[1]张徐,徐亚伟,孟世龙,等.益气温经穴位贴贴敷联合西药口服治疗绝经后骨质疏松症肾虚血瘀证的临床研究[J].中医正骨,2025,37(07):21-27.
　ZHANG Xu,XU Yawei,MENG Shilong,et al.Yiqi Wenjing(益气温经)acupoint sticking therapy combined with oral application of western medicine for treatment of postmenopausal osteoporosis with the syndrome of kidney deficiency and blood stagnation:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(07):21-27.
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益气温经穴位贴贴敷联合西药口服治疗绝经后骨质疏松症肾虚血瘀证的临床研究()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年07期
页码:
21-27
栏目:
临床研究
出版日期:
2025-07-20

文章信息/Info

Title:
Yiqi Wenjing(益气温经)acupoint sticking therapy combined with oral application of western medicine for treatment of postmenopausal osteoporosis with the syndrome of kidney deficiency and blood stagnation:a clinical study
作者:
张徐1; 徐亚伟1; 孟世龙1; 余阳1; 曹延广2; 张颖凯3; 史晓林2; 刘康2
1.浙江中医药大学第二临床医学院,浙江 杭州 310053; 2.浙江中医药大学附属第二医院,浙江 杭州 310005; 3.仙居县中医院,浙江 仙居 317300
Author(s):
ZHANG Xu1; XU Yawei1; MENG Shilong1; YU Yang1; CAO Yanguang2; ZHANG Yingkai3; SHI Xiaolin2; LIU Kang2
1.The Second Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China 2.The Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,Zhejiang,China 3.Xianju TCM Hospital,Xianju 317300,Zhejiang,China
关键词:
骨质疏松; 绝经后;  肾虚血瘀;  穴位贴敷疗法;  益气温经穴位贴;  随机对照试验专题
Keywords:
osteoporosis; postmenopausal;  kidney deficiency and blood stagnation;  acupoint sticking therapy;  Yiqi Wenjing acupoint patch;  randomized controlled trials as topic
摘要:
目的:观察益气温经穴位贴贴敷联合西药口服治疗绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)肾虚血瘀证的临床疗效。方法:将符合要求的120例PMOP肾虚血瘀证患者随机分为2组,每组60例,分别采用单纯西药(阿仑膦酸钠片、钙尔奇D片、骨化三醇胶丸)口服治疗(西药治疗组)与益气温经穴位贴贴敷联合西药口服治疗(联合治疗组)。3个月为1个疗程,每个疗程之间隔1个月,共治疗3个疗程。分别于治疗前、治疗开始后6个月、治疗开始后12个月,比较2组患者的骨密度T值、血清雌二醇(estradiol,E2)水平、血清卵泡刺激素(follicle stimulating hormone,FSH)水平、血清Ⅰ型前胶原氨基端前肽(N-terminal propeptide of typeⅠprecollagen,PⅠNP)水平、血清Ⅰ型胶原羧基端肽β特殊序列(β-C-terminal telopeptide of typeⅠcollagen,β-CTX)水平、腰背部疼痛视觉模拟量表(visual analogue scale,VAS)评分、简明健康状况调查表(short form 36 health survey questionnaire,SF-36)评分。结果:①一般情况。共5例患者退出试验,其中西药治疗组3例、联合治疗组2例。最终西药治疗组纳入57例患者,联合治疗组纳入58例患者。②骨密度T值。治疗前后骨密度T值总体上随时间推移呈上升趋势(F=109.349,P=0.000),2组间差异无统计学意义(F=0.014,P=0.905)。③血清E2水平。治疗前后西药治疗组患者血清E2水平随时间推移无明显变化(F=0.790,P=0.456),联合治疗组患者血清E2水平随时间推移呈上升趋势(F=6.559,P=0.002)。治疗开始后6个月、12个月,联合治疗组患者血清E2水平均高于西药治疗组(t=-3.983,P=0.000; t=-4.177,P=0.000)。④血清FSH水平。治疗前后血清FSH水平总体上随时间推移呈下降趋势(F=17.933,P=0.000),2组间差异无统计学意义(F=1.123,P=0.291)。⑤血清PⅠNP水平。治疗前后西药治疗组患者血清PⅠNP水平随时间推移无明显变化(F=0.368,P=0.693),联合治疗组患者血清PⅠNP水平随时间推移呈上升趋势(F=11.724,P=0.000)。治疗开始后6个月、12个月,联合治疗组患者血清 PⅠNP 水平均高于西药治疗组(t=-5.844,P=0.000; t=-5.619,P=0.000)。⑥血清β-CTX水平。治疗前后血清β-CTX水平总体上随时间推移呈下降趋势(F=6.371,P=0.002),2组间差异无统计学意义(F=1.898,P=0.171)。⑦腰背部疼痛VAS评分。治疗前后2组患者腰背部疼痛VAS评分随时间推移均呈下降趋势(F=35.668,P=0.000; F=147.005,P=0.000)。治疗开始后6个月、12个月,联合治疗组患者腰背部疼痛VAS评分均低于西药治疗组(t=12.848,P=0.000; t=13.291,P=0.000)。⑧SF-36 评分。治疗前后2组患者SF-36评分随时间推移均呈上升趋势(F=54.622,P=0.000; F=105.957,P=0.000)。治疗开始后6个月、12个月,联合治疗组患者SF-36评分均高于西药治疗组(t=-10.331,P=0.000; t=-10.323,P=0.000)。结论:益气温经穴位贴贴敷联合西药口服治疗PMOP肾虚血瘀证,在提高血清E2水平、促进骨形成、减轻腰背部疼痛、改善患者生活质量方面优于单纯西药口服治疗; 但两者在降低血清FSH水平、抑制骨吸收、提高骨密度方面的效果相当。
Abstract:
Objective:To evaluate the clinical therapeutic effects of Yiqi Wenjing(益气温经,YQWJ)acupoint sticking therapy combined with oral application of western medicine(WM)in treatment of postmenopausal osteoporosis(PMOP)with the syndrome of kidney deficiency and blood stagnation.Methods:One hundred and twenty eligible PMOP patients diagnosed with the syndrome of kidney deficiency and blood stagnation were enrolled in the study and were randomized into 2 groups,with 60 ones in each group.The patients were treated with YQWJ acupoint sticking therapy combined with oral application of WM(combination