目的 探討血塞通片聯(lián)合特立帕肽治療老年骨質(zhì)疏松癥的臨床療效及安全性。方法 選取南京醫(yī)科大學(xué)第二附屬醫(yī)院2018年1月—2019年12月收治的80例老年骨質(zhì)疏松癥患者作為研究對象，將所有患者按照數(shù)字隨機表法分為對照組和觀察組，每組各40例。對照組患者皮下注射特立帕肽注射液，20 μg/d，注射部位應(yīng)選擇大腿或腹部。觀察組患者在對照組治療的基礎(chǔ)上口服血塞通片，1片/次，3次/d。兩組均治療2周。觀察兩組患者的臨床療效和不良反應(yīng)發(fā)生情況，同時比較兩組治療前后的骨密度、骨代謝指標水平。結(jié)果 治療后，觀察組的患者治療總有效率為97.5%，顯著高于對照組的70.0%（P<0.05）。治療后，兩組的腰椎骨、股骨頸和股骨大轉(zhuǎn)子骨密度檢測值明顯升高（P<0.05），且觀察組患者高于對照組（P<0.05）。治療后兩組患者血清I型膠原氨基端前肽（P1NP）、Ⅰ型膠原羧基端交聯(lián)肽（CTX）水平均顯著降低，骨鈣素（BGP）和25-羥基維生素D（25（OH）D）水平均顯著升高（P<0.05）；且治療后，觀察組患者P1NP、CTX顯著低于對照組，BGP、25（OH）D顯著高于對照組（P<0.05）。治療期間，兩組患者不良反應(yīng)發(fā)生率在整個治療期間的對比沒有統(tǒng)計學(xué)差異。結(jié)論 血塞通片聯(lián)合特立帕肽治療老年骨質(zhì)疏松可提高患者骨密度，改善相關(guān)骨代謝指標，安全有效，值得臨床推廣應(yīng)用。

Objective To investigate the clinical efficacy and safety of Xuesaitong Tablets combined with teriparatide in treatment of senile osteoporosis. Methods Elderly patients (80 cases) with osteoporosis in the Second Affiliated Hospital of Nanjing Medical University from January 2018 to December 2019 were divided into control and observation groups by numerical random table method, each group had 40 cases. Patients in the control group were subcutaneously injected with Teriparatide Injection, 20 μg/d, and the injection site should be thigh or abdomen. Patients in the observation group were po administered with Xuesaitong Tablets on the basis of control group, 1 tablet/time, three times daily. Both groups were treated for 2 weeks. After treatment, the clinical efficacy and adverse reactions of two groups were observed, and the bone mineral density, and bone metabolism indexes before and after treatment in two groups were compared. Results After treatment, the total effective rate in the observation group was 97.5%, which was significantly higher than 70.0% in the control group (P<0.05). After treatment, the bone mineral density of lumbar vertebrae, femoral neck, and greater trochanter in two groups were significantly increased (P<0.05), and these indexes in the observation group were significantly higher than those in the control group (P<0.05). After treatment, P1NP and CTX levels in two groups were significantly decreased, while BGP and 25 (OH) D levels were significantly increased (P<0.05). After treatment, P1NP and CTX in the observation group were significantly lower than those in the control group, and BGP and 25 (OH) D were higher than those in the control group (P<0.05). There was no statistical difference in the incidence of adverse reactions between two groups during the treatment. Conclusion Xuesaitong Tablets combined with teriparatide in treatment of senile osteoporosis can improve the bone density of patients, improve the related bone metabolism indexes, safe and effective, it is worthy of clinical application.

R982

江蘇省第五期“333工程”培養(yǎng)資助項目（BRA2018170）