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Article(id=1322925387205968757, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.05.047, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339591075, onlineDateStr=2026-10-30, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339591075, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339591075, creator=13701087609, updateTime=1793339591075, updator=13701087609, issue=Issue{id=1322923490592043032, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='5', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1746806400000', pubDateStr='2025-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339138887, creator='13701087609', updateTime=1793340572227, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929502539612595, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929502539612596, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=247, endPage=250, ext={EN=ArticleExt(id=1322925387990303606, articleId=1322925387205968757, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Efficacy Observation of Qi Acupuncture Treating Osteoporosis of Kidney Deficiency Type, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the clinical efficacy and safety of Qi acupuncture treating osteoporosis of kidney deficiency type.

Methods

A total of 100 patients with osteoporosis of kidney deficiency type（admitted from June 2021 to June 2023）were included in the study. The patients were randomly divided into acupuncture and moxibustion group and control group，with 50 cases in each group. The patients in the control group were treated with alendronate tablets and calcium carbonate D3 tablets. Those in the acupuncture and moxibustion group were treated with Qi acupuncture on the basis of the treatment in the control group. During the treatment，4 patients in the acupuncture and moxibustion group fell off and 2 in the control group fell off. The clinical efficacy of each group and the integral changes of traditional Chinese medicine symptoms（lower back pain，foot weakness，tinnitus，deafness，skeletal weakness，forgetfulness and confusion）of patients before and after treatment were compared. The visual analog scale（VAS）was used to evaluate the degree of back pain in each group before and after treatment，and the oswestry disability index（ODI）to evaluate the back pain dysfunction. The changes in serum calcium（Ca）and phosphorus（P），N-terminal mid segment osteocalcin（N-MID），alkaline phosphatase（ALP），human Beta-Crossstraps（β-CTX）and changes in bone density of lumbar spine and femoral neck were observed. The adverse reactions were observed.

Results

The effective rate of patients in the acupuncture and moxibustion group was higher than that in the control group（P<0.05）. Before treatment，the scores of traditional Chinese medicine symptoms（lower back pain，foot weakness，tinnitus，deafness，skeletal weakness，forgetfulness and confusion），VASand ODIscores，serum levels of Ca，P，N-MID，ALPandβ-CTX，lumbar spine and femoral neck bone density between two group had no significant（P>0.05）. After treatment，there were no significant changes in serum Ca or P in each group. The scores of traditional Chinese medicine symptoms（lower back pain，foot weakness，tinnitus，deafness，skeletal weakness，forgetfulness and confusion），VASand ODI scores，the levels of N-MID，ALP andβ-CTX，bone density of lumbar vertebrae and femoral neck were all improved，while in the acupuncture and moxibustion group，the scores of TCM symptoms（lower back pain，foot weakness，tinnitus，deafness，skeletal weakness，forgetfulness and confusion），VAS and ODI scores，the levels of N-MID，ALP andβ-CTX，lumbar spine and femoral neck bone density were superior to those in the control group（P<0.05）. There were fewer adverse reactions in each group（P>0.05）.

Conclusion

The clinical effect of Qi acupuncture on osteoporosis of kidney deficiency type is very good. The pain of patients is relieved，the symptoms are improved and the bone density is increased. There are fewer adverse reactions and it is safe and reliable.

, authors=Yun WANG, Lingli LI, Jinqing HU, Lu CHEN, Ruixin GU, Jie WANG, authorsList=Yun WANG, Lingli LI, Jinqing HU, Lu CHEN, Ruixin GU, Jie WANG, authorCompany=null, correspAuthors=Jinqing HU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322925392587260804, articleId=1322925387205968757, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=元气针灸治疗肾虚型骨质疏松症临床疗效观察, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

探讨元气针灸治疗肾虚型骨质疏松症的临床疗效以及安全性。

方法

研究共计纳入100例肾虚型骨质疏松症患者，采取随机数字表法将患者分为针灸组以及对照组，每组50例，对照组采取阿仑膦酸钠片、碳酸钙D3片治疗，针灸组在对照组治疗基础上结合元气针灸治疗，治疗过程中针灸组脱落4例，对照组脱落2例，对比两组临床疗效；治疗前后中医证候（腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚）积分变化；采取视觉模拟疼痛评分法（Visual analogue scale，VAS）评估两组治疗前后腰背部疼痛程度及Oswestry功能障碍指数（Oswestry Disability Index，ODI）评价患者腰痛功能障碍；血清钙（Serum calcium，Ca）、磷（Phosphorus，P）指标变化；N端中段骨钙素（HumanN-MIDOsteocalcin，N-MID）及磷酸酶（Alkaline Posphatase，ALP）及β胶原交联C端肽（Human Beta-Crosslaps，β-CTX）水平变化；腰椎、股骨颈骨密度变化；不良反应。

