补肾活血方对沙鼠增龄过程中腰椎软骨终板钙化干预作用的初步研究

目的:探讨补肾活血方对腰椎软骨终板钙化的干预作用。方法:选取30只2月龄和7月龄健康雄性长爪沙鼠,分别喂养至2月龄(50~60 g)和12月龄(60~80 g)建立老龄沙鼠模型,采用随机数字表方法分为5组:正常组(n=6),模型组(n=6,给予生理盐水4 ml/kg,灌胃30 d),补肾活血方低剂量组(n=6,给予补肾活血方1.9×10-3 ml/g灌胃30 d),补肾活血方中剂量组(n=6,给予补肾活血方3.8×10-3 ml/g灌胃30 d),补肾活血方高剂量组(n=6,给予补肾活血方7.6×10-3ml/g灌胃30 d),干预组从7月龄开始连续给药1.36 g,30 d。正常组2月龄及其他组12个月龄时处死动物,取腰椎间盘组织,HE染色体视法分析腰椎体软骨终板组织形态学、血管芽面积、非钙化/钙化层比值,兔单克隆抗体免疫组化染色方法测定软骨终板X型胶原、BMPs的表达。结果:软骨终板血管芽相对面积测量显示,与模型组相比,补肾活血方中剂量组,正常组增高(P0.05),大、小剂量组虽各有不同程度的增加,但差异均无统计学意义(P0.05);软骨终板非钙化层/钙化层厚度比值测量显示,与模型组相比,补肾活血方中剂量、正常组增加,差异具有统计学意义(P0.05),而补肾活血方大、小剂量组虽各有不同程度的增加,但差异均无统计学意义(P0.05)。免疫组化染色软骨终板X型胶原的表达与模型组相比,正常组、补肾活血方低、中、高剂量组均降低,差异具有统计学意义(P0.01);BMPs的表达,与模型组相比,正常组、补肾活血方中剂量组升高,差异具有统计学意义(P0.01),大、小剂量组虽各有不同程度的升高,但差异均无统计学意义(P0.05)。结论:补肾活血方中剂量可延缓增龄过程中椎间盘软骨终板钙化,提示可作为早期椎间盘退变的预防用药。     

中药疗法改善中度氟骨症患者肢体关节功能的随机对照研究

Objective To observe the improving effect in joint function of moderate skeletal fluorosis treated by traditional Chinese medication(main ingredient was Strychnine).Methods From December 2007 to July 2009,120 moderate skeletal fluorosis patients met the inclusion criteria were divided into the treatment group(60 cases)and the control group(60 cases)in the skeletal fluorosis hospital of Xinzhou,the treatment group was given basic treatment and traditional Chinese medication,the control group wa8 given basic treatment and placebo.The treatment lasted 12 weeks,follow up 24 weeks.Before treatment,after treatment 4 weeks,8 weeks,12 weeks,36 weeks,a third party evaluate comprehensive function of both upper and lower limb and joint dysfunction.Results The main effect of both drugs was statistically significance in the scores of the upper forearm in the finger by touching the posterior contralateral ear, upper arm touched by the finger back in the opposite corner subscapularis function, lower limb function and single-joint dysfunction(F values were 4.08,14.32,35.81,13.02, all P<0.05), the main effect of time also was significant (F values were 82.63,72.82,277.33,328.16, all P<0.05),①the upper forearm in the finger by touching the posterior contralateral ear functions:At the time of 8,12 weeks,scores of the treatment group were lower than those of before treatment and control group (all P<0.05);At the time of 36 weeks,scores of the treatment group were lower than that 12 weeks(all P<0.05);At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment(all P < 0.05);②upper arm function, namely fingers touching the opposite corner subscapularis:At the time of 4,8,12 weeks, scores of the treatment group were lower than those of before treatment(all P<0.05); At the time of 36 weeks, scores of the treatment group were lower than that 12 weeks(all P<0.05); At the time of 8,12,36 weeks, scores of the treatment group were lower than those of the control group (all P<0.05);③Lower extremity functions: At the time of 8,12 weeks,scores of the treatment group were lower than those of before treatment and control group (all P<0.05);At the time of 36 weeks, scores of the treatment group were lower than that 12 weeks(all P<0.05) ; At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment (all P<0.05);④single joint functions:At the time of 4,8,12 weeks,scores of the treatment group were lower than those of before treatment(all P<0.05); At the time of 36 weeks,scores of the treatment group were lower than that 12 weeks(all P<0.05) ; At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment(all P<0.05);At the time of 4,8,12,36 weeks, scores of the treatment group were lower than those of control group(all P<0.05);⑤At the end of treatment and follow-up,the improvement rate in joint functions in the treatment group were 88.33% (53/60),93.33% (56/60); the control group were 28.07%(16/57),40.35%(23/57), (Fisher test, P<0.01,X2=56.21, P<0.01). Conclusion Traditional Chinese medication(its main ingredient is Strychnine), an effective drug for improving joint dysfunction in patients suffering from moderate skeletal fluorosis, is simple and effective.     

