發(fā)布時(shí)間：2018-06-16 05:40

  本文選題：健脾益氣膏方 + 原發(fā)性骨質(zhì)疏松　； 參考：《廣西中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:經(jīng)過(guò)中醫(yī)健脾益氣膏方治療原發(fā)性骨質(zhì)疏松癥的臨床應(yīng)用,觀察其臨床效果,為中醫(yī)藥臨床治療原發(fā)性骨質(zhì)疏松癥的臨床治療提供客觀依據(jù)。方法:選取2014年9月-2015年1月廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院骨傷三區(qū)門(mén)診及病房,收集符合脾胃氣虛型原發(fā)性骨質(zhì)疏松癥的診斷標(biāo)準(zhǔn)和納入標(biāo)準(zhǔn)的患者70例,按照隨機(jī)數(shù)字表將入選的70例脾胃氣虛型原發(fā)性骨質(zhì)疏松癥患者分為治療35例和對(duì)照組35例,治療組運(yùn)用阿侖膦酸鈉片和健脾益氣膏方的綜合療法;對(duì)照組運(yùn)單純運(yùn)用阿倫磷酸鈉片的單純療法。一個(gè)療程為8周,連用兩個(gè)療程后,觀察兩組原發(fā)性骨質(zhì)疏松患者治療前后的癥狀變化,并對(duì)原發(fā)性骨質(zhì)疏松治療前和治療兩個(gè)療程后使用骨密度檢測(cè)、VAS疼痛評(píng)分、血清鈣和血清磷進(jìn)行療效評(píng)價(jià)并計(jì)算出治療期間兩組發(fā)生的不良率,所有數(shù)據(jù)經(jīng)過(guò)統(tǒng)計(jì)分析軟件SPSS20.0進(jìn)行分析處理,評(píng)價(jià)兩組治療方法的效果是否有明顯差異。結(jié)果:兩組脾胃氣虛型原發(fā)性骨質(zhì)疏松患者經(jīng)過(guò)治療以后各項(xiàng)癥狀、體征都得到了明顯改善。(1)使用健脾益氣膏方和阿侖膦酸鈉綜合治療的治療組總有效率為91.4%,單純使用阿侖膦酸鈉治療的對(duì)照組總有效率為62.9%。治療組的總有效率明高于對(duì)照組,說(shuō)明治療脾胃氣虛型原發(fā)性骨質(zhì)疏松健脾益氣膏方加阿侖膦酸鈉臨床療效比較好。(2)對(duì)照組和治療組兩組患者中醫(yī)癥候積分在治療8周和治療16周后均有所下降,治療8周后治療組優(yōu)于對(duì)照組,治療16周后治療組和對(duì)照組之間,治療組臨床效果明顯好于對(duì)照組,p0.05。治療組能更好的緩解脾胃氣虛型原發(fā)性骨質(zhì)疏松癥患者的腰脊疼痛,酸軟少力,神疲倦怠。肢體軟弱乏力,漸致緩縱不收,食少便溏或久瀉不止,甚者畏寒肢冷等癥狀。(3)對(duì)照組和治療組兩組視覺(jué)模擬積分顯示,兩組患者在治療8周和16周之后均有臨床效果,治療8周后對(duì)照組和治療組臨床效果區(qū)別不大,但是治療16周之后對(duì)照組和治療組組間比較,治療組治療16周后疼痛緩解效果明顯好于對(duì)照組。健脾益氣膏方聯(lián)合阿侖膦酸鈉綜合療法對(duì)緩解脾胃氣虛型原發(fā)性骨質(zhì)疏松腰背疼痛具有顯著的臨床效果(4)對(duì)照組患者腰椎(l2-4)和股骨頸兩個(gè)位置的骨密度經(jīng)過(guò)16周治療后,骨密度并沒(méi)有明顯改善。單純使用阿侖膦酸鈉對(duì)改善脾胃氣虛型原發(fā)性骨質(zhì)疏松的骨密度臨床效果不明顯。治療組患者治療八周后骨密度沒(méi)有改善和治療前區(qū)別不大,但是治療16周后治療組患者腰椎(l2-4)和股骨頸兩個(gè)部位的骨密度均較治療前有所改善。表明健脾益氣膏方聯(lián)合阿侖膦酸鈉對(duì)改善脾胃氣虛型骨質(zhì)疏松需要長(zhǎng)時(shí)間用藥,但是治療組較對(duì)照組能夠更好的提高脾胃氣虛型原發(fā)性骨質(zhì)疏松患者的骨密度,增加骨的強(qiáng)性。(5)血清鈣和血清磷在對(duì)照組和治療組治療八周和十六周后較前均沒(méi)有得到明顯的臨床改善,療效不明顯,說(shuō)明健脾益氣膏方和阿侖膦酸鈉在短時(shí)間內(nèi)對(duì)改善骨生化指標(biāo)不明顯。結(jié)論:運(yùn)用健脾益氣膏方和阿侖膦酸鈉綜合療法的臨床效果明顯優(yōu)于對(duì)照組,且提高原發(fā)性骨質(zhì)疏松患者整體的生存質(zhì)量包括緩解疼痛、提高骨密度等方面較單純使用阿侖膦酸鈉更有優(yōu)勢(shì)。
[Abstract]:Objective: To observe the clinical effect of traditional Chinese medicine Jianpi Yiqi cream prescription in the treatment of primary osteoporosis, and to provide an objective basis for the clinical treatment of primary osteoporosis in Chinese medicine. Methods: in January, -2015 year of September 2014, Guangxi traditional Chinese medicine university was attached to the three District outpatient and ward of the bone injury in ruigkang hospital. 70 patients with spleen and stomach qi deficiency primary osteoporosis were divided into 70 cases of spleen and stomach qi deficiency primary osteoporosis, which were divided into 35 cases and 35 cases in the control group. The treatment group was treated with Alendronate Sodium Tablets and Jianpi Yi Qi Decoction, and the control group was used for simple operation. The simple therapy of Allen sodium phosphate. One course of treatment was 8 weeks. After two courses of treatment, the changes of symptoms before and after treatment in two groups of patients with primary osteoporosis were observed. Bone density detection, VAS pain score, serum calcium and serum phosphorus were evaluated and treated for treatment of primary osteoporosis before and after two courses of treatment. During the two groups, all data were analyzed and processed by statistical analysis software SPSS20.0. The results of the two groups of treatment methods were significantly different. Results: the symptoms and signs of the two groups of patients with