本文關(guān)鍵詞： 絕經(jīng)后骨質(zhì)疏松癥 青娥丸 舌象參數(shù)　出處：《湖北中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察絕經(jīng)后骨質(zhì)疏松癥腎虛血瘀證患者的舌象參數(shù)變化和青娥丸的治療作用,以期為建立具有中醫(yī)特色的療效評(píng)價(jià)體系提供客觀依據(jù)。方法:2014年9月至2014年12月華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬協(xié)和醫(yī)院骨質(zhì)疏松癥專病門診確診的絕經(jīng)后骨質(zhì)疏松癥腎虛血瘀證患者48例,根據(jù)就診順序編號(hào)并按隨機(jī)數(shù)字表法分為青娥丸治療組和青娥丸模擬劑對(duì)照組,每組各24例。兩組均給予鈣爾奇D作為基礎(chǔ)治療,青娥丸治療組服用青娥丸,青娥丸模擬劑對(duì)照組服用青娥丸模擬劑,療程均為24周。分別于基線和治療24周后對(duì)兩組舌形參數(shù)(老嫩指數(shù)、胖瘦指數(shù)、齒痕指數(shù)、點(diǎn)刺指數(shù)、裂紋指數(shù)、瘀斑指數(shù))、苔質(zhì)參數(shù)(厚薄指數(shù)、潤(rùn)燥指數(shù)、腐膩指數(shù)、剝苔指數(shù))、有效性評(píng)價(jià)指標(biāo)(主要臨床癥狀評(píng)分、腰背四肢疼痛VAS評(píng)分、中醫(yī)證候計(jì)分、骨代謝標(biāo)志物、骨密度)進(jìn)行檢測(cè)和比較。分別于基線、治療8周、16周、24周后對(duì)一般體格檢查(身高、體重、體溫、呼吸、心率、血壓等)、血常規(guī)、尿常規(guī)、大便常規(guī)、肝功能、腎功能,心電圖等進(jìn)行檢測(cè)和比較。分別于基線及治療24周后對(duì)安全性評(píng)價(jià)指標(biāo)(性激素水平、乳腺B超、子宮B超、胸腰椎X線等)進(jìn)行檢測(cè)和比較。隨時(shí)記錄不良事件。結(jié)果:青娥丸能顯著降低絕經(jīng)后骨質(zhì)疏松癥腎虛血瘀證患者舌象胖瘦指數(shù)、齒痕指數(shù)、瘀斑指數(shù)、腰背疼痛VAS評(píng)分、主要臨床癥狀計(jì)分、中醫(yī)證候總計(jì)分、腰背疼痛和腰膝酸軟癥狀程度,并能顯著降低血清β-CTX水平,差異有統(tǒng)計(jì)學(xué)意義(P0.05);下肢痿弱、步履艱難、耳鳴癥狀程度無(wú)明顯改善,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);舌象老嫩指數(shù)、點(diǎn)刺指數(shù)、裂紋指數(shù)、厚薄指數(shù)、潤(rùn)燥指數(shù)、腐膩指數(shù)及剝苔指數(shù)無(wú)明顯改變,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);腰椎L2-L4及股骨頸骨密度值無(wú)明顯增加,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。青娥丸模擬劑對(duì)照組腰椎L2-L4及股骨頸骨密度值與基線比較明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。青娥丸治療組總有效率為75%。結(jié)論:青娥丸能顯著降低絕經(jīng)后骨質(zhì)疏松癥腎虛血瘀證患者舌象胖瘦指數(shù)、齒痕指數(shù)和瘀斑指數(shù),改善腰背疼痛和腰膝酸軟癥狀,顯著降低β-CTX水平。
[Abstract]:Objective: to observe the changes of tongue parameters in postmenopausal osteoporosis patients with kidney deficiency and blood stasis syndrome and the therapeutic effect of Qing'e pill. Methods: from September 2014 to December 2014, the postmenopausal bone of the Union Medical College affiliated to Tongji Medical College of Huazhong University of Science and Technology was diagnosed in the Osteoporosis outpatient Clinic of the affiliated Medical College of Tongji University of Science and Technology, Huazhong University of Science and Technology. 48 patients with kidney deficiency and blood stasis syndrome, According to the number of patients, they were divided into two groups: the treatment group and the control group with 24 cases in each group. Both groups were treated with Calcidum D as the basic therapy, and the treatment group took the Qinge pill in the treatment group. The control group was treated with Qinge pill for 24 weeks. The tongue shape parameters (old tender index, fat thin index, tooth mark index, prick index, crack index) were measured at baseline and 24 weeks after treatment. Index of ecchymosis, index of moss quality (thickness index, moistening index, greasy index, exfoliation index, effective evaluation index (main clinical symptom score, VAS score of back and back pain, TCM syndrome score, biomarker of bone metabolism), Bone mineral density (BMD) was measured and compared at baseline, 8 weeks, 16 weeks and 24 weeks after treatment. General physical examination (height, weight, body temperature, respiration, heart rate, blood pressure etc.), blood routine, urine routine, stool routine, liver function, renal function, etc. Electrocardiogram (ECG) was measured and compared at baseline and 24 weeks after treatment. Adverse events were recorded at any time. Results: Qinge pills could significantly reduce the fat tongue index, tooth mark index, ecchymosis index and VAS score of lumbar back pain in postmenopausal osteoporosis patients with kidney deficiency and blood stasis syndrome. The score of main clinical symptoms, the total score of TCM syndromes, the pain of back and back, the degree of acerbity and softness of waist and knee, and the level of serum 尾 -CTX were significantly decreased, the difference was statistically significant (P 0.05), the weakness of lower limbs, the difficulty of walking, and the degree of tinnitus symptoms were not obviously improved. There was no significant difference (P 0.05), while there was no significant change in tongue appearance index, puncturing index, crack index, thickness index, wetting index, greasy index and peeling index, but there was no significant difference between them, and there was no significant increase in bone mineral density of lumbar vertebrae L2-L4 and femoral neck. The bone mineral density of lumbar vertebrae L2-L4 and femoral neck in the control group was significantly lower than that in the baseline group. The difference was statistically significant (P 0.05). The total effective rate of Qing E pill group was 75. Conclusion: Qing E pill can significantly reduce the tongue fat index, tooth mark index and ecchymosis index of postmenopausal osteoporosis patients with kidney deficiency and blood stasis syndrome. To ameliorate the pain of the back of the waist and the soft symptoms of the waist and knee, and significantly reduce the level of 尾-CTX.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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