發(fā)布時(shí)間：2018-05-08 13:56

  本文選題：益腎復(fù)原方 + 骨質(zhì)疏松癥�。� 參考：《浙江中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的通過(guò)董飛俠主任中醫(yī)師治療老年性骨質(zhì)疏松癥的經(jīng)驗(yàn)方益腎復(fù)原方的臨床研究,評(píng)價(jià)其臨床療效,為中藥復(fù)方的臨床應(yīng)用奠定理論基礎(chǔ),豐富中醫(yī)臨床抗骨質(zhì)疏松癥的治療方案。方法將60例臨床符合納入標(biāo)準(zhǔn)的老年性骨質(zhì)疏松癥且中醫(yī)辨證為腎精虧虛證患者,隨機(jī)分為治療組30例,對(duì)照組30例。對(duì)照組給予鈣爾奇D片、羅蓋全膠丸、阿侖膦酸鈉治療。治療組在對(duì)照組的基礎(chǔ)上給予益腎復(fù)原方煎劑,每日1劑,每日2次,每次服用200ml。3個(gè)月為1個(gè)療程,2個(gè)療程后判斷臨床療效,并觀察記錄其藥物不良反應(yīng),于療程結(jié)束后,復(fù)查實(shí)驗(yàn)室指標(biāo),并評(píng)價(jià)療效。結(jié)果治療組總體有效率為90%,對(duì)照組總體有效率為70%,經(jīng)統(tǒng)計(jì)學(xué)分析差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療前治療組與對(duì)照組各中醫(yī)證候評(píng)分比較無(wú)明顯差異(P0.05)。治療組與對(duì)照組在經(jīng)過(guò)治療后,治療組在腰膝酸軟、耳鳴耳聾、性欲減淡、發(fā)脫齒松、兩足萎軟、舌淡、脈弱等中醫(yī)證候改善方面均優(yōu)于對(duì)照組,在統(tǒng)計(jì)學(xué)上有顯著差異(P0.05)。對(duì)于試驗(yàn)前、后血清Ca、P、ALP濃度變化情況,兩組治療前、后血清P、ALP的濃度無(wú)明顯改變,差異無(wú)顯著性意義(P0.05)；兩組治療前、后血清Ca的濃度明顯改變,差異有顯著性意義(P0.05),治療后組間比較,治療組較對(duì)照組更能提高患者Ca濃度(P=0.3720.05)；試驗(yàn)前、后血清PINP、β-CTx濃度變化情況,兩組治療前、后血清PINP、β-CTx的濃度明顯改變,差異有顯著性意義(P0.05)；治療后組間比較,治療組較對(duì)照組更能提高患者PINP濃度,降低β-CTx的濃度(P0.05)。對(duì)于股骨頸(Neck)、股骨粗隆(Troch)和腰椎(L1-L4)骨密度檢測(cè)比較情況,治療組中治療前后組內(nèi)比較,P0.05,存顯著性差異。對(duì)照組中治療前后組內(nèi)比較,P0.05,有顯著性差異。兩組治療后組間比較,P0.05,有顯著性差異。結(jié)論益腎復(fù)原方治療老年性骨質(zhì)疏松癥具有較好的療效,能顯著改善患者的臨床癥狀,試驗(yàn)組和對(duì)照組都可以改善患者骨密度值,提高血清PINP,降低血清β-CTX,加用益腎復(fù)原方,改善效果更明顯,該復(fù)方能安全有效治療老年性骨質(zhì)疏松癥。
[Abstract]:Objective to evaluate the clinical effect of Fang Yishen Restoration recipe through the experience of Director Dong Feixia in the treatment of senile osteoporosis, so as to lay a theoretical foundation for the clinical application of traditional Chinese medicine. Enrich the Chinese medicine clinical anti-osteoporosis treatment plan. Methods 60 cases of senile osteoporosis with syndrome differentiation of deficiency of kidney essence were randomly divided into treatment group (n = 30) and control group (n = 30). The control group was treated with calcium D tablet, Luogai total rubber pill and alendronate sodium. On the basis of the control group, the treatment group was given Yishen Restoration decoction once a day, twice a day, each time taking 200ml.3 for a course of treatment. After two courses of treatment, the clinical efficacy was evaluated, and the adverse drug reactions were observed and recorded. To review the laboratory indexes and evaluate the efficacy. Results the total effective rate was 90 in the treatment group and 70 in the control group. There was no significant difference in the scores of TCM syndromes between the treatment group and the control group before treatment (P 0.05). After treatment, the treatment group and the control group were superior to the control group in improving the TCM syndromes, such as weak waist and knee, tinnitus and deafness, decreased libido, loose hair, weak feet, weak tongue, weak pulse and so on. There was significant difference in statistics between the treatment group and the control group (P 0.05). Before and after the treatment, the changes of serum calcium concentration in the two groups were not obvious, but there was no significant difference between the two groups before and after the treatment, and the changes of the serum Ca levels before and after treatment in the two groups were not significant, but there was no significant difference between the two groups before and after the treatment. The difference was significant (P 0.05). Compared with the control group, the serum PINP and 尾 -CTx concentrations in the treatment group were significantly higher than those in the control group, and the changes of serum PINP and 尾 -CTx levels before and after the treatment were significantly different between the two groups before and after treatment. After treatment, the concentration of PINP in the treatment group was higher than that in the control group, and the concentration of 尾 -CTX was lower than that in the control group. The bone mineral density (BMD) of Neckus femoris trochanter and L1-L4 in the treatment group was significantly higher than that in the control group before and after treatment (P 0.05). In the control group, there was a significant difference between the two groups before and after treatment (P 0.05). There was significant difference between the two groups after treatment (P 0.05). Conclusion Yishenghuangfang has good curative effect on senile osteoporosis, and can improve the clinical symptoms of the patients. Both the experimental group and the control group can improve the bone mineral density, increase serum PINP, decrease serum 尾 -CTX, and add Yishen Restoration recipe. The improvement effect is more obvious, this compound can treat senile osteoporosis safely and effectively.
【學(xué)位授予單位】：浙江中醫(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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