雌激素+黄体素联合常规方案治疗女性绝经后骨质疏松症的效果观察
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篇名: 雌激素+黄体素联合常规方案治疗女性绝经后骨质疏松症的效果观察
TITLE:
摘要: 目的:探讨雌激素+黄体素联合常规方案在女性绝经后骨质疏松症中的临床应用价值。方法:126例绝经后骨质疏松症患者按照就诊时间分成联合组(A组)和常规组(B组),各63例。B组患者予以钙剂+维生素D等常规治疗措施,A组患者在常规治疗基础上加以雌激素+黄体素联合治疗措施。比较两组患者治疗前后骨密度(BMD)、数字疼痛分级法(NRS)评分、匹兹堡睡眠质量指数(PSQI)评分、血清骨钙素(BGP)、血液骨源性碱性磷酸酶(BAP)、血清降钙素(h-CT)、甲状旁腺激素(PTH)水平,并记录不良反应发生情况。结果:治疗后,两组患者BMD水平均较治疗前显著提升,NRS评分与PSQI评分均较治疗前显著降低,差异有统计学意义(P<0.001);且A组患者各指标改善幅度大于B组,差异有统计学意义(P<0.001)。两组患者BGP、h-CT水平均较治疗前显著提升,BAP、PTH水平均较治疗前显著降低,差异有统计学意义(P<0.001);且A组患者各指标改善幅度大于B组,差异有统计学意义(P<0.01)。两组患者用药后均无严重不良反应发生,A组患者轻微不良反应发生率为19.0%,与B组患者的17.5%比较差异无统计学意义(P>0.05)。结论:对绝经后骨质疏松症患者予以常规治疗联合雌激素+黄体素方案,疗效确切,可有效改善BMD,减轻疼痛症状,对促进病情转归、提高患者预后水平具有积极影响。
ABSTRACT: OBJECTIVE: To explore the clinical application value of routine regimen of estrogen combined with and progesterone in the treatment of female postmenopausal osteoporosis. METHODS: 126 patients with postmenopausal osteoporosis were randomly divided into combination group (group A) and routine group (group B), with 63 cases in each group. Group B was treated with routine treatment, such as calcium and vitamin D, while group A was additionally treated with estrogen and progesterone on the basis of routine treatment. The bone mineral density (BMD), numeric rating scores (NRS) and Pittsburgh sleep quality index (PSQI) scores were compared between 2 groups before and after treatment. The levels of serum bone gla protein (BGP), blood bone alkaline phosphatase (BAP), serum calcitonin (h-CT) and parathyroid hormone (PTH) were also compared between 2 groups before and after treatment, and the occurrence of ADR was recorded. RESULTS: After treatment, BMD of 2 groups were significantly higher than before, and NRS and PSQI were significantly lower than before, with statistical significance (P<0.001); the improvement of each index in group A was greater than in group B, with statistical significance (P<0.001). After treatment, the levels of BGP and h-CT in 2 groups were significantly improved, compared with those before treatment while levels of BAP and PTH were significantly lower than those before treatment, with statistical significance (P<0.001); the improvement of each index in group A was greater than in group B, with statistical significance (P<0.01). No serious ADR was found in 2 groups after medication. The incidence of mild ADR in group A was 19.0%; compared with 17.5% in group B, there was no statistical significance (P>0.05). CONCLUSIONS: For patients with postmenopausal osteoporosis, conventional treatment combined with estrogen and progesterone shows definite therapeutic efficacy, and can effectively improve BMD value, relieve the pain symptoms and has positive effect on promoting prognosis and improving the prognosis.
期刊: 2016年第27卷第2期
作者: 王峰,李振武,严锐峰,李志安
AUTHORS: WANG Feng,LI Zhenwu,YAN Ruifeng,LI Zhian
关键字: 雌激素;黄体素;绝经后骨质疏松症;临床疗效;预后
KEYWORDS: Estrogen; Progesterone; Postmenopausal osteoporosis; Clinical efficacy; Prognosis
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