中药疗法改善中度氟骨症患者肢体关节功能的随机对照研究

目的 观察中药疗法(主要成分中药马钱子)对改善中度氟骨症患者关节功能的疗效.方法 2007年12月至2009年7月,在忻州市氟骨症专科医院对符合纳入标准的120例中度氟骨症患者分为治疗组和对照组,每组60例.治疗组给予基础治疗和中药疗法治疗,对照组给予基础治疗和安慰剂治疗,疗程12周,随访24周,分别于治疗前(O周)、第4、8、12、36周时进行上肢综合功能、下肢综合功能、关节功能障碍指标评估.结果 对于上肢前臂经枕后中指尖触及对侧耳廓功能评分、上肢前臂经后背中指尖触及对侧肩胛下角功能评分、下肢功能评分、单关节功能障碍评分,药物的主效应均有统计学意义(F值分别为4.08、14.32、35.81、13.02,P均<0.05),时间的主效应也均有统计学意义(F值分别为82.63、72.82、277.33、328.16,P均<0.05).①上肢前臂经枕后中指尖触及对侧耳廓功能:治疗组第8、12周的评分均低于治疗前和对照组(P均<0.05);第36周的评分低于12周(P均<0.05);对照组的第8、12、36周的评分均低于治疗前(P均<0.05);②上肢前臂经后背中指尖触及对侧肩胛下角功能:治疗组的第4、8、12周的评分均低于治疗前(P均<0.05),第36周的评分低于12周(P均<0.05);第8、12、36周时治疗组的评分低于对照组(P均<0.05);③下肢功能:治疗组的第8、12周的评分均低于治疗前和对照组(P均<0.05),第36周的评分低于12周(P均<0.05),对照组的第8、12、36周的评分均低于治疗前(P均<0.05);④单关节功能:治疗组的第4、8、12周的评分均低于治疗前(P均<0.05),第36周的评分低于12周(P均<0.05);对照组的第8、12、36周的评分均低于治疗前(P均<0.05);第4、8、12、36周时治疗组的评分低于对照组(P均<0.05);⑤治疗结束及随访结束肢体关节功能改善率治疗组分别为88.33%(53/60),93.33%(56/60),对照组分别为28.07%(16/57),40.35%(23/57),组间比较(fisher检验,P<0.01,X2=56.21,P<0.01).结论 以马钱子为主的中药疗法对中度氟骨症患者肢体的关节功能障碍改善疗效确切,是治疗氟骨症的一种简便易行的有效方法.     

中药疗法改善中度氟骨症患者肢体关节功能的随机对照研究

Objective To observe the improving effect in joint function of moderate skeletal fluorosis treated by traditional Chinese medication(main ingredient was Strychnine).Methods From December 2007 to July 2009,120 moderate skeletal fluorosis patients met the inclusion criteria were divided into the treatment group(60 cases)and the control group(60 cases)in the skeletal fluorosis hospital of Xinzhou,the treatment group was given basic treatment and traditional Chinese medication,the control group wa8 given basic treatment and placebo.The treatment lasted 12 weeks,follow up 24 weeks.Before treatment,after treatment 4 weeks,8 weeks,12 weeks,36 weeks,a third party evaluate comprehensive function of both upper and lower limb and joint dysfunction.Results The main effect of both drugs was statistically significance in the scores of the upper forearm in the finger by touching the posterior contralateral ear, upper arm touched by the finger back in the opposite corner subscapularis function, lower limb function and single-joint dysfunction(F values were 4.08,14.32,35.81,13.02, all P<0.05), the main effect of time also was significant (F values were 82.63,72.82,277.33,328.16, all P<0.05),①the upper forearm in the finger by touching the posterior contralateral ear functions:At the time of 8,12 weeks,scores of the treatment group were lower than those of before treatment and control group (all P<0.05);At the time of 36 weeks,scores of the treatment group were lower than that 12 weeks(all P<0.05);At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment(all P < 0.05);②upper arm function, namely fingers touching the opposite corner subscapularis:At the time of 4,8,12 weeks, scores of the treatment group were lower than those of before treatment(all P<0.05); At the time of 36 weeks, scores of the treatment group were lower than that 12 weeks(all P<0.05); At the time of 8,12,36 weeks, scores of the treatment group were lower than those of the control group (all P<0.05);③Lower extremity functions: At the time of 8,12 weeks,scores of the treatment group were lower than those of before treatment and control group (all P<0.05);At the time of 36 weeks, scores of the treatment group were lower than that 12 weeks(all P<0.05) ; At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment (all P<0.05);④single joint functions:At the time of 4,8,12 weeks,scores of the treatment group were lower than those of before treatment(all P<0.05); At the time of 36 weeks,scores of the treatment group were lower than that 12 weeks(all P<0.05) ; At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment(all P<0.05);At the time of 4,8,12,36 weeks, scores of the treatment group were lower than those of control group(all P<0.05);⑤At the end of treatment and follow-up,the improvement rate in joint functions in the treatment group were 88.33% (53/60),93.33% (56/60); the control group were 28.07%(16/57),40.35%(23/57), (Fisher test, P<0.01,X2=56.21, P<0.01). Conclusion Traditional Chinese medication(its main ingredient is Strychnine), an effective drug for improving joint dysfunction in patients suffering from moderate skeletal fluorosis, is simple and effective.