特立帕肽联合阿仑膦酸钠治疗绝经后骨质疏松症的临床研究

目的探讨特立帕肽联合阿仑膦酸钠治疗绝经后骨质疏松症的临床疗效。方法选取2014年1月—2015年6月天津中医药大学第一附属医院收治的绝经后骨质疏松症患者140例,随机分为对照组和治疗组,每组各70例。对照组患者口服阿仑膦酸钠片,1片/次,1次/d。治疗组在对照组治疗基础上皮下注射特立帕肽注射液,20μg/次,1次/d。两组患者均连续治疗6个月。观察两组患者治疗前后骨密度和骨代谢指标的变化情况。结果治疗组治疗3个月时腰椎骨密度相对于治疗前有明显上升,全髋与股骨颈骨密度则无明显变化,治疗组治疗6个月时腰椎、全髋、股骨颈骨密度均明显上升,同组治疗前后差异具有统计学意义(P0.05);对照组治疗3个月各部位骨密度均未出现明显上升,治疗6个月腰椎骨密度较治疗前有明显上升(P0.05)。治疗组治疗6个月时腰椎、全髋、股骨颈骨密度改善情况明显优于对照组,两组比较差异有统计学意义(P0.05)。治疗组治疗3、6个月血清骨钙素(OC)水平逐渐上升,均明显高于治疗前,同组治疗前后差异具有统计学意义(P0.05);对照组则逐渐下降,均明显低于治疗前(P0.05);治疗组治疗3、6个月血清Ⅰ型胶原羧基端肽交联(β-CTX)水平逐渐下降,对照组也逐渐下降,对照组下降幅度则明显大于治疗组(P0.05)。结论特立帕肽联合阿仑膦酸钠治疗绝经后骨质疏松症具有较好的临床疗效,可增加患者的骨密度,可有效改善骨代谢,具有一定的临床推广应用价值。

Clinical study on teriparatide combined with alendronate in treatment of postmenopausal osteoporosis

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 werepo 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 serumβ-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).ConclusionTeriparatide 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.