)藥治療骨質(zhì)疏松癥文獻(xiàn)復(fù)習(xí)為基礎(chǔ),參照諸多學(xué)者意見,采用中醫(yī)基本證候獨(dú)立診斷的方法,將納入的100例停經(jīng)后骨松癥患者按照中醫(yī)辨證分型分為腎虛血瘀、脾腎陽虛、肝腎陰虛、腎精不足,共4型,測(cè)定三組患者血清中骨鈣素、雌二醇,尿NTx以及L2~L4椎體正位骨密度。結(jié)果:(1)骨松組、非骨松組骨鈣素、尿NTx數(shù)值均顯著高于正常育齡期女性,雌二醇水平明顯低于正常育齡期女性,差異有統(tǒng)計(jì)學(xué)意義(P0.05);(2)絕經(jīng)后骨質(zhì)疏松癥的主要證侯分別為:腰膝部酸困痛、眩暈耳鳴、五心煩熱、盜汗顴紅、舌紫暗有瘀斑、脈細(xì)數(shù)、弦澀等;(3)絕經(jīng)后女性骨質(zhì)疏松癥的中醫(yī)證型分布常見的有四種,其中最多的是:腎虛血瘀型,其次為:肝腎陰虛、脾腎兩虛、腎精虧虛。(4)絕經(jīng)后骨質(zhì)疏松癥各中醫(yī)辨證分型在骨鈣素、尿NTx、骨密度值之間的差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:骨代謝指標(biāo)具有較高的敏感性和特異性,因此在絕經(jīng)后骨松癥的早期,監(jiān)測(cè)骨代謝指標(biāo)能及早反映病情,因此在OP的早期診斷和藥物療效監(jiān)測(cè)中具有重要臨床應(yīng)用價(jià)值。
[Abstract]:Objective: to investigate the significance of osteocalcin, estradiol and urinary NTx in postmenopausal osteopenia, 20 postmenopausal non-osteopenia patients and 20 women of childbearing age. To explore the difference of bone metabolism indexes in TCM classification of postmenopausal osteopenia, and to provide some basis for the diagnosis and differentiation of osteopenia. Methods: according to the BMD value measured by dual X-ray absorptiometry, We selected 100 cases of postmenopausal osteoporosis (including 100 cases of osteopenia), 20 cases of postmenopausal non-osteoporosis (non-osteoporosis group) and 20 cases of normal bone mineral density (control group). In accordance with the national standards of the people's Republic of China, the TCM clinical diagnosis and treatment term symptom part, based on the review of domestic literature on the treatment of osteoporosis with Chinese medicine, and referring to the opinions of many scholars, adopts the method of independent diagnosis of the basic syndromes of traditional Chinese medicine. The 100 postmenopausal patients with osteosarcoma were divided into 4 types according to TCM syndrome differentiation: kidney deficiency and blood stasis, spleen and kidney yang deficiency, liver and kidney yin deficiency, kidney essence deficiency, total 4 types. Serum osteocalcin and estradiol were measured in three groups. Results the bone mineral density (BMD) of NTx and L2 / L4 vertebrae were significantly higher in bone loose group and non osteosong group than in normal reproductive age group, and the level of estradiol was significantly lower than that in normal reproductive age group. The main symptoms of postmenopausal osteoporosis were: lumber and knee pain, vertigo tinnitus, five upset heat, night sweating zygomaticus red, tongue purple dark ecchymosis, fine pulse count. There are four common types of TCM syndrome in postmenopausal women with osteoporosis, the most common of which are deficiency of kidney and blood stasis, followed by deficiency of liver and kidney yin, deficiency of spleen and kidney, There was no significant difference in osteocalcin, urinary NTxand bone mineral density in postmenopausal osteoporosis. Conclusion: the indexes of bone metabolism have high sensitivity and specificity, so in the early stage of postmenopausal osteopenia, there is no significant difference in the differentiation of TCM syndromes in postmenopausal osteoporosis. The monitoring of bone metabolism can reflect the disease as early as possible, so it has important clinical application value in the early diagnosis of op and the monitoring of drug efficacy.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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