摘要
目的:观察参续补骨汤联合温针灸治疗绝经后骨质疏松性腰背痛的效果。方法:将80例绝经后骨质疏松性腰背痛患者按照随机数字表法分为对照组和观察组,每组各40例。对照组给予西药常规治疗,观察组在对照组基础上给予参续补骨汤联合温针灸治疗,对比两组治疗的总有效率、骨密度,采用视觉模拟评分法(Visual Analogue Scale,VAS)评价痛感,检测骨代谢指标[β-I型胶原羧基端肽(β-C-terminal cross-linking telopeptide of typeⅠcollagen,β-CTX)、骨保护素(OsteoprotegerinF,OPG)]、疼痛因子(前列腺素E_(2)、神经肽Y)水平。结果:观察组的总有效率明显高于对照组(P<0.05)。观察组患者治疗后的股骨颈骨、腰椎L_(1~4)骨密度分别为(0.77±0.15)mg/cm^(2)、(0.78±0.20)mg/cm^(2),均明显高于对照组的(0.63±0.13)mg/cm^(2)、(0.69±0.09)mg/cm^(2),差异有统计学意义(P<0.05)。治疗1周、治疗2周后,观察组的疼痛VAS评分分别为(4.23±0.78)分、(2.35±0.37)分,均明显低于对照组的(5.57±0.98)分、(3.44±0.65)分,差异有统计学意义(P<0.05)。观察组患者治疗后的血清中骨代谢指标β-CTX明显降低,OPG水平明显升高(P<0.05),血清中前列腺素E_(2)、神经肽Y等疼痛相关因子水平显著降低(P<0.05)。结论:参续补骨汤联合温针灸有利于增加绝经后骨质疏松性腰背痛患者的骨密度,缓解痛感,其原因可能与改善骨代谢、抑制致痛介质表达有关。
Objective:To observe the effect of the Shenxu Bugudecoction(参续补骨汤)with warm acupuncture in the treatment of postmenopausal osteoporotic low back pain.Methods:Eighty patients with postmenopausal osteoporotic low back pain were divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was given conventional treatment in Western medicine,and the observation group was treated with the Shenxu Bugu decoction with warm acupuncture more.The total effective rate and bone density in the two groups was compared,and visual analogue scale was used to evaluate pain,and the levels of bone metabolism indexes(β-CTX,OPG),pain factor(prostaglandin E_(2),neuropeptide Y)were detected.Results:The total effective rate in the observation group was significantly higher than that in the control group(P<0.05).The L_(1-4)BMD in the treated femoral neck bone and lumbar spine in the observation group was(0.77±0.15)mg/cm^(2)and(0.78±0.20)mg/cm^(2),respectively,which were significantly higher than(0.63±0.13)mg/cm^(2)and(0.69±0.09)mg/cm^(2)in the control group,and the differences were statistically significant(P<0.05).After 1 week of treatment and 2 weeks of treatment,the pain VAS scores in the observation group were(4.23±0.78)and(2.35±0.37),respectively,which were significantly lower than(5.57±0.98)and(3.44±0.65)in the control group,and the differences were statistically significant(P<0.05).After treatment,the serum bone metabolism indexβ-CTX was significantly reduced,the OPG level was significantly increased(P<0.05),and the serum levels of PGE_(2),NPY and other pain-related factors were significantly reduced(P<0.05).Conclusion:The Shenxu Bugu decoction with warm acupuncture is beneficial to increase bone density and relieve pain in patients with postmenopausal osteoporotic low back pain,which may be related to improving bone metabolism and inhibiting the expression of pain-causing mediators.
出处
《中医临床研究》
2023年第3期116-119,共4页
Clinical Journal Of Chinese Medicine
关键词
参续补骨汤
温针灸
绝经后
骨质疏松性腰背痛
The Shenxu Bugu decoction
Warm acupuncture
Postmenopausal
Osteoporotic low back pain
作者简介
通讯作者:王锡(1980―),副院长、副主任中医师,研究方向为针药结合治疗各种疼痛。
