目的 探討仙靈骨葆膠囊聯(lián)合阿侖膦酸鈉對骨質(zhì)疏松癥患者骨代謝及骨轉(zhuǎn)換指標的影響。方法 選取2015年9月—2018年9月西寧市第一人民醫(yī)院92例骨質(zhì)疏松癥患者作為研究對象，按照隨機數(shù)字法將患者分為對照組和觀察組，每組各46例。對照組患者口服阿侖膦酸鈉片，10 mg/次，1次/d。觀察組在對照組的基礎上口服仙靈骨葆膠囊，2粒/次，3次/d，兩組均持續(xù)治療3個月。觀察兩組患者的臨床療效，同時比較兩組治療前后的骨代謝、骨轉(zhuǎn)換指標及腰椎L_2-4和股骨頸骨密度。結果 治療后，觀察組總有效率為93.48%，對照組總有效率為78.26%，兩組總有效率比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組患者骨源性堿性磷酸酶（BAP）、骨鈣素（BGP）和堿性磷酸酶（ALP）水平均顯著升高，24 h尿鈣（U-Ca）水平顯著降低（P<0.05），且觀察組骨代謝各指標水平顯著優(yōu)于對照組（P<0.05）。治療后，兩組患者的核因子κB受體活化因子配基（RANKL）及Ⅰ型膠原交聯(lián)C-末端肽（CTX-1）水平均顯著降低，骨保護素（OPG）水平顯著升高（P<0.05），且觀察組各骨轉(zhuǎn)換指標水平顯著優(yōu)于對照組（P<0.05）。兩組治療后腰椎L_2-4和股骨頸骨密度均顯著增加（P<0.05），且觀察組腰椎L_2-4和股骨頸骨密度顯著高于對照組（P<0.05）。結論 仙靈骨葆膠囊聯(lián)合阿侖膦酸鈉可有效改善患者的骨代謝、骨轉(zhuǎn)換指標及骨密度水平，療效確切，在骨質(zhì)疏松癥患者治療中具有較高的應用價值。

Objective To investigate the effects of Xianling Gubao Capsules combined with alendronate sodium on bone metabolism and bone conversion indexes in osteoporosis patients. Methods A total of 92 patients with osteoporosis in the First People's Hospital of Xining from September 2015 to September 2018 were selected as the research subjects. Patients were randomly divided into control group and observation group, with 46 patients in each group. Patients in the control group were po administered with Alendronate Sodium Tablets, 10 mg/time, once daily. Patients in the observation group were po administered with Xianling Gubao Capsules on the basis of control group, two capsules/time, three times daily. Patients in two groups were treated for three months. The clinical efficacy in two groups was observed, and the bone metabolism, bone conversion indexes and lumbar L_2-4 and femoral neck bone densityof two groups before and after treatment were compared. Results After treatment, the total effective rate was 93.48% in the observation group and 78.26% in the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, BAP, BGP and ALP levels in two groups were significantly increased, while U-CA levels were significantly decreased (P<0.05), and bone metabolism indexes in the observation group were significantly better than those in the control group (P<0.05). After treatment, RANKL and CTX-1 levels in two groups were significantly decreased, OPG levels were significantly increased (P<0.05), and the levels of bone transformation indicators in the observation group were significantly better than those in the control group (P<0.05). After treatment, the bone mineral density of L_2-4 and femoral neck in two groups was significantly increased (P<0.05), and the bone mineral density of L_2-4 and femoral neck in the observation group was significantly higher than those in the control group (P<0.05). Conclusion Xianling Gubao Capsules combined with alendronate sodium can effectively improve the level of bone metabolism, bone conversion indicators and bone mineral density in patients, with an exact curative effect, and has a high application value in the treatment of osteoporosis patients.

R982

西寧市科技項目（2015-K-25）