treatment group)and oral application of WM(alendronate sodium tablets,caltrate D tablets,and calcitriol softgel capsules)alone(WM treatment group),respectively,for consecutive 3 courses of treatment,3 months for each course with a 1-month interval between courses.The bone mineral density(BMD)T-score,low back pain visual analogue scale(VAS)score,short form 36 health survey questionnaire(SF-36)score and the serum levels of estradiol(E2),follicle stimulating hormone(FSH),N-terminal propeptide of typeⅠprecollagen(PⅠNP)and β-C-terminal telopeptide of typeⅠcollagen(β-CTX)were compared between the 2 groups before the treatment and at 6 and 12 months after initiation of the treatment,respectively.Results:①General condition.Five patients withdrew from the trial,comprising 3 cases in WM treatment group and 2 cases in combination treatment group.Finally,57 patients in WM treatment group and 58 ones in combination treatment group were included in the study.②BMD T-score.The BMD T-score presented a significant increasing trend over time in the 2 groups before and after the treatment(F=109.349,P=0.000),with no significant difference observed between the 2 groups(F=0.014,P=0.905).③Serum E2 level.The serum E2 level presented no evident change over time in WM treatment group before and after the treatment(F=0.790,P=0.456),while a significant increasing trend over time was found in combination treatment group(F=6.559,P=0.002).Moreover,the serum E2 level was higher in combination treatment group compared to WM treatment group at 6 and 12 months after initiation of the treatment(t=-3.983,P=0.000; t=-4.177,P=0.000).④Serum FSH level.The serum FSH level presented a decreasing trend over time before and after the treatment(F=17.933,P=0.000),with no significant difference observed between the 2 groups(F=1.123,P=0.291).⑤Serum PⅠNP level.The serum PⅠNP level remained stable over time in WM treatment group before and after the treatment(F=0.368,P=0.693),but increased significantly over time in combination treatment group(F=11.724,P=0.000),and it was higher in combination treatment group compared to WM treatment group at 6 and 12 months after initiation of the treatment(t=-5.844,P=0.000; t=-5.619,P=0.000).⑥Serum β-CTX level.The serum β-CTX level presented a decreasing trend over time before and after the treatment(F=6.371,P=0.002),with no significant difference observed between the 2 groups(F=1.898,P=0.171).⑦Low back pain VAS score.The low back pain VAS score presented a decreasing trend over time in the 2 groups before and after the treatment(F=35.668,P=0.000; F=147.005,P=0.000),and it was lower in combination treatment group compared to WM treatment group at 6 and 12 months after initiation of the treatment(t=12.848,P=0.000; t=13.291,P=0.000).⑧SF-36 score.The SF-36 score presented a increasing trend over time in the 2 groups before and after the treatment(F=54.622,P=0.000; F=105.957,P=0.000),and it was higher in combination treatment group compared to WM treatment group at 6 and 12 months after initiation of the treatment(t=-10.331,P=0.000; t=-10.323,P=0.000).Conclusion:Combination of YQWJ acupoint sticking therapy with oral application of WM is superior to oral application of WM alone in elevating serum E2 level,promoting bone formation,alleviating low back pain,and improving patients' quality of life in treatment of PMOP with the syndrome of kidney deficiency and blood stagnation.However,the both demonstrate comparable efficacy in reducing serum FSH level,inhibiting bone resorption,and improving BMD.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(82274272); 浙江省中医药重点研究项目(2022ZZ020)
通讯作者:刘康 E-mail:Liukang1982@163.com
更新日期/Last Update: 1900-01-01