补肾调冲方治疗绝经后骨质疏松症临床研究

目的:观察补肾调冲方治疗绝经后骨质疏松症的临床疗效及对患者各项骨生化标志物的影响。方法:将100例绝经后骨质疏松症患者随机按数字表法分为对照组和观察组,每组50例。对照组口服利塞膦酸钠片和乳酸钙咀嚼片,观察组在对照组治疗的基础上加用补肾调冲方(淫羊藿10 g,补骨脂20 g,熟地黄20 g,鹿角胶10 g,枸杞子20 g,墨旱莲20g,骨碎补10 g,杜仲15 g,桑寄生15 g,续断15 g,山萸肉10 g,丹参15 g,红花6 g)治疗,两组患者疗程均为6个月。观察治疗前后两组患者相关症状、疼痛视觉评分(visual analogue scale,VAS)、临床疗效,并分别对两组患者各项骨生化指标进行测定。结果:观察组有效率为92.00%,对照组有效率为72.00%,两组比较,差异有统计学意义(P0.05);治疗后观察组腰背部疼痛VAS评分以及骨钙素(bone gla protein,BGP)、血清碱性磷酸酶(serum alkaline phosphatase,ALP)、白介素-1(Interleukin-1,IL-1)和白介素-6(Interleukin-6,IL-6)水平低于对照组,差异有统计学意义(P0.05);治疗后两组血清钙(serum calcium,SCa)、血清磷(Serum phosphorus,SP)、活性维生素D3、雌二醇(estradiol,E2)水平以及腰椎正位(L2~L4)及左股骨颈的骨密度明显升高,且观察组高于对照组,差异有统计学意义(P0.05);治疗后两组促卵泡刺激素(follicle-stimulating hormone,FSH)和促黄体生成素(luteotropic hormone,LH)水平较治疗前均明显下降,差异有统计学意义(P0.05)。结论:补肾调冲方能显著减轻腰背部疼痛,增加腰椎正位(L2~L4)及左股骨颈的骨密度,提高血Ca水平,降低ALP及BGP水平,且治疗后发现观察组活性维生素D3浓度升高较对照组明显,更能促进成骨细胞活性增加,有益于骨组织生成。治疗后观察组E2水平高于对照组,IL-1和IL-6水平低于对照组,表明补肾调冲方对升高雌激素水平有显著作用,并有效抑制了IL-1和IL-6等炎症因子生成,并抑制骨吸收,促进骨形成,起到延缓和防治绝经后骨质疏松症的作用。

Clinical Study on Bushen Tiaochong Decoction in Treatment of Postmenopausal Osteoporosis

Objective:To discuss the curative efficacy of Bushen Tiaochong Decoction in treatment of Postmenopausal osteoporosis (PMOP) and the impact on patients' biochemical markers of bone.Methods:One hundred patients with PMOP were randomly divided into control group (50 cases) and observation group (50 cases).Patients in the control group took Risedronate Sodium Tablets and Calcium Lactate Chewable Tablets.In addition to that of the control group,patients in the observation group were given Bushen Tiaochong Decoction (Epimedium 10 g,Psoralen 20 g,Rehmannia 10 g,Lycium 20 g,Eclipta 20 g,Rhizoctonia 10 g,Eucommia 15 g,Sang Sen 15 g,Dipsacus 15 g,dogwood 10 g,Salvia 15 g,Safflower 6 g).All patients in both two groups received 6 months of treatment.Before and after treatment,the related symptoms,and visual pain score (VAS),curative efficacy and the bone biochemical indicators of the two groups were observed and compared.Results:The effective rate in the observation group was 92.00％,which was significantly higher than that (72.00％) in the control group (P ＜ 0.05).After treatment,the VAS score of the lower back pain and the bone gla protein,serum alkaline phosphatasc,(IL-1) and interleukin-6 (IL-6) of the observation group were significantly lower than those in the control group (P ＜ 0.05).The levels of serum calcium,serum phosphorus,active vitamin D3,estradiol,and Lumbar anteroposterior (L2-L4) and left femoral neck bone density of both groups significantly raised and the differences were significant beween both groups (P ＜ 0.05).After treatment,the levels of follicle-stimulating hormone (FSH) and luteotropic hormone were significantly lower than those of the control group(P ＜ 0.05).Conclusion:Bushen Tiaochong Decoction can significantly reduce the pain of the lower back,increase the bone position of the lumbar anteroposterior (L2-L4) and the left femoral neck,increase the blood Ca levels,decrease the level of ALP and BGP.The 1,25 (OH) 2 D3 of the observation group increased significantly compared with that of the control group,thereby the osteoblast activity can be promoted,which is beneficial to bone tissue formation.After treatment,the level of E2 in the observation group was higher than that in the control group and the levels of IL-1 and IL-6 were lower than those of the control group,which indicates that Kidney-toning had significant effect on the level of estrogen,and effectively inhibited IL-1 and IL-6 Inflammatory factors,inhibited bone absorption,promote bone formation and eventually played a role in delaying and prevention of postmenopausal osteoporosis.