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目的:探讨妇女绝经后骨质疏松症(PMO)应用阿伦膦酸钠(ALN)与阿法骨化醇联合治疗的临床效果。方法:选取我院门诊2013年1月~2015年3月收治的98例PMO患者,按照数字随机表法均分为两组。对照组:在常规钙剂基础上,给予阿法骨化醇治疗;观察组:在对照组基础上,给予ALN治疗。记录比较两组治疗前后Ward三角区、股骨颈及腰椎L2~L4骨密度(BMD)水平,治疗前后翻身、前屈后伸及自发性腰背痛视觉模拟评分法(VAS)评分,治疗前后血清骨钙素(BGP)、骨碱性磷酸酶(BALP)、Ⅰ型胶原C端肽(CTX)及抗酒石酸酸性磷酸酶5b(TRACP-5b)水平,用药期间不良反应。结果:观察组治疗后Ward三角区、股骨颈及腰椎L2~L4 BMD水平与治疗前比较,均明显改善(P<0.05),且观察组改善程度更加明显(P<0.05);观察组治疗后翻身、前屈后伸及自发性腰背痛VAS评分与治疗前比较,均显著降低(P<0.01),且观察组改善程度更为显著(P<0.01);观察组治疗后血清BGP、BALP、CTX及TRACP-5b水平与治疗前比较,均显著下降(P<0.01),且观察组改善幅度更为显著(P<0.01)。结论:妇女PMO应用ALN与阿法骨化醇联合治疗更能显著提高BMD水平,缓解患者疼痛症状,改善骨代谢指标,疗效切实,安全可靠,具有较高临床参考价值。
Objective: To investigate the clinical effect of combined use of alendronate (ALN) and alfacalcidol in women with postmenopausal osteoporosis (PMO). Methods: A total of 98 patients with PMO admitted to our hospital from January 2013 to March 2015 were selected and divided into two groups according to the digital random table method. Control group: on the basis of conventional calcium, given alfacalcidol treatment; observation group: on the basis of the control group, give ALN treatment. The levels of L2 ~ L4 bone mineral density (BMD) in the Ward trigone, femoral neck and lumbar spine before and after treatment were recorded and compared between the two groups before and after treatment. The visual analogue scale (VAS) BGP, BALP, CTX and TRACP-5b, adverse reactions during the treatment. Results: The levels of L2 ~ L4 BMD in Ward trigone, femoral neck and lumbar spine in the observation group were significantly improved compared with those before treatment (P <0.05), and the improvement in the observation group was more obvious (P <0.05). After the treatment, The VAS scores of patients in stand-in, flexion-extension and spontaneous back pain were significantly lower than those before treatment (P <0.01), and the improvement in observation group was more significant (P <0.01) , CTX and TRACP-5b levels were significantly lower than those before treatment (P <0.01), and the improvement in the observation group was more significant (P <0.01). Conclusion: The combination of ALN and alfacalcidol in women PMO can significantly improve the level of BMD, alleviate the pain symptoms and improve the indexes of bone metabolism. The curative effect is practical, safe and reliable, and has a high clinical reference value.