目的 探討維D鈣咀嚼片聯(lián)合依替膦酸二鈉治療骨質疏松癥的臨床療效。方法 選取2018年1月-2021年12月南通大學附屬南通第三醫(yī)院骨科診療的120例骨質疏松患者,按照隨機數(shù)字表法分為對照組和治療組,每組各60例。對照組患者口服依替膦酸二鈉片,0.2 g/次,2次/d。治療組在對照組的治療基礎上口服維D鈣咀嚼片,1片/次,2次/d。兩組用藥8周。觀察兩組的臨床療效,比較兩組癥狀改善時間、骨代謝指標和血清炎性因子水平。比較兩組不良反應情況。結果 治療后,治療組總有效率為98.33%,顯著高于對照組的85.00%(P<0.05)。經(jīng)治療,治療組出現(xiàn)腰痛、背痛、胸悶、肌肉痛改善時間均顯著短于對照組(P<0.05)。治療后,兩組患者堿性磷酸酶(BAP)、骨鈣素(N-MID)均顯著升高,而β-膠原片段(β-CTX)顯著降低(P<0.05);治療后,治療組骨代謝指標改善優(yōu)于對照組(P<0.05)。治療后,兩組血清白細胞介素-6(IL-6)、腫瘤壞死因子-α(TNF-α)、轉化生長因子-β(TGF-β1)水平均較治療前顯著降低,而血管內(nèi)皮生長因子(VEGF)升高(P<0.05);治療后,治療組血清學指標改善優(yōu)于對照組(P<0.05)。治療后,治療組不良發(fā)生發(fā)生率是5.02%,顯著低于對照組的11.67%(P<0.05)。結論 維D鈣咀嚼片聯(lián)合依替膦酸二鈉治療骨質疏松癥效果確切,能有效改善患者癥狀,改善機體骨代謝,調(diào)節(jié)機體血清學指標,值得借鑒和推廣。

Objective To investigate the effect of Calcium Supplement with Vitamin D Chewable Tablets combined with etidronate disodium in treatment of osteoporosis. Methods A total of 120 patients with osteoporosis treated in the Department of Orthopedics of Nantong Third Hospital Affiliated to Nantong University from January 2018 to December 2021 were selected and divided into control group and treatment group according to random number table method, with 60 cases in each group. Patients in the control group were po administered with Etidronate Disodium Tablets, 0.2 g/time, twice daily. Patients in the treatment group were po administered with Calcium Supplement with Vitamin D Chewable Tablets on the basis of the control group, 1 tablet/time, twice daily. Both groups were treated for 8 weeks. The clinical efficacy of the two groups was observed, and the improvement time of symptoms, bone metabolism indexes and serum inflammatory factors were compared between the two groups. The adverse reactions of the two groups were compared. Results After treatment, the total effective rate of the treatment group was 98.33%, which was significantly higher than that of the control group 85.00% (P＜0.05). After treatment, the improvement time of lumbago, back pain, chest tightness, muscle pain and other symptoms in the treatment group was significantly shorter than that in the control group (P＜0.05). After treatment, alkaline phosphatase (BAP) and osteocalcin (N-MID) were significantly increased in two groups, but β-collagen fragment (β-CTX) were significantly decreased (P＜0.05). After treatment, the improvement of bone metabolism indexes in treatment group was better than that in control group (P＜0.05). After treatment, serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and transforming growth factor-β (TGF-β1) in two groups were significantly decreased compared with before treatment, while vascular endothelial growth factor (VEGF) was increased (P＜0.05). After treatment, the improvement of serological indexes in treatment group was better than that in control group (P＜0.05). After treatment, the incidence of adverse events in the treatment group was 5.02%, which was significantly lower than that in the control group (11.67%, P＜0.05). Conclusion Calcium Supplement with Vitamin D Chewable Tablets combined with etidronate disodium has exact effect in treatment of osteoporosis, and can effectively improve the patients’ symptoms and the bone metabolism, and can regulate the serological indicators, which is worth learning and promoting.

R9285.5

南通市科技局民生科技計劃項目(MSZ19181)