Abstract:

Objective　Analysis of the effect of zoledronic acid combined with Wenjing decoction on patients with postmenopausal osteoporosis of the kidney deficiency and blood stasis type. Methods　A retrospective analysis was conducted on 87 patients with postmenopausal osteoporosis of the kidney deficiency and blood stasis type who were admitted to Baoji High-tech Hospital from July 2022 to August 2023. These patients were divided into the control group (42 cases) and the observation group (45 cases) according to the treatment methods. Control group: Age (56.21±7.43) years, Menopause (4.51±0.85) years, Duration of disease (9.34±1.70) weeks; Received treatment with zoledronic acid. Observation group: Age (57.10±7.89) years, menopause (4.79±0.72) years, disease duration (9.61±1.52) weeks; Treated with Wenjing decoction on the basis of the control group. Compare the traditional Chinese medicine symptom scores, sex hormones, oxidative stress responses, bone metabolism, as well as clinical efficacy and adverse reactions before treatment and 3 months after treatment between the two groups. Statistical methods employed were the χ² test and the t test. Results　After treatment, the total score of TCM syndromes in the observation group was lower than that in the control group [(3.16±0.73) points vs. (5.82±1.59) points], and the difference was statistically significant (t=10.139, P<0.05). The levels of luteinizing hormone (LH), progesterone (P), and estradiol (E2) in the observation group were all higher than those in the control group (all P<0.05). The levels of monoamine oxidase A (MAOA), advanced oxidation protein products (AOPP), type I collagen cross-linked carboxy-terminal peptide (β-CTX), and bone alkaline phosphatase (BALP) in the observation group were all lower than those in the control group, while the total antioxidant capacity (T-AOC) and type I procollagen amino-terminal propeptide (PINP) were all higher than those in the control group (all P<0.05). The total effective rate of the observation group was higher than that of the control group [91.11% (41/45) vs. 73.81% (31/42)], and the difference was statistically significant (χ²=4.558, P<0.05). The comparison of the total incidence of adverse reactions between the two groups [8.89% (5/45) vs. 7.14% (3/42)] showed no statistically significant difference (χ²=0.090, P>0.05). Conclusion　Zoledronic acid combined with Wenjing decoction is highly effective in treating postmenopausal osteoporosis of the kidney-yin and blood-stasis type. It can increase sex hormone levels, reduce oxidative stress responses, improve bone metabolism, and is safe and reliable.

Key words: 绝经后骨质疏松, 唑来膦酸, 温经汤, 骨代谢, 肾虚血瘀型, 临床疗效

摘要： 目的　分析唑来膦酸联合温经汤对肾虚血瘀型绝经后骨质疏松患者的影响。方法　选择宝鸡高新医院2022年7月至2023年8月收诊的87例肾虚血瘀型绝经后骨质疏松患者进行回顾性分析，按治疗方法将其分成对照组（42例）和观察组（45例）。对照组：年龄（56.21±7.43）岁，绝经（4.51±0.85）年，病程（9.34±1.70）周；接受唑来膦酸治疗。观察组：年龄（57.10±7.89）岁，绝经（4.79±0.72）年，病程（9.61±1.52）周；在对照组的基础上接受温经汤治疗。比较两组治疗前、治疗3个月后的中医症候评分、性激素、氧化应激反应、骨代谢，以及临床疗效、不良反应。统计学方法采用χ²检验与t检验。结果　治疗后，观察组中医症候总评分低于对照组［（3.16±0.73）分比（5.82±1.59）分］，差异有统计学意义（t=10.139，P<0.05）；观察组黄体生成素（LH）、孕酮（P）及雌二醇（E2）均高于对照组（均P<0.05）；观察组单胺氧化酶A（MAOA）、高级氧化蛋白产物（AOPP）、I型胶原交联羧基末端肽（β-CTX）、骨碱性磷酸酶（BALP）均低于对照组，总抗氧化能力（T-AOC）、I型前胶原氨基端前肽（PINP）均高于对照组（均P<0.05）；观察组总有效率高于对照组［91.11%（41/45）比73.81%（31/42）］，差异有统计学意义（χ²=4.558，P<0.05）。两组不良反应总发生率比较［8.89%（5/45）比7.14%（3/42）］，差异无统计学意义（χ²=0.090，P>0.05）。结论　唑来膦酸联合温经汤治疗肾虚血瘀型绝经后骨质疏松患者疗效确切，可提高性激素水平，减轻氧化应激反应，改善骨代谢，且安全可靠。

关键词: 绝经后骨质疏松, 唑来膦酸, 温经汤, 骨代谢, 肾虚血瘀型, 临床疗效