围绝经期妇女骨质疏松症的中医证候与骨折的相关性分析
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摘要
目的:探讨围绝经期妇女骨质疏松症的中医证候分型及与骨折的相关性。方法:对117例围绝经期骨质疏松患者进行中医辨证分型,收集各证型的基本资料、中医证候积分、BMD值及骨折特点。结果:三种证候的腰椎及股骨BMD值进行比较,脾肾两虚兼血瘀及脾肾两虚型的BMD值显著小于肝肾不足型;三种证候的积分比较,脾肾两虚兼血瘀型>脾肾两虚型>肝肾不足型;三个证候的骨折发生率为脾肾两虚兼血瘀型>脾肾两虚型>肝肾不足型;分析总体证候积分与BMD的相关性,中医证候积分与股骨BMD存在负相关,而与腰椎BMD则不存在相关性。结论:脾肾两虚兼血瘀证是围绝经期骨质疏松症三种中医证候中积分与骨折发生率最高的一型。
Objective:To explore the relationship between traditional Chinese medicine syndrome and bone fracture in the women with perimenopausal osteoporosis.Methods:We collected baseline data,TCM syndrome scores,BMD and fracture characteristics in 117 perimenopausal osteoporosis cases,and analyzed the TCM syndrome differentiation of them.Results:Compared lumbar spine BMD with the femoral BMD in three kinds of TCM syndromes,spleen-kidney deficiency with blood stasis syndrome and spleen-kidney deficiency syndrome BMD value was significantly greater than liver-kidney deficiency syndrome.The TCM syndrome scores in three kinds of syndromes from high to low were spleen-kidney deficiency with blood stasis syndrome,spleen-kidney deficiency syndrome,liver-kidney deficiency syndrome.The incidence of fractures in three kinds of syndromes from high to low were spleen-kidney deficiency with blood stasis syndrome,spleen-kidney deficiency syndrome,liver-kidney deficiency syndrome.By analyzing the correlation between overall TCM syndrome scores and BMD values,there was a negative correlation between TCM syndrome scores and femoral BMD values,and no correlation with lumbar BMD values.Conclusion:Spleen and kidney deficiency and blood stasis syndrome has the highest incidence of fracture and TCM syndrome scores in three kinds of syndromes of perimenopausal osteoporosis.
Objective:To explore the relationship between traditional Chinese medicine syndrome and bone fracture in the women with perimenopausal osteoporosis.Methods:We collected baseline data,TCM syndrome scores,BMD and fracture characteristics in 117 perimenopausal osteoporosis cases,and analyzed the TCM syndrome differentiation of them.Results:Compared lumbar spine BMD with the femoral BMD in three kinds of TCM syndromes,spleen-kidney deficiency with blood stasis syndrome and spleen-kidney deficiency syndrome BMD value was significantly greater than liver-kidney deficiency syndrome.The TCM syndrome scores in three kinds of syndromes from high to low were spleen-kidney deficiency with blood stasis syndrome,spleen-kidney deficiency syndrome,liver-kidney deficiency syndrome.The incidence of fractures in three kinds of syndromes from high to low were spleen-kidney deficiency with blood stasis syndrome,spleen-kidney deficiency syndrome,liver-kidney deficiency syndrome.By analyzing the correlation between overall TCM syndrome scores and BMD values,there was a negative correlation between TCM syndrome scores and femoral BMD values,and no correlation with lumbar BMD values.Conclusion:Spleen and kidney deficiency and blood stasis syndrome has the highest incidence of fracture and TCM syndrome scores in three kinds of syndromes of perimenopausal osteoporosis.
引文
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[2] 沈汝,张凇文,王军华,等.北京地区围绝经期妇女骨质疏松流行病学调查与分析[J].中国妇幼保健,2004,19(4):71-74.
[3] 张智海,刘忠厚,李娜.中国人骨质疏松症诊断标准专家共识(第三稿·2014版)[J].中国骨质疏松杂志,2014(9):1007-1010.
[4] 刘忠厚.骨质疏松学[M].北京:科学出版社,2001:162.
[5] 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:356.
[6] 李岩,李跃华,郭红灵,等.原发性骨质疏松症中医证候与骨折相关性分析[J].中医学报,2014,29(10):1436-1437.
[7] 许惠娟,李生强,陈娟,等.绝经后骨质疏松症不同年龄段中医证型分布特点[J].中国实验方剂学杂志,2017(12):157-161.
[8] 许兵,刘慧,金红婷,等.经典骨质疏松症模型大鼠的肾虚证研究[J].中国骨伤,2012,25(9):766-770.
[9] 马伟,牟慧琴,马占洋.绝经后骨质疏松症中医病因病机研究概况[J].中医杂志,2012,53(13):1152-1154.
[10] 晁洁,卢苏.围绝经期骨质疏松症中医研究进展[J].辽宁中医药大学学报,2015,17(3):210-212.
[11] 黄宏兴,吴青,李跃华,等.肌肉、骨骼与骨质疏松专家共识[J].中国骨质疏松杂志,2016,22(10):1221-1229,1236.
[12] 盛彤,谢培凤,王新祥,等.骨质疏松症中医脾虚病机认识的现代医学基础[J].中国骨质疏松杂志,2013,19(5):509-513.
[13] 刘丹,赵培,李跃华.李跃华教授膏方治疗骨质疏松[J].吉林中医药,2016,36(10):988-990.
[14] Ekman EF.The role of the orthopedic surgeon in minimizing mortality and morbidity associated with fragility fractures[J].J Am Acad Orthop Surg,2010,18(5):278-285.
[15] Ralston SH,Lara G,Farquhar DJ,et al.NICE on osteoporosis.Women over 75 with fragility fractures should have DEXA[J].BMJ,2009,338:b2340.
[16] 高丽萍,林求诚,王和鸣.绝经后骨质疏松症的中西医危险因素调查研究[J].康复学报,2007,17(4):13-16.