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目的探讨抗骨质疏松症药物(anti osteoporosis drug therapy,AODT)与药物联合脉冲电磁场治疗(drug and pulse electromagnetic field,DPEF)对骨质疏松症伴认知功能障碍老年患者的治疗效果及生活质量的影响对比。方法回顾性分析2011年9月—2014年7月于华北石油总医院就诊的96例骨质疏松症的老年患者的临床资料,根据治疗方法的不同,分为AODT组和DPEF组,各48例。在治疗前和治疗后3、6和12个月,采用X线骨密度仪测定骨密度;采用简易精神状况量表(SPMSQ)评定患者的认知功能;采用功能独立性量表(FIM)评定患者的功能独立性;采用欧洲五维健康量表(EQ-5D)评定患者的生活质量。结果 1DPEF组治疗后6和12个月骨密度分别为(1.02±0.11)、(1.13±0.24)g/cm3,分别高于AODT组的(0.87±0.13)、(0.93±0.35)g/cm3;两组治疗后6和12个月骨密度差异均有统计学意义(均P<0.05)。2DPEF组治疗后6个月正常和认知功能障碍轻度、中度所占比例分别为25.00%、58.33%、16.67%,而12个月分别为33.33%、56.25%、10.42%;AODT组治疗后6个月正常和认知功能障碍轻度、中度所占比例分为6.25%、64.58%、29.17%,而12个月分别为14.58%、58.33%、27.08%。两组治疗后6和12个月的SPMSQ评分均差异有统计学意义(P<0.05)。3DPEF组治疗后6和12个月的FIM评分分别为(3.93±0.48)、(4.04±0.17)分,分别高于AODT组的(3.12±0.38)、(3.52±0.13)分,差异有统计学意义(P<0.05)。4DPEF组治疗后6和12个月的EQ-5D评分均明显高于AODT组的,差异有统计学意义(P<0.05)。结论与AODT治疗方法对比,DPEF能有效地增加骨质疏松症伴认知功能障碍老年患者的骨密度,降低认知功能障碍,提高功能独立性和生活质量。
Objective To investigate the therapeutic effect and quality of life of anti-osteoporosis drug therapy (AODT) combined with drug and pulse electromagnetic field (DPEF) on senile patients with osteoporosis and cognitive impairment Impact comparison. Methods The clinical data of 96 elderly patients with osteoporosis who were treated in Huabei Petroleum General Hospital from September 2011 to July 2014 were retrospectively analyzed. According to the different treatment methods, the patients were divided into AODT group and DPEF group, 48 cases in each group . BMD was measured by X-ray absorptiometry before treatment and at 3, 6 and 12 months after treatment. The patients’ cognitive function was assessed by using the Simple Mental Status Scale (SPMSQ). The functional independence scale (FIM) Patients’ functional independence was evaluated using the European Five-Dimensional Health Scale (EQ-5D) to assess the patient’s quality of life. Results The bone mineral density in the 1DPEF group was (1.02 ± 0.11) and (1.13 ± 0.24) g / cm3 at 6 and 12 months after treatment, respectively, which were significantly higher than those in the AODT group (0.87 ± 0.13 and 0.93 ± 0.35) g / cm3, There was significant difference in bone mineral density between the two groups 6 and 12 months after treatment (both P <0.05). The mild and moderate proportions of normal and cognitive dysfunction in 2DPEF group were 25.00%, 58.33% and 16.67% at 6 months after treatment, respectively, and were 33.33%, 56.25% and 10.42% at 12 months respectively. AODT treatment After 6 months, the rates of mild and moderate cognitive impairment were 6.25%, 64.58% and 29.17%, respectively, while those of 12 months were 14.58%, 58.33% and 27.08% respectively. There was significant difference in SPMSQ score between the two groups 6 and 12 months after treatment (P <0.05). The FIM scores of 3DPEF group were (3.93 ± 0.48) and (4.04 ± 0.17) at 6 and 12 months after treatment, respectively, which were significantly higher than those in AODT group (3.12 ± 0.38 and 3.52 ± 0.13) Significance (P <0.05). The EQ-5D score of 4DPEF group was significantly higher than that of AODT group at 6 and 12 months after treatment (P <0.05). Conclusion Compared with AODT treatment, DPEF can effectively increase the bone mineral density in elderly patients with osteoporosis and cognitive impairment, reduce cognitive dysfunction and improve functional independence and quality of life.