结果

针灸组治疗有效率比对照组更高，差异有统计学意义（P<0.05）；两组治疗前中医证候（腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚）积分、VAS评分及ODI评分、血清Ca及P、N-MID、ALP、β-CTX、腰椎、股骨颈骨密度比较，差异无统计学意义（P>0.05），经治疗后两组患者血清Ca及P无明显变化，中医证候（腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚）积分、VAS评分及ODI评分、N-MID、ALP、β-CTX、腰椎、股骨颈骨密度均改善，而针灸组治疗后中医证候（腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚）积分、VAS评分及ODI评分、N-MID、ALP、β-CTX、腰椎、股骨颈骨密度等指标优于对照组，差异有统计学意义（P<0.05）；两组不良反应均较少，差异无统计学意义（P>0.05）。

结论

元气针灸治疗肾虚型骨质疏松症的临床疗效甚佳，患者疼痛缓解，症状改善，骨密度增加，不良反应较少，较为安全与可靠。

, authors=王芸, 李伶俐, 胡锦庆, 陈璐, 辜锐鑫, 王杰, authorsList=王芸, 李伶俐, 胡锦庆, 陈璐, 辜锐鑫, 王杰, authorCompany=null, correspAuthors=胡锦庆, authorNote=

王芸（1991-），女，湖北潜江人，医师，硕士，研究方向：中西医结合治疗骨质疏松症及相关骨病。

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胡锦庆（1982-），女，湖北宜昌人，副主任医师，博士，研究方向：中西医结合诊治骨质疏松症及相关骨病。E-mail：。
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王芸（1991-），女，湖北潜江人，医师，硕士，研究方向：中西医结合治疗骨质疏松症及相关骨病。

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王芸（1991-），女，湖北潜江人，医师，硕士，研究方向：中西医结合治疗骨质疏松症及相关骨病。

