密盖息联合仙灵骨葆胶囊治疗骨质疏松症的疗效

目的探析密盖息联合仙灵骨葆胶囊治疗骨质疏松症的疗效。方法将2011年4月～2017年12月在我院接受治疗的311例骨质疏松症患者作为研究对象,采用随机分配的方法进行分组,两组患者均给予钙尔奇-D治疗,对照组(n=155)增加密盖息治疗,观察组(n=156)给予密盖息联合仙灵骨葆胶囊治疗,比较两组的治疗有效性和安全性。结果通过比较两组的治疗有效率,发现观察组的总有效率显著高于对照组,差异有统计学意义(P 0.05);通过对两组治疗前后骨密度的变化情况进行比较,发现治疗后两组患者的腰椎和股骨颈骨密度较治疗前均增加,且观察组明显优于对照组,差异有统计学意义(P 0.05);经比较两组治疗前后的骨代谢指标,发现治疗后两组的血清钙、血清磷、碱性磷酸酶较治疗前均增加,且观察组明显优于对照组,差异有统计学意义(P 0.05);经比较两组的用药安全性,观察组与对照组患者治疗期间的不良反应发生率比较,差异无统计学意义(P 0.05)。结论在骨质疏松症的临床治疗上,采用密盖息联合仙灵骨葆胶囊的方案进行治疗效果显著,可改善患者的骨密度和骨代谢,且安全性高,能够提升患者的生活质量,值得推广和应用。     

仙灵骨葆胶囊致全身皮疹

1例36岁女性开放性骨缺损患者外固定术后恢复期给予仙灵骨葆胶囊1.5 g,2次/d口服。首次服药后约5 h,患者双膝关节处出现少许红色丘疹,未停药。次日,红色丘疹遍及全身。停服仙灵骨葆胶囊,给予氯雷他定10 mg,1次/d口服。3 d后,皮疹颜色变暗。继续服用氯雷他定2 d。4周后,皮疹基本消退。     

仙灵骨葆胶囊治疗原发性骨质疏松症的疗效观察

目的探讨仙灵骨葆胶囊辅助治疗原发性骨质疏松症的临床疗效。方法将72例原发性骨质疏松症患者随机分为治疗组和对照组,两组均常规使用鲑鱼降钙素注射液肌肉注射和钙尔奇D口服,治疗组在此基础上加用仙灵骨葆胶囊。结果经过12周的治疗,治疗组总有效率为86.1%,对照组总有效率为72.2%,两组差异有统计学意义(P<0.05)。结论仙灵骨葆胶囊用于原发性骨质疏松症疗效肯定。     

仙灵骨葆胶囊治疗58例骨折体会

1998年7月～12月我们对58例骨折病人服用仙灵骨葆胶囊和未服用的治疗愈合期观察。现分 析报道如下：1 临床资料本文58例,经X线确诊,锁骨骨折4例,肱骨干骨折4例,肱骨髁上骨折6例,股骨颈骨折4例 ,股骨干骨折3例,膑骨骨折2例,胫腓骨干骨折4例,跟骨骨折4例,跖骨骨折6例。本组男3 3例,女25例;年龄5～76岁,1～76岁,1～5d就诊,均为新骨折患者。本组有30例服“仙灵 骨葆胶囊”,28例未服;两组对比在年龄、性别、职业、饮食习惯、烟酒嗜好及遗传因素均 无明显差异。2 疗效观察2.1 对照组28例骨折患者,都按骨折治疗处理,未服药或服…     

仙灵骨葆胶囊致肝功能异常2例

2名患者服用仙灵骨葆胶囊治疗骨质疏松症引致肝功能异常。第1例为65岁女性高血压伴脑供血不足患者,长期服用降压0号和银杏叶片。2004年2月24日开始加用仙灵骨葆胶囊1.5g,2次/d,6个月后体检发现其ALT和AST分别为85U/L和93U/L,停用仙灵骨葆胶囊,继续服用降压0号和银杏叶片。追踪随访,停药约20个月后,患者的ALT和AST分别下降为17U/L和28U/L。第2例为68岁女性萎缩性胃炎患者,长期服用西沙必利,2004年1月患者开始服用仙灵骨葆胶囊1.5g,2次/d。2个月后,实验检查显示:ALT158U/L,AST123U/L。停用仙灵骨葆胶囊,仍服西沙必利,并加服葡醛内酯200mg,3次/d,连续服用15d。约6个月后,患者的ALT为35U/L,AST为23U/L。     