spleen and stomach qi deficiency primary osteoporosis were obviously improved after treatment. (1) the use of Jianpi Yiqi ointment and opiate. The total effective rate of the treatment group was 91.4%. The total effective rate of the control group treated with alendronate alone was higher than that of the control group, which indicated that the treatment of spleen and stomach qi deficiency type of primary osteoporosis Jianpi Yiqi cream and alendronate was better than the control group. (2) the control group and the treatment group were two. (2) the control group and the treatment group were two. Group patients with TCM syndrome score decreased after 8 weeks of treatment and after 16 weeks of treatment. After 8 weeks of treatment, the treatment group was better than the control group. After 16 weeks of treatment, the clinical effect of the treatment group was better than the control group. The treatment group was better than the control group. The p0.05. treatment group could better alleviate the lumbar spine pain, soft and less of the spleen and stomach qi deficiency patients with primary osteoporosis. (3) the two groups of visual analog points in the control group and the treatment group showed that two groups of patients had clinical effects after 8 and 16 weeks of treatment, and the clinical effect of the control group and the treatment group was not very different after the treatment for 8 weeks, but the treatment 16 was 16. Compared with the control group after week, the pain relief effect of the treatment group after 16 weeks was better than that of the control group. The combined therapy of Jianpi Yiqi cream combined with alendronate has significant clinical effect on relieving the low back pain of the spleen and stomach qi deficiency type of primary osteoporosis (4) in the group of patients with L2-4 and femur neck in two positions. Bone mineral density did not improve significantly after 16 weeks of bone density. The clinical effect of simple use of alendronate on improving the bone density of primary osteoporosis of the spleen and stomach was not obvious. The bone density did not improve after eight weeks of treatment in the treatment group, but the treatment group was treated with the lumbar (L2-4) and the femur after 16 weeks. The bone density of the two parts of the neck was better than that before the treatment. It showed that the combination of Jianpi Yiqi cream and alendronate needed a long time to improve the spleen and stomach qi deficiency osteoporosis, but the treatment group was better than the control group to improve the bone density and bone strength of the patients with spleen and stomach qi deficiency primary osteoporosis. (5) serum calcium and blood. There was no obvious clinical improvement in the treatment group and the treatment group for eight weeks and sixteen weeks after treatment. The curative effect was not obvious. It showed that the Jianpi Yiqi cream side and alendronate sodium did not improve the bone biochemical indexes in a short time. Conclusion: the clinical effect of the combined therapy of Jianpi Yiqi cream and A Lun phosphonate is obviously superior to that of the pair. The overall quality of life in patients with primary osteoporosis, including alleviating pain and improving bone mineral density, is more advantageous than the simple use of alendronate.
【學(xué)位授予單位】：廣西中醫(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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