加味五子衍宗丸治疗脾肾阳虚型骨质疏松症的临床疗效观察OA
Clinical Efficacy Observation of the Modified Wuzi Yanzong Pills in Treating Osteoporosis with Yang Deficiency of Spleen and Kidney
目的:观察加味五子衍宗丸治疗脾肾阳虚型骨质疏松症的临床疗效.方法:回顾性分析2024年1月至2025年1月收治的58例脾肾阳虚型骨质疏松症患者的临床资料,根据治疗方式不同分为对照组和观察组,其中对照组26例,观察组32例.对照组采用骨化三醇与碳酸钙D3 片口服,观察组采用加味五子衍宗丸汤剂(黄精24 g、菟丝子24 g、枸杞子24 g、覆盆子12 g、五味子6 g、车前子6 g、三棱15 g、莪术15 g,具有温补脾肾、活血化瘀之效)联合骨化三醇与碳酸钙D3 片治疗,疗程为6个月.比较两组患者疼痛视觉模拟量表(VAS)评分、临床症状评分、骨密度变化、骨标志物变化、中医证候评分.结果:治疗6个月后,观察组VAS疼痛评分、临床症状评分、中医证候评分较对照组均降低,升高Ⅰ型原胶原氨基端前肽(PⅠNP)水平,降低Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平,差异有统计学意义(P<0.05),骨密度值未见上升,差异无统计学意义(P>0.05);而对照组骨密度值与治疗前相比出现下降,差异有统计学意义(P<0.05).结论:加味五子衍宗丸能改善脾肾阳虚型骨质疏松症患者的骨痛症状,维持骨密度水平,其机制可能与影响成骨细胞和破骨细胞的活性有关.
Objective:To evaluate the clinical efficacy of the modified Wuzi Yanzong pills in treating of osteoporosis with Yang deficiency of the spleen and kidney pattern.Methods:The clinical data of 58 patients with osteoporosis of Yang defi-ciency of the spleen and kidney from January 2024 to January 2025,were retrospectively analyzed.These patients were di-vided into control group of 26 cases and observation group with 32 cases according to the different treatment modalities.The control group was treated with calcitriol and calcium,and the observation group was treated with modified Wuzi Yanzong pills decoction(Polygonati Rhizoma 24 g,Cuscutae Semen 24 g,Lycii Fructus 24 g,Rubi Fructus 12 g,Schisandrae Sphenantherae Fructus 6 g,Plantaginis Semen 6 g,Sparganii Rhizoma 15 g,Curcumae Rhizoma 15 g.This formula warms and tonifies the spleen and kidneys while promoting blood circulation and resolving stasis)combined with calcitriol and calcium carbonate D3 tablets.The results of pain VAS score,clinical symptoms scores,bone mineral density(BMD),bone markers,TCM syndrome score were compared between the two groups.Results:After 6 months of treatment,the pain VAS score,clinical symptoms score,and TCM syndrome score in the observation group were all lower than those in the control group.Additionally,the observation group showed an increase in PINP level and a decrease in β-CTX level(P<0.05).However,there was no increase in BMD in the observation group(P>0.05),while the BMD in the control group decreased compared with that before treatment(P<0.05).Conclusion:Modified Wuzi Yanzong pills can relieve bone pain in patients with osteoporosis due to Yang deficiency of the spleen and kidney and maintain BMD levels,the underlying mechanism may be related to regulating the activity of osteoblasts and osteoclasts.
李扬;石龙;陈龙;章轶立;张志文
湖北省中医院/湖北中医药大学附属医院(武汉,430061)||中医肝肾研究及应用湖北省重点实验室(湖北省中医院)||湖北时珍实验室湖北中医药大学针灸骨伤学院湖南中医药大学第一附属医院南京中医药大学中西医结合学院湖北省中医院/湖北中医药大学附属医院(武汉,430061)||中医肝肾研究及应用湖北省重点实验室(湖北省中医院)||湖北时珍实验室
医药卫生
加味五子衍宗丸骨质疏松症骨密度脾肾阳虚型骨代谢标志物
modified Wuzi Yanzong pillsosteoporosisbone mineral densityYang deficiency of spleen and kidneybone metabolic markers
《中国中医骨伤科杂志》 2026 (2)
64-68,5
湖北省重点研发计划项目(2024BCB035)
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