仙灵骨葆胶囊不良反应文献分析

目的探讨仙灵骨葆胶囊引起不良反应的临床特点及发生规律,为临床合理用药提供参考。方法对1995～2010年中国期刊全文数据库文献进行检索,对其中涉及仙灵骨葆胶囊致不良反应报道的有关数据进行统计分析。结果共检索到有关仙灵骨葆胶囊致不良反应的文献12篇,涉及患者病例75例,其不良反应主要表现为消化系统的损害,有恶心、欲呕、胃脘不适、大便秘结及肝功能异常等。结论提示临床医护工作者加强临床用药的监护,合理用药,从而保证公众用药安全。     

仙灵骨葆胶囊治疗围绝经期骨质疏松的疗效观察

目的 观察仙灵骨葆胶囊治疗围绝经期骨质疏松的临床疗效.方法 选择该院治疗的围绝经期骨质疏松患者60例,患者均予仙灵骨葆胶囊治疗,治疗后观察临床疗效.治疗前后测定左前臂尺骨鹰嘴至茎突间距远端1/3处骨密度值.结果 60例患者中痊愈15例（25.0%）,显效32例（53.3%）,有效8例（13.3%）,无效5例（8.3%）,总有效率为91.7%.治疗前骨密度为（0.542±0.058）g/cm2低于治疗后的（0.685±0.063）g/cm2,差异有统计学意义（P＜0.05）.结论 仙灵骨葆胶囊治疗围绝经期骨质疏松患者疗效显著,值得临床推广应用.     

仙灵骨葆胶囊临床验证总结

柔壹牌仙灵骨葆胶囊是根据著名伤科专家时光达教授的经验方研制而成的纯中药制剂.其选用贵州独特的黔岭粗毛淫羊藿及补肾壮骨的川续断、补骨脂等名贵天然中药组成,具有温肾壮阳、接骨续筋、强身健骨之功能.     

仙灵骨葆胶囊联合钙尔奇-D治疗骨质疏松症的临床研究

目的探讨仙灵骨葆胶囊联合钙尔奇-D治疗骨质疏松症的疗效。方法86例患者随机分为两组各43例,治疗组用仙灵骨葆胶囊联合钙尔奇-D治疗,对照组单用钙尔奇-D治疗,均治疗两个疗程后统计疗效。结果总有效率治疗组为93.0%,对照组为60.5%;治疗组治疗2个疗程后临床主症积分、骨密度,总有效率均优于对照组(P<0.05)。结论仙灵骨葆胶囊联合钙尔奇-D治疗骨质疏松症的疗效较好。     

仙灵骨葆胶囊对股骨颈骨折内固定患者骨折愈合及骨密度的影响

目的:探讨仙灵骨葆胶囊对股骨颈骨折内固定患者术后恢复状况的影响.方法:选取2016年10月—2019年10月120例就诊于我院的股骨颈骨折内固定患者,按随机数字表法分为两组,各60例.对照组予以固定术治疗,观察组加用仙灵骨葆胶囊治疗.比较两组髋关节恢复优良率、骨折愈合时间、下床活动时间、骨密度及血清学指标,并记录并发症...     