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articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2023, volume=40, issue=5, pageStart=1168, pageEnd=1172, url=null, language=null, rfNumber=［21］, rfOrder=20, authorNames=陶李, 周颖, 李卿卿, journalName=广州中医药大学学报, refType=null, unstructuredReference=陶李，周颖，李卿卿，等. 针刺联合骨痛组方熏蒸治疗糖尿病性骨质疏松症的临床观察［J］. 广州中医药大学学报，2023，40（5）：1168-1172., articleTitle=针刺联合骨痛组方熏蒸治疗糖尿病性骨质疏松症的临床观察, refAbstract=null), Reference(id=1322925415735624674, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2023, volume=29, issue=1, pageStart=117, pageEnd=120, url=null, language=null, rfNumber=［22］, rfOrder=21, authorNames=李婷, 孙丰雷, 李念虎, journalName=中医药导报, refType=null, unstructuredReference=李婷，孙丰雷，李念虎. 右归丸治疗骨质疏松症作用机制的研究进展［J］. 中医药导报，2023，29（1）：117-120., articleTitle=右归丸治疗骨质疏松症作用机制的研究进展, refAbstract=null), Reference(id=1322925416008254435, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2023, volume=55, issue=1, pageStart=13, pageEnd=17, url=null, language=null, rfNumber=［23］, rfOrder=22, authorNames=万东平, 昝强, journalName=江苏中医药, refType=null, unstructuredReference=万东平，昝强. 从玄府论治绝经后骨质疏松症［J］. 江苏中医药，2023，55（1）：13-17., articleTitle=从玄府论治绝经后骨质疏松症, refAbstract=null), Reference(id=1322925416092140516, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2023, volume=25, issue=4, pageStart=92, pageEnd=95, url=null, language=null, rfNumber=［24］, rfOrder=23, authorNames=汤园园, journalName=湖北中医药大学学报, refType=null, unstructuredReference=汤园园. 针刺联合理疗在治疗老年骨质疏松症椎体压缩性骨折中的运用［J］. 湖北中医药大学学报，2023，25（4）：92-95., articleTitle=针刺联合理疗在治疗老年骨质疏松症椎体压缩性骨折中的运用, refAbstract=null), Reference(id=1322925416448656358, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2023, volume=42, issue=4, pageStart=391, pageEnd=394, url=null, language=null, rfNumber=［25］, rfOrder=24, authorNames=田春艳, 杨晶晶, 刀叶婷, journalName=上海针灸杂志, refType=null, unstructuredReference=田春艳，杨晶晶，刀叶婷，等. 俞募配穴联合少阳经穴针刺对骨质疏松症骨代谢的影响［J］. 上海针灸杂志，2023，42（4）：391-394., articleTitle=俞募配穴联合少阳经穴针刺对骨质疏松症骨代谢的影响, refAbstract=null), Reference(id=1322925417878914023, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2022, volume=24, issue=7, pageStart=2883, pageEnd=2891, url=null, language=null, rfNumber=［26］, rfOrder=25, authorNames=朱婵, 张强, 韩栩珂, journalName=世界科学技术-中医药现代化, refType=null, unstructuredReference=朱婵，张强，韩栩珂，等. 针刺防治骨质疏松症：基于动物实验机制研究的最新进展［J］. 世界科学技术-中医药现代化，2022，24（7）：2883-2891., articleTitle=针刺防治骨质疏松症：基于动物实验机制研究的最新进展, refAbstract=null), Reference(id=1322925417962800105, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2022, volume=29, issue=1, pageStart=33, pageEnd=38, url=null, language=null, rfNumber=［27］, rfOrder=26, authorNames=刘恩琦, 徐慧, 郑好, journalName=中国中医药信息杂志, refType=null, unstructuredReference=刘恩琦，徐慧，郑好，等. 基于数据挖掘探究针刺治疗原发性骨质疏松症选穴规律［J］. 中国中医药信息杂志，2022，29（1）：33-38., articleTitle=基于数据挖掘探究针刺治疗原发性骨质疏松症选穴规律, refAbstract=null), Reference(id=1322925418097017835, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2023, volume=29, issue=3, pageStart=349, pageEnd=355，384, url=null, language=null, rfNumber=［28］, rfOrder=27, authorNames=郭迪, 高志攀, 张亚平, journalName=中国骨质疏松杂志, refType=null, unstructuredReference=郭迪，高志攀，张亚平，等. 针刺通过Wnt信号通路对绝经后骨质疏松骨折大鼠骨密度和骨代谢的作用研究［J］. 中国骨质疏松杂志，2023，29（3）：349-355，384., articleTitle=针刺通过Wnt信号通路对绝经后骨质疏松骨折大鼠骨密度和骨代谢的作用研究, refAbstract=null), Reference(id=1322925418159932396, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2022, volume=41, issue=6, pageStart=610, pageEnd=616, url=null, language=null, rfNumber=［29］, rfOrder=28, authorNames=石娜, 朱崇田, 欧阳钢, journalName=上海针灸杂志, refType=null, unstructuredReference=石娜，朱崇田，欧阳钢. 电针对绝经后骨质疏松症模型大鼠肠黏膜维生素D膜相关性快速反应类固醇结合蛋白表达的影响［J］. 上海针灸杂志，2022，41（6）：610-616., articleTitle=电针对绝经后骨质疏松症模型大鼠肠黏膜维生素D膜相关性快速反应类固醇结合蛋白表达的影响, refAbstract=null), Reference(id=1322925418550002669, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2022, volume=42, issue=9, pageStart=979, pageEnd=984, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=陈艳婷, 林丽梅, 王晓东, journalName=中国针灸, refType=null, unstructuredReference=陈艳婷，林丽梅，王晓东，等. 岭南陈氏针法治疗绝经后骨质疏松症及对血清GH、IGF-1的影响［J］. 中国针灸，2022，42（9）：979-984., articleTitle=岭南陈氏针法治疗绝经后骨质疏松症及对血清GH、IGF-1的影响, refAbstract=null), Reference(id=1322925418965238767, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2022, volume=47, issue=9, pageStart=809, pageEnd=813, url=null, language=null, rfNumber=［31］, rfOrder=30, authorNames=刘静, 王彤, 徐道明, journalName=针刺研究, refType=null, unstructuredReference=刘静，王彤，徐道明，等. 雷火灸对骨质疏松症伴骨骼肌质量减少患者运动功能的影响：随机对照试验［J］. 针刺研究，2022，47（9）：809-813., articleTitle=雷火灸对骨质疏松症伴骨骼肌质量减少患者运动功能的影响：随机对照试验, refAbstract=null), Reference(id=1322925419028153329, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, doi=null, pmid=null, pmcid=null, year=2022, volume=47, issue=7, pageStart=605, pageEnd=610, url=null, language=null, rfNumber=［32］, rfOrder=31, authorNames=徐道明, 刘静, 朱璐, journalName=针刺研究, refType=null, unstructuredReference=徐道明，刘静，朱璐，等. 艾灸“肝俞”“肾俞”对骨质疏松大鼠肌肉骨骼的影响［J］. 针刺研究，2022，47（7）：605-610., articleTitle=艾灸“肝俞”“肾俞”对骨质疏松大鼠肌肉骨骼的影响, refAbstract=null)], funds=[Fund(id=1322925409280590790, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, awardId=wJ2019H412, language=CN, fundingSource=湖北省卫生健康委员会联合基金项目(wJ2019H412), fundOrder=null, country=null), 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tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, companyId=1322925393803608965, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=武汉市第四医院，湖北 武汉 430033)])], figs=[ArticleFig(id=1322925405186950072, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
对照组4826（54.17）13（27.08）9（18.75）39（81.25）
针灸组4635（76.09）9（19.57）2（4.35）44（95.65）
χ2值----4.715 3
P值----0.029 9
), ArticleFig(id=1322925405522494393, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=CN, label=表1, caption=

