目的 探讨壮骨止痛胶囊联合雷洛昔芬治疗绝经后骨质疏松的临床疗效。方法 选取2018年10月—2020年10月在天津市宝坻区人民医院骨科门诊治疗的108例绝经后妇女骨质疏松患者，根据随机数字法分为对照组和治疗组，每组各54例。对照组口服盐酸雷洛昔芬片，60 mg/次，1次/d。治疗组患者在对照组的基础上口服壮骨止痛胶囊，4粒/次，3次/d。两组患者连续服用药物8周。观察两组患者的临床疗效，比较两组患者临床症状缓解时间、骨密度、骨硬化蛋白（SOST）、白细胞介素6（IL-6）、雌二醇（E₂）、钙、磷、碱性磷酸酶（ALP）水平。结果 治疗后，治疗组患者总有效率是98.15%，显著高于对照组的81.48%（P<0.05）。治疗组患者腰背疼痛、腰膝酸软、烘热汗出、心烦少寐症状缓解时间均短于对照组（P<0.05）。治疗后，两组患者骨密度、E₂水平显著升高，但SOST、IL-6水平显著降低（P<0.05）；治疗后，治疗组骨密度、SOST、IL-6、E₂水平改善情况优于对照组（P<0.05）。治疗后，两组患者血清钙水平显著提高，但血清磷、ALP显著降低（P<0.05）；治疗后，治疗组血液生化指标改善优于对照组（P<0.05）。结论 壮骨止痛胶囊联合雷洛昔芬治疗绝经后妇女骨质疏松患者临床效果显著，症状好转明显，能有效提高骨密度，值得临床借鉴与推广。

Objective To investigate the efficacy of Zhuanggu Zhitong Capsules combined with raloxifene in treatment of postmenopausal osteoporosis. Methods A total of 108 postmenopausal women with osteoporosis treated in the orthopedic Outpatient Department of Tianjin Baodi District People's Hospital from October 2018 to October 2020 were selected and divided into control group and treatment group according to random number method, with 54 cases in each group. Patients in the control group were po administered with Raloxifene Hydrochloride Tablets, 60 mg/time, once daily. Patients in the treatment group were po administered with Zhuanggu Zhitong Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and clinical symptom remission time, bone mineral density, osteosclerosis protein (SOST), interleukin-6 (IL-6), estradiol (E₂), calcium, phosphorus and alkaline phosphatase (ALP) levels were compared between two groups. Results After treatment, the total effective rate98.15% in the treatment group was significantly higher than that in the control group (81.48%) (P < 0.05). In the treatment group, the relief time of the symptoms of low back pain, low back and knee soreness, hot heat sweating and restlessness were shorter than those in the control group (P < 0.05). After treatment, bone mineral density and E₂ levels in two groups were significantly increased, but SOST and IL-6 levels were significantly decreased (P < 0.05). After treatment, the improvement of bone mineral density, SOST, IL-6 and E₂ in the treatment group was better than that in the control group (P < 0.05). After treatment, serum calcium level in two groups was significantly increased, but serum phosphorus and ALP were significantly decreased (P < 0.05). After treatment, the improvement of blood biochemical indexes in the treatment group was better than that in the control group (P < 0.05). Conclusion Zhuanggu Zhitong Capsules combined with raloxifene has remarkable clinical effect in treatment of postmenopausal osteoporosis, and can improve the symptoms and the bone mineral density obviously, which is worth clinical reference and promotion.

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