目的 比較鮭魚降鈣素噴鼻劑或阿侖膦酸鈉片聯(lián)合戊酸雌二醇片治療絕經(jīng)后骨質(zhì)疏松的臨床療效和安全性。方法 選取2012年1月—2015年6月就診于天津市河西區(qū)康復(fù)醫(yī)院并進(jìn)行治療的120例絕經(jīng)后骨質(zhì)疏松患者,隨機(jī)分為對照組和治療組,每組各60例。對照組患者口服戊酸雌二醇片1 mg,1次/d,用藥3周后停藥1周;口服阿侖膦酸鈉片10 mg,1次/d。治療組患者口服戊酸雌二醇片1 mg,1次/d,用藥3周后停藥1周;鮭魚降鈣素噴鼻劑20 μg噴鼻,1次/d或分次給藥。兩組患者均連續(xù)治療6個(gè)月。觀察兩組的臨床療效,同時(shí)比較骨密度值、血鈣、血磷和血清骨鈣素水平以及疼痛評價(jià)。結(jié)果 治療后,對照組患者總有效率88.33%,治療組患者總有效率90.00%,兩組總有效率比較差異無統(tǒng)計(jì)學(xué)意義。兩組患者治療后L2、L3、L4及股骨頸骨密度值均較治療前明顯提高,同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05),但是組間比較差異無統(tǒng)計(jì)學(xué)意義。治療后兩組患者血清骨鈣素較治療前明顯升高,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組患者治療后VAS評分較治療前明顯降低,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05),組間比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 戊酸雌二醇片聯(lián)合阿侖膦酸鈉片或鮭魚降鈣素噴鼻劑治療絕經(jīng)后骨質(zhì)疏松均安全有效,提高骨密度值和血清骨鈣素水平,降低疼痛,且不良反應(yīng)發(fā)生率較低,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To compare the clinical curative and safety of Salmon Calcitonin Nasal Spray or Sodium Citrate Tablets combined with Estradiol Valerate Tabletes in treatment of postmenopausal osteoporosis. Methods Patients (120 cases) with postmenopausal osteoporosis in Rehabilitation Hospital of Hexi District in Tianjin City from January 2012 to June 2015 were randomly divided into control and treatment groups. Each group had 60 cases. Patients in the control group were po administrated with Estradiol Valerate Tabletes 1 mg, once daily, and stopped for one week after treatment for three weeks, and also po administrated with Sodium Citrate Tablets 10 mg, once daily. Patients in the treatment group were po administrated with Estradiol Valerate Tabletes 1 mg, once daily, and stopped for one week after treatment for three weeks, but were given Salmon Calcitonin Nasal Spray by nasal spray, 1 time/d or graded administration. Two groups were treated for six months. After treatment, the efficacy was evaluated, and the bone mineral density, serum calcium, serum phosphorus, serum bone gla protein, and pain score were compared. Results After treatment, the efficacies in the control and treatment groups were 88.33% and 90.00%, respectively, and there were no significant difference between two groups. After treatment, the bone mineral densities of L2, L3, L4, and femoral neck bone in two groups was significantly increased, and the difference was statistically significant in the same group (P< 0.05), but there were no significant difference between two groups. After treatment, the levels of serum bone gla protein in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P< 0.05). After treatment, VAS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05), but there were no significant difference between two groups. Conclusion Salmon Calcitonin Nasal Spray or Sodium Citrate Tablets combined with Estradiol Valerate Tabletes has safety and good efficacy in treatment of postmenopausal osteoporosis, and can significantly improve the bone mineral density and levels of serum bone gla protein, and relieve pain with lower incidence of adverse reactions, which has a certain clinical application value.