两组肾虚型骨质疏松症患者临床疗效分析

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
对照组4826（54.17）13（27.08）9（18.75）39（81.25）
针灸组4635（76.09）9（19.57）2（4.35）44（95.65）
χ2值----4.715 3
P值----0.029 9
), ArticleFig(id=1322925405614769082, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点腰背酸痛足痿无力耳鸣耳聋骨骼痿软健忘恍惚
对照组48治疗前2.41±0.272.31±0.202.10±0.212.05±0.171.84±0.20
治疗后0.69±0.10*0.65±0.14*0.61±0.17*0.59±0.11*0.60±0.13*
针灸组46治疗前2.38±0.312.27±0.182.07±0.262.01±0.181.86±0.19
治疗后0.19±0.03*#0.17±0.04*#0.16±0.05*#0.14±0.03*#0.15±0.04*#
), ArticleFig(id=1322925406000645051, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=CN, label=表2, caption=

两组肾虚型骨质疏松症患者中医证候积分分析（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点腰背酸痛足痿无力耳鸣耳聋骨骼痿软健忘恍惚
对照组48治疗前2.41±0.272.31±0.202.10±0.212.05±0.171.84±0.20
治疗后0.69±0.10*0.65±0.14*0.61±0.17*0.59±0.11*0.60±0.13*
针灸组46治疗前2.38±0.312.27±0.182.07±0.262.01±0.181.86±0.19
治疗后0.19±0.03*#0.17±0.04*#0.16±0.05*#0.14±0.03*#0.15±0.04*#
), ArticleFig(id=1322925406352966588, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点VAS评分ODI评分
对照组48治疗前5.99±0.1033.26±4.15
治疗后1.02±0.37*20.15±6.23*
针灸组46治疗前6.03±0.1433.29±4.19
治疗后0.34±0.09*#16.83±3.17*#
), ArticleFig(id=1322925406420075453, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=CN, label=表3, caption=

两组肾虚型骨质疏松症患者VAS评分及ODI评分分析（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点VAS评分ODI评分
对照组48治疗前5.99±0.1033.26±4.15
治疗后1.02±0.37*20.15±6.23*
针灸组46治疗前6.03±0.1433.29±4.19
治疗后0.34±0.09*#16.83±3.17*#
), ArticleFig(id=1322925406776591294, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点CaP
对照组48治疗前2.35±0.121.22±0.05
治疗后2.36±0.101.24±0.05
针灸组46治疗前2.36±0.111.21±0.06
治疗后2.39±0.141.25±0.06
), ArticleFig(id=1322925406839505855, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=CN, label=表4, caption=

两组肾虚型骨质疏松症患者血清Ca及P变化（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点CaP
对照组48治疗前2.35±0.121.22±0.05
治疗后2.36±0.101.24±0.05
针灸组46治疗前2.36±0.111.21±0.06
治疗后2.39±0.141.25±0.06
), ArticleFig(id=1322925407196021696, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点N-MID/（ng/mL）ALP/（U/L）β-CTX/（mmol/L）
对照组48治疗前23.29±5.92122.64±6.83649.52±62.32
治疗后24.76±5.12*116.23±5.82*312.26±48.36*
针灸组46治疗前23.32±6.00122.59±6.90659.29±61.76
治疗后26.88±4.82*#102.63±5.14*#230.12±40.65*#
), ArticleFig(id=1322925408861160385, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=CN, label=表5, caption=

两组肾虚型骨质疏松症患者N-MID、ALP、β-CTX水平分析（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点N-MID/（ng/mL）ALP/（U/L）β-CTX/（mmol/L）
对照组48治疗前23.29±5.92122.64±6.83649.52±62.32
治疗后24.76±5.12*116.23±5.82*312.26±48.36*
针灸组46治疗前23.32±6.00122.59±6.90659.29±61.76
治疗后26.88±4.82*#102.63±5.14*#230.12±40.65*#
), ArticleFig(id=1322925408970212291, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点腰椎骨密度股骨颈骨密度
对照组48治疗前0.73±0.010.77±0.01
治疗后0.79±0.01*0.80±0.01*
针灸组46治疗前0.72±0.010.76±0.02
治疗后0.89±0.02*#0.83±0.01*#
), ArticleFig(id=1322925409045709765, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925387205968757, language=CN, label=表6, caption=

两组肾虚型骨质疏松症患者腰椎、股骨颈骨密度变化分析（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间点腰椎骨密度股骨颈骨密度
对照组48治疗前0.73±0.010.77±0.01
治疗后0.79±0.01*0.80±0.01*
针灸组46治疗前0.72±0.010.76±0.02
治疗后0.89±0.02*#0.83±0.01*#
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元气针灸治疗肾虚型骨质疏松症临床疗效观察
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王芸 , 李伶俐 , 胡锦庆 , 陈璐 , 辜锐鑫 , 王杰
中华中医药学刊 | 省级项目平台 2025,43(5): 247-250
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中华中医药学刊 |省级项目平台 2025 , 43 (5) : 247 -250
元气针灸治疗肾虚型骨质疏松症临床疗效观察
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王芸（1991-），女，湖北潜江人，医师，硕士，研究方向：中西医结合治疗骨质疏松症及相关骨病。