复方补骨胶囊对去势大鼠骨密度的影响

目的研究复方补骨胶囊对去势大鼠骨密度、血清生化指标的影响,为其应用于临床提供理论依据。方法 Wistar大鼠被随机分为假手术组(Shame)、去势组(OVX)、妇复春组(FFC)、降钙素组(CT)和复方补骨胶囊组(CBC)。假手术组在手术中不摘除卵巢,其他4组大鼠手术摘除卵巢制成骨质疏松动物模型。用药3个月后,测定大鼠的骨密度及各种有关生化指标。根据实验结果研究药物对骨代谢的影响,评价复方补骨胶囊对去势大鼠的治疗效果。结果 对照组(Sham)同去势组(OVX)比较:血钙值差异无显著;血磷值低,差异显著(,J<0.05);骨密度(BMD)高、碱性磷酸酶(ALP)低、抗酒石酸碱性磷酸酶(TRAP)低,差异均非常显著(P<0.01)。复方补骨胶囊(CBC)组同去势组比较:血磷、血钙差异无显著;骨密度高、碱性磷酸酶低、抗酒石酸碱性磷酸酶低,差异均非常显著(P<0.01)。复方补骨胶囊组与妇复春(FFC)组、降钙素(CT)组比较,各种数据差异均无显著性。结论 去势组(OVX)同对照组(Sham)的对比结果表明动物模型较为可靠。动物实验结果证实复方补骨胶囊可以有效降低去势大鼠的骨代谢速率、减缓由于雌激素分泌减少而造成的骨量丢失,可用于骨质疏松的预防和治疗。     

Two-year changes in bone mineral density and T scores in patients treated at a pharmacist-run teriparatide clinic

STUDY OBJECTIVES: To determine changes in bone mineral density (BMD) and T scores of patients after 2 years of teriparatide therapy, and to determine the number of fractures that occurred during therapy. DESIGN: Prospective, observational study. SETTING: Pharmacist-run teriparatide clinic in a private-practice endocrinology group. PATIENTS: Sixty patients with osteoporosis who experienced fractures or adverse events while receiving antiresorptive therapy and were referred by the endocrinologists to the clinic between January 1, 2002, and January 1, 2004. INTERVENTION: After a 1-hour counseling and training session with a clinical pharmacist, patients self-administered subcutaneous teriparatide 20 microg/day for the next 2 years. MEASUREMENTS AND MAIN RESULTS: Primary outcome measures were dual x-ray absorptiometry-determined BMDs and T scores for the total hip, spine, and wrist at baseline and at 1 and 2 years. Patients' BMDs for the hip significantly increased by 3.5% at 1 year and by 3.9% at 2 years. In addition, BMD for the spine significantly increased by 7.2% at 1 year and 10.9% at 2 years. In 56 (93%) patients, BMD for the spine increased after 2 years of treatment. For the wrist, BMD decreased by 0.75% at 1 year and by 2.4% at 2 years, but the change was only significant at 2 years (p=0.011). At both 1 and 2 years, T scores for the total hip and spine significantly improved from baseline (p< or =0.019), whereas T scores for the wrist significantly declined after 2 years of therapy (p<0.003). No new fractures were documented in any of the patients. CONCLUSION. In patients with osteoporosis, the use of teriparatide in a pharmacist-run clinic significantly increased BMD at the total hip and spinal sites and significantly decreased BMD in the wrist.     

自拟补肾健脾通络汤对骨质疏松症患者疼痛及骨密度的影响探讨

目的：探讨骨质疏松症取自拟补肾健脾通络汤对疼痛程度及骨密度的影响。方法：本次研究选取40例骨质疏松症患者,均于我院骨科2013年3月～2014年9月收治,取补肾健脾通络汤,对疼痛程度资料及骨密度资料进行回顾。结果：临床总有效率为87.5%。与治疗前比较,观察组评估的疼痛评分显著降低,骨密度检测改善明显,差异均有统计学意义（P<0.05）。结论：在西医常规方案应用基础上,针对骨质疏松症采用补肾健脾通络方治疗,可较大程度地缓解疼痛症状,增加骨钙量,促使临床症状改善,保障生活质量。     

Managing and maintaining bone mineral density in diabetes patients with pharmacotherapy

Introduction: The population of patients with osteoporosis and diabetes is increasing as the aging population increases. Loss of bone mineral density occurs in patients with diabetes, but is not always a priority in the practice setting. The aim of this review is to discuss clinical considerations when managing osteoporosis in patients with diabetes.

