补肾调冲方治疗绝经后骨质疏松症62例

目的:探讨补肾调冲方治疗绝经后骨质疏松症(PMOP)的临床疗效及对性激素和血清白细胞介素1(IL-1),IL-6水平的影响。方法:将124例PMOP随机按数字表法分为对照组和观察组各62例。对照组口服阿仑膦酸钠片,10mg·d-1;和碳酸钙D3咀嚼片,0.6g·d-1。观察组在对照组治疗的基础上内服补肾调冲方,1剂/d,常规水煎分2次服用。两组疗程均为6个月。进行治疗前后腰背部疼痛评分,测量治疗前后腰椎L2-4的骨密度,检测治疗前后血清钙(Ca),血清磷(P),碱性磷酸酶(ALP),骨钙素(BGP),雌二醇(E2),促卵泡刺激素(FSH),促黄体生成素(LH),IL-1和IL-6水平。结果:骨质疏松症观察组总有效率为91.9%,对照组为77.4%,观察组优于对照组(P<0.05);观察组腰背部疼痛VAS评分低于对照组(P<0.01);观察组腰椎L2-4的骨密高于对照组(P<0.01);治疗后观察组BGP和ALP水平低于对照组,Ca水平均高于对照组(P<0.01);治疗后两组E2水平明显升高,治疗后观察组E2水平高于对照组(P<0.01);治疗后两组FSH水平均比治疗前下降(P<0.01);治疗后观察组IL-1和IL-6水平低于对照组(P<0.01)。结论:补肾调冲方能提高PMOP患者骨密度,减轻疼痛等症状,综合疗效优于单纯西医治疗,其作用机制可能与升高雌激素水平,抑制破骨因子,促进骨形成,抑制骨吸收有关。

Effect of Bushen Tiaochong Decoction in Treating 62 Patients with Osteoporosis After Menopause

Objective: To discuss the curative efficacy of Bushen Tiaochong decoction in treating postmenopausal osteoporosis (PMOP) and to investigate its influence on interleukin-1 (IL-1) and interleukin-6 (IL-6). Method: One hundred and twenty-four patients with PMOP were randomly divided into the control group (62 cases) and the observation group (62 cases) by a random number table. Patients in the control group took 10 mg alendronate sodium tablets and 0.6 g calcium carbonate D₃ chewable tablets orally. Based on the treatment of the control group, patients in the observation group added 1 dose Bushen Tiaochong decoction in twice daily. All patients in both two groups received 6 months of treatment. Before and after treatment, score of pain of lower back was graded by visual analogue scales (VAS), bone mineral density of lumbar L_2-4 and levels of serous calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), bone gla protein (BGP), estrogen₂(E₂), follicle-stimulating hormone (FSH), luteinizing hormone (LH), interleukin-1 (IL-1) and interleukin-6 (IL-6) were detected. Result: The total effective rate of osteoporosis in the observation group was 91.9%, which is superior to 77.4% in the control group (P<0.05). VAS of pain of lower back in the observation group was lower than that in the control group (P<0.01). After treatment, bone mineral density of lumbar L_2-4 was higher (P<0.01), levels of BGP and ALP were lower, and level of Ca was higher than those in the control group (P<0.01). E₂ level in both groups increased obviously and the result in the observation group was better than that in the control group (P<0.01). Levels of FSH decreased in both groups (P<0.01). Levels of IL-1 and IL-6 in the observation group were lower than those in the control group (P<0.01). Conclusion: Bushen Tiaochong decoction could improve bone mineral density and relieve pain symptoms of patients with PMOP. The comprehensive curative effect was superior to Western medicine treatment alone, and its mechanism of action may be related to improving the level of estrogenic hormone, inhibiting osteoclast-activating factor, promoting osteogenesis and inhibiting bone resorption.