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王芸（1991-），女，湖北潜江人，医师，硕士，研究方向：中西医结合治疗骨质疏松症及相关骨病。

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王芸, 李伶俐, 胡锦庆 , 陈璐, 辜锐鑫, 王杰
作者信息
  • 武汉市第四医院，湖北 武汉 430033
通讯作者:
胡锦庆（1982-），女，湖北宜昌人，副主任医师，博士，研究方向：中西医结合诊治骨质疏松症及相关骨病。E-mail：。
作者简介:

王芸（1991-），女，湖北潜江人，医师，硕士，研究方向：中西医结合治疗骨质疏松症及相关骨病。

Clinical Efficacy Observation of Qi Acupuncture Treating Osteoporosis of Kidney Deficiency Type
Yun WANG, Lingli LI, Jinqing HU , Lu CHEN, Ruixin GU, Jie WANG
Affiliations
  • Wuhan Fourth Hospital，Wuhan 430033，Hubei，China
出版时间: 2025-05-10 doi: 10.13193/j.issn.1673-7717.2025.05.047
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摘要
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目的

探讨元气针灸治疗肾虚型骨质疏松症的临床疗效以及安全性。

方法

研究共计纳入100例肾虚型骨质疏松症患者，采取随机数字表法将患者分为针灸组以及对照组，每组50例，对照组采取阿仑膦酸钠片、碳酸钙D3片治疗，针灸组在对照组治疗基础上结合元气针灸治疗，治疗过程中针灸组脱落4例，对照组脱落2例，对比两组临床疗效；治疗前后中医证候（腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚）积分变化；采取视觉模拟疼痛评分法（Visual analogue scale，VAS）评估两组治疗前后腰背部疼痛程度及Oswestry功能障碍指数（Oswestry Disability Index，ODI）评价患者腰痛功能障碍；血清钙（Serum calcium，Ca）、磷（Phosphorus，P）指标变化；N端中段骨钙素（HumanN-MIDOsteocalcin，N-MID）及磷酸酶（Alkaline Posphatase，ALP）及β胶原交联C端肽（Human Beta-Crosslaps，β-CTX）水平变化；腰椎、股骨颈骨密度变化；不良反应。

结果

针灸组治疗有效率比对照组更高，差异有统计学意义（P<0.05）；两组治疗前中医证候（腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚）积分、VAS评分及ODI评分、血清Ca及P、N-MID、ALP、β-CTX、腰椎、股骨颈骨密度比较，差异无统计学意义（P>0.05），经治疗后两组患者血清Ca及P无明显变化，中医证候（腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚）积分、VAS评分及ODI评分、N-MID、ALP、β-CTX、腰椎、股骨颈骨密度均改善，而针灸组治疗后中医证候（腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚）积分、VAS评分及ODI评分、N-MID、ALP、β-CTX、腰椎、股骨颈骨密度等指标优于对照组，差异有统计学意义（P<0.05）；两组不良反应均较少，差异无统计学意义（P>0.05）。

结论

元气针灸治疗肾虚型骨质疏松症的临床疗效甚佳，患者疼痛缓解，症状改善，骨密度增加，不良反应较少，较为安全与可靠。

骨质疏松症  /  肾虚型  /  元气针灸  /  疗效  /  腰痛功能障碍
Objective

To explore the clinical efficacy and safety of Qi acupuncture treating osteoporosis of kidney deficiency type.

Methods

A total of 100 patients with osteoporosis of kidney deficiency type（admitted from June 2021 to June 2023）were included in the study. The patients were randomly divided into acupuncture and moxibustion group and control group，with 50 cases in each group. The patients in the control group were treated with alendronate tablets and calcium carbonate D3 tablets. Those in the acupuncture and moxibustion group were treated with Qi acupuncture on the basis of the treatment in the control group. During the treatment，4 patients in the acupuncture and moxibustion group fell off and 2 in the control group fell off. The clinical efficacy of each group and the integral changes of traditional Chinese medicine symptoms（lower back pain，foot weakness，tinnitus，deafness，skeletal weakness，forgetfulness and confusion）of patients before and after treatment were compared. The visual analog scale（VAS）was used to evaluate the degree of back pain in each group before and after treatment，and the oswestry disability index（ODI）to evaluate the back pain dysfunction. The changes in serum calcium（Ca）and phosphorus（P），N-terminal mid segment osteocalcin（N-MID），alkaline phosphatase（ALP），human Beta-Crossstraps（β-CTX）and changes in bone density of lumbar spine and femoral neck were observed. The adverse reactions were observed.