Areas covered: The pathophysiology of decreased bone mineral density in patients with diabetes is discussed. Additionally, diabetic risk factors for fracture, such as hypoglycemia, the National Osteoporosis Foundation recommendations for osteoporosis, and secondary causes of osteoporosis, including disease and medication related causes, are discussed. Furthermore, recommendations for antihyperglycemic agents, thiazolidinediones, canagliflozin, insulin, metformin, and sitagliptin are discussed due to their effects on bone mineral density.

Expert opinion: Even though diabetes is an important risk factor for osteoporosis, assessing bone health in diabetic patients is often overlooked. Ensuring adequate prevention and treatment strategies for osteoporosis is vitally important with our diabetic patients as the population ages. T-scores and FRAX scores likely underrepresent a diabetic patients risk for fracture, and this should be taken into consideration in treatment decisions. Future studies are needed to determine optimal pharmacologic treatment of hyperglycemia in this population.     

阿仑膦酸钠对类风湿关节炎患者骨质疏松或骨量减少的疗效观察

目的 观察阿仑膦酸钠对类风湿关节炎(RA)合并骨质疏松或骨量减少的患者骨密度(BMD)的影响.方法 将42例RA患者随机分成2组,所有患者均服用MTX 10 mg/周、叶酸片5 mg/d和钙尔奇-D 600 mg/d,治疗组加用阿仑膦酸钠70 mg/周,2组共服药6个月.使用双能X线吸收仪分别检测治疗前和治疗6个月后腰椎(L1～4)后前位、股骨颈、大转子、Ward区部位的BMD,评估RA疾病活动度并分析二者间的相关性.结果 治疗6个月后治疗组RA患者的腰椎BMD与基线相比明显上升(P<0.05),并且高于对照组(P<0.05).而股骨颈、Ward区和大转子部位的BMD有所增加,但与基线及对照组相比,差异无统计学意义.21例治疗组患者经过6个月治疗后腰椎BMD的变化与RA疾病活动性指标如ESR、CRP、RF、HAQ评分、关节肿胀个数、关节压痛个数和DAS28均无相关性(P>0.05).结论 与MTX联用,阿仑膦酸钠可增加骨质疏松或骨量减少RA患者的腰椎BMD,是治疗RA伴发骨质疏松或骨量减少的有效手段.     

雄激素对雄性骨质疏松大鼠骨代谢及骨骼生物力学的影响

目的探讨雄激素对男性骨质疏松骨代谢及骨骼生物力学的影响。方法采用15周龄雄性SD大鼠随机分为正常对照组、模型（去睾）组和雄激素治疗组（十-酸睾酮）。28周后行血尿生化、骨密度、骨骼生物力学检查。结果与正常对照组比较,模型组睾酮水平、全身及股骨中点骨密度均明显下降,碱性磷酸酶降低,24h尿羟脯氨酸、尿钙、与尿磷肌酐比值显著增高,股骨生物力学指标-最大受力负荷（Pb）及股骨最大挠度（δb）也显著下降。应用雄激素替代治疗后,上述指标好转。结论雄性大鼠去睾28周后形成了骨质疏松。雄激素在骨代谢过程中对骨形成与骨吸收均有影响,并最终影响骨骼生物力学性能,早期应用雄激素替代治疗可预防这种骨质疏松的发生。     

Management of glucocorticoid-induced osteoporosis: clinical data in relation to disease demographics,bone mineral density and fracture risk

Introduction: Glucocorticoid-induced osteoporosis (GIOP) is the most common type of secondary osteoporosis. Patient selection and the treatment choice remain to be controversial. None of the proposed management guidelines are widely accepted. We evaluate the available clinical data, the efficacy of current medication and we propose an overall algorithm for managing GIOP.

Areas covered: This article provides a critical review of in vivo and clinical evidence regarding GIOP and developing evidence-based algorithm of treatment. Data base used includes MEDLINE® (1950 to May 2014).

