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目的研究低剂量阿仑膦酸钠配合鼓励教育是否能提高骨质疏松症患者服药依从性。方法 210例已接受阿仑膦酸钠常规剂量治疗半年的骨质疏松症妇女随机分为干预组与对照组,干预组(n=105)给予低剂量阿仑膦酸钠(70 mg,2周1次)治疗;对照组(n=105)为常规剂量(70 mg,每周1次)治疗。两组均依据入组前后骨转换指标变化,教育鼓励患者坚持服药。观察两组治疗6、12、18个月时的服药顺应性、服药持续性和不良反应。运用治疗期间的药物持有率(MPR)判断患者服药顺应性,MPR≥80%为服药有顺应性;采用治疗期间开始用药至终止用药的天数表达患者服药持续性,停药间隔超过30 d判断为终止用药。结果在第12个月和18个月随访期,干预组MPR中位数均高于对照组(P<0.05)。在第6个月随访期干预组和对照组的有服药顺应性的患者比例分别为89.5%和76.2%(P=0.010);在第12个月随访期分别为73.3%和58.1%(P=0.020);在第18个月随访期分别为67.6%和48.6%(P=0.005),两组比较均有显著差异。同样,随访期第12个月和第18个月干预组持续服药天数中位数也均高于对照组,分别为360(225,360)d和360(120,360)d(P=0.030),540(225,540)d和390(120,540)d(P=0.002)。结论低剂量阿仑膦酸钠(70 mg,2周1次)口服配合鼓励教育能提高骨质疏松症患者服药依从性。
Objective To investigate if low dose alendronate combined with encouragement of education can improve the compliance of patients with osteoporosis. Methods 210 cases of osteoporosis women who had been treated with the conventional dose of alendronate for six months were randomly divided into intervention group and control group. The intervention group (n = 105) was given low dose alendronate (70 mg for 2 weeks 1) treatment; control group (n = 105) for the conventional dose (70 mg once a week) treatment. Both groups were based on changes in bone turnover indicators before and after enrollment, education encouraged patients to adhere to medication. Observe the medication compliance, medication continuity and adverse reactions in both groups at 6, 12 and 18 months after treatment. The medication compliance (MPR) during treatment was used to judge the patient’s compliance with medication. MPR≥80% was consistent with taking medication. The patient’s medication duration was expressed by the number of days from the start of medication to the end of medication during the treatment period. To stop the medication. Results At the 12th month and the 18th month follow-up, the median MPR in the intervention group was higher than that in the control group (P <0.05). At the 6th month follow-up, the proportion of patients with medication compliance in the intervention and control groups was 89.5% and 76.2%, respectively (P = 0.010) and 73.3% and 58.1% at the 12th month follow-up (P = 0.020). At the 18th month of follow-up, they were 67.6% and 48.6% respectively (P = 0.005), with significant differences between the two groups. Similarly, the median duration of medication in the intervention group was also significantly higher at 360 (225,360) d and 360 (120,360) days (P = 0.030) and 540 (225,540) at 12 and 18 months of follow-up ) d and 390 (120,540) d (P = 0.002). Conclusion Low doses of alendronate (70 mg, once a week for 2 weeks) can improve the compliance of patients with osteoporosis through oral education.