摘要
目的观察补肾益骨方对绝经后妇女骨质疏松症治疗的临床疗效并探讨其药理机制。方法选择2011年1月至2013年1月湖北医药学院附属人民医院内分泌科、妇产科就诊的住院及门诊明确诊断为绝经后骨质疏松症患者96人。分成对照组与治疗组,每组病例48人,对照组每天予以钙尔奇D及骨化三醇胶囊治疗,观察组在对照组基础上联用补肾益骨方;分别在治疗前及治疗后对患者疼痛评估、骨密度检测、雌激素水平测定、骨代谢生化指标检测;观察其各项指标改善情况。结果本研究结果显示,两组治疗后3个月,观察组总疼痛缓解率比对照组高,但两者相比较并无显著性差异(χ2=1.745,P>0.05);治疗后6个月两组疼痛缓解率进一步提高,差异有显著性(χ2=4.376,P<0.05)。治疗后两组患者骨密度均有不同程度的提高。对照组治疗后3月各部位BMD均较治疗前略有增高,差异无显著性(P>0.05);6个月后BMD继续较前增高,与治疗前相比较差异有显著性(P<0.05);观察组治疗后3、6月各部位BMD均较治疗前增高,差异有显著性(P<0.01、P<0.001)。对照组治疗后E2逐渐下降,但与治疗前相比较无显著性差异(P>0.05);观察组治疗后E2较前升高,3个月时升高不显(P>0.05),6个月时差异显著(P<0.01);两组患者治疗后3、6月BALP上升、TRACP-5b较前下降,对照组治疗后3、6月差异有显著性(P<0.05,P<0.01),观察组差异更显著(P<0.01,P<0.001)。结论在基础补充钙剂及骨化三醇胶囊的基础上联用补肾益骨方治疗绝经后骨质疏松症患者可明显缓解疼痛症状,提高患者骨密度;其抗骨质疏松部分机制可能是通过调节性激素或者通过细胞因子水平直接或间接作用于成骨细胞与破骨细胞,而降低骨转化和抑制骨吸收起作用。
Objective To observe the clinical efficacy of recipe for reinforcing kidney to strengthen bones in the treatment of osteoporosis in postmenopausal women, and to explore its pharmacological mechanism.Methods Ninety-six patients, who came to the Out-patient Department of Endocrinology and Gynecology and Obstetrics or hospitalized in the Affiliated People’ s Hospital of Hubei College of Medicine and Pharmacology from January 2011 to January 2013 and were diagnosed with postmenopausal osteoporosis, were selected.All the patients were divided into control group and treatment group, and each group had 48 patients. Patients in the control group were treated with Caltrate D and the calcitriol capsules every day.On this basis, patients in treatment group were treated with the recipe for reinforcing kidney to strengthen bones.The evaluation of the pain and the detection of bone mineral density （BMD）, estrogen （E2）, and bone metabolism biochemical indexes were performed before and after the treatment, respectively.The changes of these indexes were observed.Results The results revealed that, after 3-month treatment, the pain relief rate in treatment group was higher than that in control group, but no significant difference was observed （χ2 =1.745, P＆gt;0.05）.But after 6-month treatment, the pain relief rate increased in both groups, and the difference was significant （χ2 =4.376, P＆lt;0.05）.BMD in both groups increased.After3-month treatment, BMD of all sites in control group was slightly higher while the difference was not significant （P＆gt;0.05）.After 6-month treatment, BMD in the control group was much higher, and the difference was significant （P＆lt;0.05）.In treatment group, BMD at the 3rd month and the 6th month after the treatment was higher than that＆amp;nbsp;before the treatment, and the difference was significant （P＆lt;0.01, P＆lt;0.001）.The levels of E2 in control group gradually declined after the treatment, but without significant difference comparing to that before the treatment （ P ＆gt;0.05 ） .The levels of E2 in treatment group increased after the treatment, but without significant difference at the 3rd month （P＆gt;0.05）, and with significant difference at the 6th month （P＆lt;0.01）.The levels of bone alkaline phosphatase （BALP） increased while the levels of tartrate resistant acid phosphatase5b （TRACP-5b） decreased after 3-and 6-month treatment in both groups.And the difference in control group was significant comparing to that before the treatment （P＆lt;0.05, P＆lt;0.01）.The difference in the treatment group was more significant （P＆lt;0.01,P＆lt;0.001）.Conclusion Recipe for reinforcing kidney to strengthen bones combined with the supplement of calcium and calcitriol can significantly relieve pain and improve BMD in postmenopausal women with osteoporosis.Its possible anti-osteoporosis mechanism may be the decrease of bone turnover and inhibition of bone resorption through regulating sexual hormone or cytokines directly or indirectly acting on osteoblasts and osteoclasts.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2014年第1期49-53,61,共6页
Chinese Journal of Osteoporosis
关键词
补肾益骨方
绝经后骨质疏松症
临床研究
Recipe for reinforcing kidney to strengthen bones
Postmenopausal osteoporosis
Clinical efficacy