Results

The effective rate of patients in the acupuncture and moxibustion group was higher than that in the control group（P<0.05）. Before treatment，the scores of traditional Chinese medicine symptoms（lower back pain，foot weakness，tinnitus，deafness，skeletal weakness，forgetfulness and confusion），VASand ODIscores，serum levels of Ca，P，N-MID，ALPandβ-CTX，lumbar spine and femoral neck bone density between two group had no significant（P>0.05）. After treatment，there were no significant changes in serum Ca or P in each group. The scores of traditional Chinese medicine symptoms（lower back pain，foot weakness，tinnitus，deafness，skeletal weakness，forgetfulness and confusion），VASand ODI scores，the levels of N-MID，ALP andβ-CTX，bone density of lumbar vertebrae and femoral neck were all improved，while in the acupuncture and moxibustion group，the scores of TCM symptoms（lower back pain，foot weakness，tinnitus，deafness，skeletal weakness，forgetfulness and confusion），VAS and ODI scores，the levels of N-MID，ALP andβ-CTX，lumbar spine and femoral neck bone density were superior to those in the control group（P<0.05）. There were fewer adverse reactions in each group（P>0.05）.

Conclusion

The clinical effect of Qi acupuncture on osteoporosis of kidney deficiency type is very good. The pain of patients is relieved，the symptoms are improved and the bone density is increased. There are fewer adverse reactions and it is safe and reliable.

