目的：观察仙灵骨葆胶囊联合阿仑膦酸钠片治疗老年骨质疏松症的临床疗效及对细胞因子和骨代谢的影响。方法：选取老年骨质疏松症患者86 例，按随机数字表法分为对照组和观察组各43 例。对照组给予阿仑膦酸钠片治疗，观察组在对照组基础上联合仙灵骨葆胶囊治疗。比较2 组临床疗效、L2～4 和股骨颈骨密度、Oswestry 功能障碍评分和视觉模拟评分法（VAS） 评分、细胞因子和骨代谢水平变化。结果：观察组总有效率为93.02%，高于对照组67.44%，差异有统计学意义（P＜0.05）。治疗后，2 组L2～4 及股骨颈骨密度较治疗前增加（P＜0.05），且观察组L2～4 及股骨颈骨密度高于对照组（P＜0.05）。治疗后，2 组Oswestry 功能障碍评分及VAS 评分较治疗前降低（P＜0.05），且观察组Oswestry 功能障碍评分及VAS 评分低于对照组（P＜0.05）。治疗后，观察组血清胰岛素样生长因子-1 （IGF-1） 水平高于治疗前和对照组，而瘦素（Leptin） 及肿瘤坏死因子-α（TNF-α） 水平低于治疗前和对照组（P＜0.05）。治疗后，2 组血清骨特异性碱性磷酸酶（B-ALP） 及胶原交联C-末端肽（CTX） 水平较治疗前降低（P＜0.05），且观察组血清B-ALP 及CTX 水平低于对照组（P＜0.05）。结论：仙灵骨葆胶囊联合阿仑膦酸钠片治疗老年骨质疏松症患者效果显著，可以上调细胞因子IGF-1 表达，下调Leptin 和TNF-α 表达，降低骨代谢B-ALP 和CTX 水平。
Abstract：Objective：To observe the clinical effect of Xianling Gubao capsules combined with alendronate sodium tablets for osteoporosis in senile patients and its effect on cytokines and bone metabolism. Methods：A total of 86 cases of senile patients with osteoporosis were selected and divided into the control group and the observation group according to the random number table method， 43 cases in each group. The control group was given alendronate sodium tablets， and the observation group was additionally given Xianling Gubao capsules based on the treatment of the control group. The clinical effect， bone mineral density of lumbar vertebrae L2~4 and femoral neck， the scores of Oswestry dysfunction and Visual Analogue Scale(VAS)，and the changes in levels of cytokines and bone metabolism were compared between the two groups. Results：The total effective rate was 93.02% in the observation group，higher than that of 67.44% in the control group，the difference being significant(P＜0.05). After treatment，bone mineral density of lumbar vertebrae L2~4 and femoral neck in the two groups was increased when compared with that before treatment(P＜0.05)； bone mineral density of lumbar vertebrae L2~4 and femoral neck in the observation group was higher than that in the control group(P＜0.05). After treatment，the scores of Oswestry dysfunction and VAS in the two groups were decreased when compared with those before treatment(P＜0.05)； the two scores in the observation group were lower than those in the control group(P＜0.05). In the observation group，the level of insulin-like growth factor-1(IGF-1) in serum after treatment was higher than that before treatment and in the control group(P＜0.05). In the observation group，the levels of leptin and tumor necrosis factor- α(TNF- α) were higher than those before treatment and in the control group(P＜0.05). After treatment，the levels of bone-specific alkaline phosphatase(B-ALP) and collagen cross-linking C-terminal peptide(CTX) in serum in the two groups were decreased when compared with those before treatment(P＜0.05)； the two levels in serum in the observation group were lower than those in the control group (P＜0.05). Conclusion： The therapy of Xianling Gubao capsules combined with alendronate sodium tablets has significant curative effect in the treatment of senile patients with osteoporosis，which can up-regulate the expression level of IGF- 1， down-regulate the expression levels of leptin and TNF-α，and reduce the levels of B-ALP and CTX.