Expert opinion: Patient-specific treatment is the gold standard of care. Glucocorticoid (GC)-treated patients must comply with a healthy lifestyle and receive 1000 mg of calcium and at least 800 mg of Vitamin D daily. Bisphosphonate (BP) therapy is the current standard of care for prevention and treatment of GIOP. Most of bisphosphonates demonstrated benefit in lumbar bone mineral density (BMD) and some in hip BMD. Alendronate, risedronate and zoledronate showed vertebral anti-fracture efficacy in postmenopausal women and men. Scarce data however when compared head to head with BP efficacy. In post-menopausal women, early antiresorptive BP treatment appears to be efficient and safe. In premenopausal women and patients at high risk of fracture receiving long-term GC therapy however, teriparitide may be advised alternatively.     

2型糖尿病患者晚期糖基化终末产物水平与骨密度的相关性研究

目的 研究2型糖尿病患者体内晚期糖基化终末产物水平（AGEs）与骨密度的关系.方法 收集本院就诊的2型糖尿病患者217例,对照组为205例非糖尿病正常人群.采用酶联免疫吸附法测定血清AGEs水平,双能X线骨密度仪测定腰椎（L2～L4）及左股骨颈骨密度.结果 2型糖尿病组腰椎（L2～L4）及左侧股骨颈BMD低于对照组（P＜0.05）,但AGEs水平明显高于对照组（P＜0.05）.血清AGEs水平与腰椎骨密度（r=-0.473,P＜0.05）及股骨颈骨密度呈负相关（r=--0.429,P＜0.05）.结论 2型糖尿病患者体内晚期糖基化终末产物水平与腰椎及股骨颈骨密度密切相关.     

唑来膦酸对绝经后骨质疏松患者骨密度、骨代谢指标、生活质量及疗效的影响

目的 探讨唑来膦酸对绝经后骨质疏松患者骨密度、骨代谢指标、生活质量及疗效的影响.方法 114例绝经后骨质疏松症患者依据随机数字表法随机分为观察组与对照组,每组57例.对照组采用常规治疗,观察组在对照组基础上结合唑来膦酸治疗.2组疗程均为12个月.比较2组患者骨密度、骨代谢指标、生活质量、疗效及不良反应情况.结果 2组腰椎和Ward三角区骨密度治疗后增加(P＜0.05);观察组腰椎和Ward三角区骨密度治疗后高于对照组(P＜0.05);2组S-Ca、S-P治疗前后比较差异均无统计学意义(P＞0.05);2组ALP治疗后下降(P＜0.05);观察组ALP低于对照组(P＜0.05);观察组SF-36量表中躯体疼痛、精神健康、生理功能、生理职能、情感职能、社会功能、生命活力、总体健康治疗后高于对照组(P＜0.05);观察组总有效率高于对照组(P＜0.05);2组均未见严重用药不良反应.结论 唑来膦酸可明显改善患者骨密度,降低ALP水平,提高患者生活质量,疗效显著,安全可靠,具有重要研究价值.     

唑来膦酸对老年骨质疏松患者骨密度及骨代谢的影响

目的探讨唑来膦酸对老年骨质疏松(OP)患者骨密度(BMD)及骨代谢的影响。方法选取2015年6月～2016年7月我院骨科收治的168例OP患者,随机数字表法将所有患者分为对照组与研究组,对照组患者给予常规治疗:骨化三醇胶丸+钙尔奇D片,研究组在对照组常规治疗方案的基础上再加用唑来膦酸静脉滴注治疗,治疗后对比两组患者的临床疗效、骨密度及骨代谢指标。结果研究组治疗6、12个月后骨钙素、BALP、CTx及TRACP-5b水平低于对照组(P 0.05);研究组患者有66例在使用治疗后的3d内出现头痛、关节痛以及流感等症状,研究给予患者治疗后治疗症状得到一定缓解,且未出现下颌骨坏死或是肾损害等其他的不良反应。结论唑来膦酸应用于骨质疏松症的临床治疗,能够有效减轻OP患者骨痛,提高骨密度,改善血清骨代谢相关指标,值得临床大量推广应用。