osteoporosis  /  kidney deficiency type  /  Qi acupuncture  /  curative effect  /  low back pain dysfunction
王芸, 李伶俐, 胡锦庆, 陈璐, 辜锐鑫, 王杰. 元气针灸治疗肾虚型骨质疏松症临床疗效观察. 中华中医药学刊, 2025 , 43 (5) : 247 -250 . DOI: 10.13193/j.issn.1673-7717.2025.05.047
Yun WANG, Lingli LI, Jinqing HU, Lu CHEN, Ruixin GU, Jie WANG. Clinical Efficacy Observation of Qi Acupuncture Treating Osteoporosis of Kidney Deficiency Type[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (5) : 247 -250 . DOI: 10.13193/j.issn.1673-7717.2025.05.047
正文
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骨质疏松症是一种全身性骨病，以骨量低下、骨组织微结构损坏、导致骨脆性增加、易发生骨折为特征[1-3]。在古文献中，对肾与骨的关系有详细论述，如《素问·阴阳应象大论篇》载“肾生骨髓”；《素问·痿论篇》载“肾主身之骨髓，肾气热，则腰脊不举，骨枯而髓减，发为骨痿”；《素问·长刺节论篇》言“病在骨，骨重不可举，骨髓酸痛，寒气至，名曰骨痹”[4-5]。中医认为，骨质疏松症的发生与肾精不足、肾阳亏虚、脾胃不足、肝血不足、血瘀络阻等相关，其主要病机是“肾精不足、髓减骨痿”[6-7]。有学者在中医脏象“肾主骨”理论学基础上，同样认为肾精亏耗为骨质疏松症的重要发病机理[8-9]。肾主骨生髓，髓藏于骨腔滋养骨骼，肾精充足则骨骼强壮，骨质疏松症与肾虚的关系最为密切[10-11]。中老年人脏腑虚衰，肾气虚弱、肾精空虚，骨髓化源不足，骨骼失去濡养而易发生骨质疏松[12-14]。元气针灸在治疗肾虚型骨质疏松症方面具有一定的优势，如操作简单、疗效较好、不良反应少、价格适中等。故而本次纳入100例肾虚型骨质疏松症患者进行分组研究，探讨元气针灸治疗的效果，报道如下。
1　资料与方法
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1.1　一般资料
本研究经我院伦理委员会批准进行［伦审字（KY2023-078-01）号］，共计纳入2021年6月—2023年6月本院收治的100例肾虚型骨质疏松症患者，采取随机数字表法将患者分为针灸组以及对照组，每组50例，治疗过程中针灸组患者脱落4例，对照组患者脱落2例。针灸组46例，女20例，男26例，年龄50～69岁，平均（58.92±1.52）岁，病程2～14年，平均（7.23±0.95）年。对照组48例，女20例，男28例，年龄51～70岁，平均（58.97±1.59）岁，病程2～15年，平均（7.28±0.98）年。对比针灸组与对照组患者资料，差异无统计学意义（P>0.05）。
1.2　诊断标准
西医参照《中国骨质疏松症建议诊断标准（第二稿）》[15]中骨质疏松症诊断。中医诊断肾虚型骨质疏松症患者参照《中药新药临床研究指导原则（试行）》[16]：腰背酸痛、足痿无力、耳鸣耳聋、骨骼痿软、健忘恍惚、舌淡苔少、脉细弱无力或细数。
1.3　纳入排除标准
纳入标准：①符合骨质疏松症诊断，中医辨证为肾虚型；②自愿加入研究；③可接受阿仑膦酸钠片、碳酸钙D3片、元气针灸治疗；④伦理批准研究进行。排除标准：①半年内使用过影响骨代谢的药物；②患有继发性骨质疏松症、精神病或有严重心、肝、肾等脏器疾病的患者；③对本研究药物不耐受或者过敏患者。
1.4　治疗方法
对照组：采用阿仑膦酸钠片（福善美，规格：70 mg，国药准字J20130085）、碳酸钙D3片（钙尔奇，规格：每片含钙 600 mg、维生素D3 125 国际单位，国药准字H10950029）治疗。阿仑膦酸钠70 mg/次，1次/周，于早餐前30 min以150 mL温水送服，服药后30 min内避免平躺。碳酸钙D3片口服，1片/次，2次/d。针灸组：在对照组治疗基础上结合元气针灸治疗，选取肾俞（双）、大肠俞（双）、命门、腰阳关气海、关元等穴位，以75%乙醇棉球消毒穴位皮肤后，选取华佗牌0.3 mm×40 mm一次性无菌针灸针，医者采用右手单手进针法，命门、腰阳关、肾俞穴直刺0.5～1寸，大肠俞直刺0.8～1.2寸，使针刺得气后施补法，留针20 min。气海、关元采用温和灸，行艾灸补法，20 min/穴。隔2 d治疗1次，10次治疗为1个疗程，共3个疗程。
1.5　观察指标
①患者疗效标准[17]。显效-患者疼痛等症状显著改善，骨密度增加；有效-患者疼痛等症状一定程度改善，骨密度基本无下降；无效-患者疼痛等症状，骨密度无好转。总有效率＝显效率＋有效率。②两组患者中医证候积分比较[18]。采取0、1、2、3分评估患者治疗前后腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚等证候，分值越高表示证候越严重。③两组患者治疗前后视觉模拟疼痛评分法（Vsual analogue scale，VAS）及Oswestry功能障碍指数（Oswestry Disability Index，ODI）比较。VAS评分[19]：画一横线，一端标记为0，定为无痛；另一端标记为10，定为剧烈疼痛；0～10中间等分，分别表示不同程度的疼痛。指导患者根据自我疼痛感觉，在横线上标记，取得疼痛程度评分。ODI评分[20]：包括10个项目，各项0～5分，总分越高表示功能障碍越严重。④应用化学发光法测定两组患者治疗前后血清Ca及P水平。⑤比较两组患者治疗前后N端中段骨钙素（HumanN-MIDOsteocalcin，N-MID）及磷酸酶（Alkaline Posphatase，ALP）及β胶原交联C端肽（Human Beta-Crosslaps，β-CTX）水平。采取酶联免疫吸附法测定两组患者N-MID与β-CTX水平，采取比色法测定ALP水平。⑥比较两组治疗前后腰椎、股骨颈骨密度变化，采取双能X线骨密度仪进行测量。⑦比较两组患者不良反应。
1.6　统计学方法
采用SPSS 26.0统计软件进行数据整理和分析。计量资料若符合正态分布，采用（）表示，两组组内比较采用配对样本t检验，两组组间采用两独立样本t检验；计数资料采用频数（百分比）表示，组间比较采用卡方检验。等级资料的组间比较采用Mann-Whitney U检验。P<0.05为差异具有统计学意义。
