摘要
目的探讨补肾壮骨汤联合阿仑膦酸钠对绝经后骨质疏松(PMOP)病人外周血微RNA(miR)和骨密度的调节作用。方法采用临床随机单盲对照试验,将成都市中西医结合医院2021年9月至2022年9月收治的168例PMOP病人按随机数字表法分为对照组、试验组,各为84例。对照组给予常规治疗+阿仑膦酸钠片,试验组则联合补肾壮骨汤治疗,均治疗12周。比较两组治疗12周后的疗效,治疗前及治疗12周后的评分指标、外周血miR、骨密度、血清学指标,治疗期间的安全性。结果两组治疗12周后的总疗效相比,试验组高于对照组[89.29%(75/84)比76.19%(64/84),P<0.05];两组中医证候、视觉模拟评分法(VAS)、汉密尔顿焦虑量表(HAMA)评分及血清骨谷氨酰基蛋白(BGP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、总Ⅰ型前胶原氨基端延长肽(tP1NP)水平治疗12周后相比治疗前降低,试验组低于对照组(均P<0.05);外周血miR-21、miR-335-5p水平及股骨颈骨、大转子骨密度治疗12周后相比治疗前升高,试验组各指标分别为1.15±0.09、8.03±0.97、(0.83±0.12)g/cm^(2)、(0.71±0.06)g/cm^(2),高于对照组的0.75±0.24、1.22±0.56、(0.64±0.06)g/cm^(2)、(0.53±0.09)g/cm^(2)(均P<0.05)。两组病人在治疗期间的不良反应发生率比较,差异无统计学意义(P>0.05)。结论与阿仑膦酸钠单独治疗比较,补肾壮骨汤联合阿仑膦酸钠应用于PMOP病人可有效调节外周血miR和骨密度,改善中医证候、疼痛程度、焦虑症状及骨代谢,进而有利于提升疗效。
Objective To investigate the regulatory effects of Bushenzhuanggu decoction combined with alendronate on peripheral blood microRNA(miRNA)and bone mineral density(BMD)in patients with postmenopausal osteoporosis(PMOP).Methods In this randomized single-blind controlled trial,168 PMOP patients treated at Chengdu Integrated Traditional Chinese and Western Medicine Hospital(September 2021-September 2022)were allocated to control(n=84)and trial(n=84)groups via random number table method.The control group received conventional treatment plus alendronate sodium tablets,while the trial group received additional Bushenzhuanggu decoction,with both groups treated for 12 weeks.The efficacy after 12 weeks of treatment,the scoring indexes,peripheral blood miRNA,bone density,serological indexes before and after 12 weeks of treatment,and safety during treatment were compared between the two groups.Results The total efficacy rate of the trial group after 12 weeks of treatment was higher than that of the control group[89.29%(75/84)vs.76.19%(64/84),P<0.05].The scores of TCM syndromes,visual analog scale(VAS),Hamilton Anxiety Scale(HAMA),and levels of serum bone Gla-protein(BGP),β-cross-linked C-telopeptide of type I collagen(β-CTX),and total procollagen type I N-terminal propeptide(tP1NP)were lower after 12 weeks of treatment compared with those before treatment,and the trial group showed lower values than the control group(all P<0.05).The levels of peripheral blood miR-21,miR-335-5p,and BMD of the femoral neck and greater trochanter were higher after 12 weeks of treatment compared with those before treatment;in the trial group,these values were 1.15±0.09,8.03±0.97,(0.83±0.12)g/cm²,and(0.71±0.06)g/cm²,respectively,which were higher than those in the control group[0.75±0.24,1.22±0.56,(0.64±0.06)g/cm²,and(0.53±0.09)g/cm²;all P<0.05].There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with alendronate alone,Bushenzhuanggu decoction combined with alendronate can effectively regulate peripheral blood miRNA and BMD,improve TCM syndromes,pain levels,anxiety symptoms,and bone metabolism in PMOP patients,thereby enhancing therapeutic efficacy.
作者
刘波
周智恩
苏松川
杨逸
杨宏
吕刚
LIU Bo;ZHOU Zhien;SU Songchuan;YANG Yi;YANG Hong;LYU Gang(Department of Orthopedics and Traumatology,Chengdu Integrated Traditional Chinese and Western Medicine Hospital/Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610017,China;Department of Critical Care Medicine,Chengdu Integrated Traditional Chinese and Western Medicine Hospital/Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610017,China;Orthopedics and Traumatology Department of Chongqing Traditional Chinese Medicine Orthopedics Hospital,Chongqing 400012,China)
出处
《安徽医药》
2025年第6期1256-1260,共5页
Anhui Medical and Pharmaceutical Journal
基金
成都中医药大学“杏林学者”学科人才科研提升计划项目(YYZX2022046)。
关键词
骨质疏松
绝经后
补肾壮骨汤
阿仑膦酸钠
微RNA
骨密度
血清学
Osteoporosis,postmenopausal
Bushenzhuanggu decoction
Alendronate sodium
MicroRNA
Bone mineral density
Serological markers
