雷火灸联合脉冲磁场对原发性骨质疏松症患者运动功能和骨代谢的影响

关键词：原发性骨质疏松症  脉冲电磁场  雷火灸  计时起立-走  骨代谢

Keywords:primary osteoporosis  pulsed electromagnetic fields  thunder-fire moxibustion  timed up-and-go  bone metabolism

摘要：

      摘要 目的：观察雷火灸联合脉冲电磁场（pulsed electromagnetic fields， PEMFs）对原发性骨质疏松症患者骨代谢和运动功能的影响。 方法：本研究入组原发性骨质疏松症患者90例，采用信封法分为PEMFs组、雷火灸组和PEMFs＋雷火灸组，每组30例。PEMFs治疗频率为16Hz，强度为20mT；雷火灸选取双侧肝俞、肾俞部位施灸。治疗时间均为30min，每周3次，连续3个月。在治疗前、治疗3个月及入组6个月随访时评估计时起立-走（TUG）、血清I型前胶原氨基末端肽（PINP）和血清Ⅰ型胶原交联C-末端肽（CTX-I），并在入组6个月随访时进行骨密度（BMD）检测。 结果：①组间比较：与PEMFs组比较，PEMFs+雷火灸组治疗3个月降低TUG用时和血清CTX-Ⅰ水平显著（P＜0.05），血清PINP水平降低更显著（P＜0.01）。入组6个月随访时，PEMFs+雷火灸组降低TUG用时较PEMFs组显著（P＜0.01）。与雷火灸组比较，PEMFs+雷火灸组治疗3个月降低血清CTX-Ⅰ水平显著（P＜0.05）。②组内比较：治疗3个月与治疗前比较，PEMFs组降低TUG用时和血清CTX-Ⅰ水平显著（P＜0.05）；雷火灸组和PEMFs+雷火灸组TUG用时和血清PINP与CTX-Ⅰ水平显著降低（P＜0.01）。入组6个月随访时与治疗前比较，PEMFs组降低TUG用时显著（P＜0.05）；PEMFs+雷火灸组TUG用时和血清PINP水平显著降低（P＜0.01）。三组患者腰总和髋总BMD在入组6个月随访和治疗前比较均无显著差异（P＞0.05）。 结论：雷火灸联合PFMFs可提高原发性骨质疏松症患者运动功能、改善骨代谢指标；骨密度值呈好转趋势。

Abstract:

      Abstract Objective： To investigate the effect of thunder-fire moxibustion combined with pulsed electromagnetic fields （PEMFs） on bone metabolism and motor function in individuals with primary osteoporosis. Method： Ninety patients with primary osteoporosis were randomly assigned to three groups using the envelope method： PEMFs group （n=30）， thunder-fire moxibustion group （n=30）， and PEMFs+thunder-fire moxibustion group （n=30）. The PEMFs treatment frequency was 16Hz with an intensity of 20mT， while thunder-fire moxibustion was applied at bilateral Ganshu （BL18） and Shenshu （BL23）. Each treatment session lasted 30 minutes， conducted three times a week for three consecutive months. The timed up-and-go （TUG） test， serum typeⅠprocollagen amino-terminal peptide（PINP） and type I collagen carboxy-terminal peptide （CTX-I） were assessed before treatment， after 3-month treatment， and at 6-month follow-up. Bone mineral density （BMD） was measured at 6-month follow-up. Result： ①Inter-group comparison：after 3-month treatment, the PEMFs + Thunder-Fire Moxibustion group showed a significant reduction in TUG time and serum CTX-I levels compared to the PEMFs group (P<0.05), and a more significant reduction in serum PINP levels (P<0.01). At the 6-month follow-up， the TUG time in PEMFs+thunder-fire moxibustion group was significantly lower than PEMFs group（P<0.01）. Compared to the thunder-fire moxibustion group， the PEMFs+thunder-fire moxibustion group serum level of CTX-Ⅰ of decreased significantly after 3-month treatment（P<0.05）.②Intra-group comparison： After three months of treatment compared to baseline, the PEMFs group showed a significant reduction in TUG time and serum CTX-I levels (P<0.05), while both the Thunder-Fire Moxibustion group and the PEMFs+Thunder-Fire Moxibustion group showed significant reductions in TUG time and serum PINP and CTX-I levels (P<0.01). Comparison between 6-month follow-up and before treatment， the TUG time of PEMFs group decreased significantly（P<0.05）. The TUG time and the serum level of PINP in PEMFs+thunder-fire moxibustion group significantly decreased （P<0.01）. There were no significant differences observed among any of the three groups regarding total BMD measurements at waist and hip regions after 6-month follow-up and before treatment （P>0.05）. Conclusion： The combination of Thunder-fire moxibustion and PEMFs can enhance motor function and bone metabolism indexes in patients with primary osteoporosis, BMD shows a trend of improvement.