2　结果
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2.1　临床疗效比较
针灸组治疗有效率比对照组更高，差异有统计学意义（P<0.05）。见表1。
2.2　中医证候积分变化
两组治疗前腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚等中医证候积分比较，差异无统计学意义（P>0.05），治疗后两组患者腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚等中医证候积分均下降，针灸组患者治疗后腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚等中医证候积分均比对照组更低，差异有统计学意义（P<0.05）。见表2。
2.3　VAS评分及ODI评分变化
两组治疗前VAS评分及ODI评分比较，P>0.05，治疗后两组患者VAS评分及ODI评分均下降，针灸组患者治疗后VAS评分及ODI评分均比对照组更低，差异有统计学意义（P<0.05）。见表3。
2.4　血清Ca及P变化
两组治疗前血清Ca及P水平比较，差异无统计学意义（P>0.05），治疗后两组患者血清Ca及P水平无明显变化，且组间比较差异也无统计学意义（P>0.05）。见表4。
2.5　N-MID、ALP、β-CTX水平变化
两组治疗前N-MID、ALP、β-CTX水平比较，差异无统计学意义（P>0.05），治疗后两组患者N-MID、ALP、β-CTX水平均改善，针灸组患者治疗后N-MID、ALP、β-CTX水平均比对照组更佳，差异有统计学意义（P<0.05）。见表5。
2.6　腰椎、股骨颈骨密度变化
两组治疗前腰椎、股骨颈骨密度指标比较，差异无统计学意义（P>0.05），治疗后两组患者腰椎、股骨颈骨密度指标均提升，针灸组患者治疗后腰椎、股骨颈骨密度指标均高于对照组，差异有统计学意义（P<0.05）。见表6。
2.7　不良反应
针灸组出现1例红肿，1例恶心，不良反应率为4.35%；对照组出现1例恶心，1例腹泻，不良反应率为4.17%。两组不良反应率数据比较χ2 ＝0.001 9（P＝0.965 3），差异无统计学意义（P>0.05）。
3　讨论
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骨质疏松属于中医“骨痿、骨枯、骨痹”等范畴，中医认为，该病发病主要以肾虚为本[21-23]。针刺属于中医外治之法，针灸之法治疗骨质疏松症取得较好效果，关于其相关报道较多[24-27]。郭迪等[28]研究指出，针刺疗法可通过Wnt信号通路来改善绝经后骨质疏松骨折大鼠的骨代谢以及骨密度情况，从而改善大鼠病情，值得探讨及分析。石娜等[29]指出，电针之法对绝经后骨质疏松症模型大鼠具有积极影响，可较好改善大鼠的病症，促进大鼠病情好转。陈艳婷等[30]指出，绝经后骨质疏松症采取岭南陈氏针法治疗取得较好效果，可较好改善患者血清生长激素、胰岛素样生长因子水平，帮助患者疾病恢复。刘静等[31]指出，雷火灸治疗骨质疏松症疗效良好。徐道明等[32]指出，骨质疏松大鼠通过艾灸“肝俞”“肾俞”可改善其病情。可见针刺治疗对骨质疏松症患者尤为重要，治疗效果可观，值得探讨。
肾虚型骨质疏松症是临床常见证型，该病患者肾虚严重，而元气针灸以补肾培元为治疗原则，基于督脉与膀胱经相互贯通、并与任脉形成督升任降的经气循环，针与灸相结合，绿色安全，无不良反应。所选取穴位中，肾俞、大肠俞属足太阳膀胱经，肾俞为肾气输注、转输于背部的腧穴，针刺肾俞穴可补肾精，充骨髓，强筋壮骨；大肠俞为大肠经气输注于背部的腧穴，针刺大肠俞可治疗肾虚劳损之腰脊强痛。命门、腰阳关均属督脉，其位于腰部，腰为肾之府，且督脉起于胞中，贯脊属肾，故均可治疗肾虚之腰骶部痛。气海、关元均属任脉，气海是人体元气汇聚之处，有通调气机、补虚固本之效；关元穴与足三阴经交会，为小肠之募穴，有培肾固本、补益元气之功效。诸穴合用，共奏补肾培元之效。
本次研究取得较好的结果，元气针灸治疗肾虚型骨质疏松症具有较好的效果，治疗总有效率高达95.65%，此外患者腰背酸痛及足痿无力、耳鸣耳聋及骨骼痿软、健忘恍惚等中医证候积分显著下降，可见患者症状显著改善，该方法可较好改善患者病症。针灸组治疗后VAS评分及ODI评分显著下降，比对照组更低，可见元气针灸可较好缓解肾虚型骨质疏松症患者疼痛，改善患者腰椎功能，可能与针灸可一定程度提升患者疼痛阈值相关。ALP水平可反映骨吸收状态，N-MID反映骨形成速率，β-CTX水平可反映骨丢失程度。肾虚型骨质疏松症患者经元气针灸治疗后，患者N-MID、ALP、β-CTX指标均改善，可见该方法可较好改善患者病情。同时，患者经元气针灸治疗后腰椎、股骨颈骨密度增加，患者恢复较好。两组不良反应均较少，提示肾虚型骨质疏松症患者元气针灸治疗较为安全可靠。
综上所述，肾虚型骨质疏松症患者元气针灸治疗效果显著，患者恢复较好，不良反应少，治疗较为安全及可靠。受限于研究时间、样本量等因素，本研究亦有不足之处，未来将进一步扩大样本收集范围、延长随访时间、探索不同治疗方法效果，为元气针灸治疗肾虚型骨质疏松症提供更加高质量的研究证据。
基金
收起
  • 湖北省卫生健康委员会联合基金项目(wJ2019H412)
  • 武汉市科技局项目(2022020801020563)
  • 武汉市卫生健康科研基金项目(WZ24A14)
文献
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2025年第43卷第5期
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doi: 10.13193/j.issn.1673-7717.2025.05.047
  • 首发时间：2026-10-30
  • 出版时间：2025-05-10
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基金
湖北省卫生健康委员会联合基金项目(wJ2019H412)
武汉市科技局项目(2022020801020563)
武汉市卫生健康科研基金项目(WZ24A14)
作者信息
    武汉市第四医院，湖北 武汉 430033

通讯作者:

胡锦庆（1982-），女，湖北宜昌人，副主任医师，博士，研究方向：中西医结合诊治骨质疏松症及相关骨病。E-mail：。
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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