目的 探討骨松康合劑聯(lián)合地諾單抗治療絕經(jīng)后骨質(zhì)疏松癥的臨床療效。方法 選取2017年3月—2020年3月在陜西省中醫(yī)醫(yī)院治療的86例絕經(jīng)后骨質(zhì)疏松癥患者，根據(jù)用藥的差別分為對照組和治療組，每組各43例。對照組腹部皮下注射地舒單抗注射液，120 mg/次，1次/4周；治療組在對照組基礎(chǔ)上口服骨松康合劑，30 mL/次，3次/d。兩組患者均治療12個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者ADL、Lysholm、VAS評分及骨代謝和骨密度指標(biāo)。結(jié)果 經(jīng)治療，對照組和治療組總有效率分別為81.40%、97.67%（P<0.05）。經(jīng)治療，兩組ADL評分和Lysholm評分明顯升高，而VAS評分明顯下降（P<0.05），且治療組評分項(xiàng)目明顯好于對照組（P<0.05）。經(jīng)治療，兩組血清骨堿性磷酸酶（BALP）、前脂肪細(xì)胞因子1（Pref-1）、骨鈣素（BGP）、I型前膠原氨基端原肽（PINP）、組織蛋白酶K（Cathe K）和抗酒石酸酸性磷酸酶（TRACP-5b）水平顯著降低（P<0.05），且治療組比對照組更低（P<0.05）。經(jīng)治療，兩組患者腰椎L_2～4、股骨頸、Ward’s三角區(qū)骨密度水平明顯升高（P<0.05），且治療組升高更明顯（P<0.05）。結(jié)論 骨松康合劑聯(lián)合地諾單抗治療絕經(jīng)后骨質(zhì)疏松癥可有效改善患者骨痛，改善骨代謝指標(biāo)及骨密度，提高患者日?；顒?dòng)能力，改善膝關(guān)節(jié)功能。

Objective To investigate the clinical efficacy of Gusongkang Mixture combined with dinosumab in treatment of postmenopausal osteoporosis. Methods Patients (86 cases) with postmenopausal osteoporosis in Shaanxi Provincial Hospital of Chinese Medicine from March 2017 to March 2020 were divided into control and treatment groups based on different treatments, and each group had 43 cases. Patients in the control group were abdominal subcutaneous injected with Denosumab Injection, 120 mg/time, once every 4 weeks. Patients in the treatment group were po administered with Gusongkang Mixture, 30 mL/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, the scores of ADL, Lysholm and VAS, and the indexes of bone metabolism and the bone mineral density in two groups before and after treatment were compared. Results After treatment, the total effective rates of the control group and the treatment group were 81.40% and 97.67%, respectively (P < 0.05). After treatment, the ADL score and Lysholm score in two groups were significantly increased, while the VAS score was significantly decreased (P < 0.05), and the score items of the treatment group were significantly better than those of the control group (P < 0.05). After treatment, the serum levels of BALP, Pref-1, BGP, PINP, Cathe K, and TRACP-5b in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the BMD of lumbar vertebrae L_2-4, femoral neck, and Ward's triangle in two groups were significantly increased (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Gusongkang Mixture combined with dinosumab in treatment of postmenopausal osteoporosis can effectively improve the bone pain, bone metabolic index and bone mineral density, ameliorate the daily activity and the function of knee joint

R977

陜西省名中醫(yī)傳承工作室建設(shè)項(xiàng)目（陜中醫(yī)藥發(fā)2019019）