| 摘要: |
| [目的] 比较温针灸、电针和艾灸联合抗骨质疏松（OP）药物对原发性骨质疏松症（POP）患者骨代谢指标与甲状旁腺激素（PTH）的影响及其差异，并探究其作用机制。[方法] 选择2021年6月—2024年6月于上海市嘉定区中心医院就诊的135例POP患者作为研究对象。采用随机数字表法分为27组，每组5例，再依据3×3×3析因设计表，以刺灸方案（A）、补钙剂量（B）和治疗周期（C）为考察因素，各设置3水平。观察治疗结束后患者的临床疗效、中医证候积分、骨密度（BMD）、骨代谢指标[Ⅰ型原胶原氨基端前肽（PINP）、Ⅰ型胶原交联羧基末端肽（CTX）]和甲状旁腺激素（PTH）。[结果] 临床疗效、中医证候积分比较，A、B、C因素的3水平比较，差异有统计学意义（P<0.05）；A与B因素、A与C因素的交互作用，差异有统计学意义（P<0.05）；A因素的1水平优于2、3水平，B因素的3水平优于1、2水平，C因素的3水平优于1、2水平，差异有统计学意义（P<0.05）。BMD、PINP、CTX、PTH比较，A、C因素的3水平比较，差异均有统计学意义（P<0.05），且A与C因素的交互作用，差异均有统计学意义（P<0.05）；BMD、PINP、CTX、PTH的A因素的1水平优于2、3水平，差异均有统计学意义（P<0.05），C因素的3水平优于1、2水平，差异有统计学意义（P<0.05）。[结论] 治疗POP的方案中，刺灸方案发挥主要作用，最佳方案为患者采取温针灸，补钙剂剂量为每日1 200 mg，治疗周期为12周。 |
| 关键词: 原发性骨质疏松症 温针灸 电针 艾灸 骨代谢 甲状旁腺激素 |
| DOI：10.11656/j.issn.1673-9043.2026.09.04 |
| 分类号:R589.5 |
| 基金项目:嘉定区公立医院改革与高质量发展示范项目中西医结合重点学科（专科）与中医优势专科建设项目（JDZXYJHZDZK01）。 |
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| The effects of different moxibustion methods combined with anti-osteoporosis drugs on bone metabolism and parathyroid hormone in osteoporosis and its mechanism discussion |
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WU Jun, YU Xiaojie, GAO Qiang, WU Haibo
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Department of Rehabilitation Medicine, Central Hospital of Jiading District, Shanghai 201800, China
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| Abstract: |
| [Objective] To compare the effects and differences of warm needle moxibustion，electroacupuncture and moxibustion combined with anti-osteoporosis（OP） drugs on bone metabolism indicators and parathyroid hormone（PTH） in patients with primary osteoporosis（POP），and to explore their mechanisms of action. [Methods] A total of 135 patients with POP who were treated from June 2021 to June 2024 were selected as the research subjects at Central Hospital of Jiading District. The patients were randomly divided into 27 groups by using the random number table method，with 5 cases in each group. Then，based on the 3×3×3 factorial design table，the following factors were investigated：acupuncture and moxibustion（A），calcium supplementation dose（B） and treatment cycle（C），with 3 levels set for each factor. The clinical efficacy，traditional Chinese medicine syndrome score，bone mineral density（BMD），bone metabolism indicators [procollagen type Ⅰ N-prepeptide(PINP) and C-terminal telopeptide of type Ⅰ collagen（CTX）] and parathyroid hormone（PTH） were observed in the patients after treatment. [Results] In terms of comparison of clinical efficacy and traditional Chinese medicine syndrome scores，there were statistically significant differences among the three levels of factors A，B，and C（P<0.05）. Additionally，the interaction effects between factor A and factor B，as well as between factor A and factor C，showed statistically significant differences（P<0.05）. Specifically，level 1 of factor A was superior to levels 2 and 3，level 3 of factor B or C was superior to levels 1 and 2，with all these differences being statistically significant（P<0.05）. For the comparisons of BMD，PINP，CTX，and PTH，there were statistically significant differences among the three levels of factors A and C（P<0.05），and the interaction effect between factor A and factor C also exhibited statistically significant differences（P<0.05）. Moreover，in terms of BMD，PINP，CTX，and PTH，level 1 of factor A was superior to levels 2 and 3，and level 3 of factor C was superior to levels 1 and 2，with all these differences being statistically significant（P<0.05）. [Conclusion] In the treatment plan for POP，the acupuncture and moxibustion play a major role. The optimal plan is to apply warming needle moxibustion to patients，with a calcium supplement dosage of 1 200 mg/day and a treatment cycle of 12 weeks. |
| Key words: primary osteoporosis warming needle moxibustion electroacupuncture moxibustion bone metabolism parathyroid hormone |
