目的 探討特立帕肽聯(lián)合阿侖膦酸鈉治療絕經(jīng)后骨質(zhì)疏松癥的臨床療效。方法 選取2014年1月-2015年6月天津中醫(yī)藥大學(xué)第一附屬醫(yī)院收治的絕經(jīng)后骨質(zhì)疏松癥患者140例，隨機分為對照組和治療組，每組各70例。對照組患者口服阿侖膦酸鈉片，1片/次，1次/d。治療組在對照組治療基礎(chǔ)上皮下注射特立帕肽注射液，20 μg/次，1次/d。兩組患者均連續(xù)治療6個月。觀察兩組患者治療前后骨密度和骨代謝指標(biāo)的變化情況。結(jié)果 治療組治療3個月時腰椎骨密度相對于治療前有明顯上升，全髖與股骨頸骨密度則無明顯變化，治療組治療6個月時腰椎、全髖、股骨頸骨密度均明顯上升，同組治療前后差異具有統(tǒng)計學(xué)意義（P<0.05）；對照組治療3個月各部位骨密度均未出現(xiàn)明顯上升，治療6個月腰椎骨密度較治療前有明顯上升（P<0.05）。治療組治療6個月時腰椎、全髖、股骨頸骨密度改善情況明顯優(yōu)于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療組治療3、6個月血清骨鈣素（OC）水平逐漸上升，均明顯高于治療前，同組治療前后差異具有統(tǒng)計學(xué)意義（P<0.05）；對照組則逐漸下降，均明顯低于治療前（P<0.05）；治療組治療3、6個月血清Ⅰ型膠原羧基端肽交聯(lián)（β-CTX）水平逐漸下降，對照組也逐漸下降，對照組下降幅度則明顯大于治療組（P<0.05）。結(jié)論 特立帕肽聯(lián)合阿侖膦酸鈉治療絕經(jīng)后骨質(zhì)疏松癥具有較好的臨床療效，可增加患者的骨密度，可有效改善骨代謝，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of teriparatide combined with alendronate in treatment of postmenopausal osteoporosis. Methods Patients (140 cases) with postmenopausal osteoporosis in First Teaching Hospital of Tianjin University of TCM from January 2014 to June 2015 were randomly divided into control and treatment groups, and each group had 70 cases. The patients in the control group were po administered with Alendronate Sodium Tablets, 1 tablet/time, once daily. The patients in the treatment group were sc administered with Teriparatide Injection on the basis of the control group, 20 μg/time, once daily. The patients in two groups were treated for 6 month. After treatment, the change of bone mineral density and bone metabolism indexes in two groups before and after treatment were compared. Results The bone mineral density of lumbar spine treated for 3 months in treatment group were significantly increased compared with before treatment, and rehabilitation and femoral neck bone mineral density had no obvious change. The bone mineral density of lumbar spine, rehabilitation and femoral neck treated for 6 months in the treatment group were significantly increased, and the difference was statistically significant in the same group (P<0.05). The bone mineral density of each part treated for 3 months in the control group had no obvious change. The bone mineral density of lumbar spine treated for 6 months in control group was significantly increased (P<0.05). The improvement of bone mineral density of lumbar spine, rehabilitation and femoral neck treated for 6 months in treatment group were better than those in the control group, with significant difference between two groups (P<0.05).The level of serum osteocalcin (OC) treated for 3 and 6 months was significantly higher than that of before treatment, and the difference was statistically significant in the same group (P<0.05). The level of OC in the control group was gradually reduced, and they were significantly lower than before treatment (P<0.05). The levels of serum β-CTX were gradually reduced treated for 3 and 6 months in the treatment and control groups than those of before treatment, and these indexes in the control group decreased significantly greater than those in the treatment group (P<0.05). Conclusion Teriparatide combined with alendronate has clinical curative effect in treatment of postmenopausal osteoporosis, and can increase the bone mineral density, also can improve the bone metabolism effectively, which has a certain clinical application value.