老年性骨质疏松症中医证型与骨代谢指标的相关性研究

目的:探讨老年性骨质疏松症(OP)中医证型与骨代谢标志物的相关性及特点。方法:选取符合入选标准并进行了骨标志物检查的154例OP患者进行中医证型分型,分为气滞血瘀组、脾气虚弱组、肝肾阴虚组、肾阳虚衰组和肾精不足组。观察各组病例骨代谢标志物I型胶原羧基末端肽(CTX-I)、总I型胶原氨基末端前肽(PINP)、血清骨钙素(BGP)和碱性磷酸酶(BALP)水平。结果:CTX-I指标气滞血瘀组和肾阳虚衰组明显高于其他组,具有统计学意义(P<0.01),PINP指标气滞血瘀组和肝肾阴虚组明显高于其他组,具有统计学意义(P<0.01),BGP水平各证型组差异无统计学意义(P>0.05),BALP指标气滞血瘀组明显高于其他组,具有统计学意义(P<0.01)。脾气虚弱组和肾精不足组在各指标中均为低水平。结论:OP气滞血瘀组有较高骨代谢水平,多为高转换状态,其次为肾阳虚衰和肝肾阴虚组,肾精不足和脾气虚弱组骨代谢水平较低,多为低转换状态。

Correlation Between Traditional Chinese Medicine Syndrome Types and Bone Metabolic Markers in the Senile Osteoporosis

Objective:To explore the correlation between traditional Chinese medicine(TCM) syndrome types and bone metabolic markers and the characteristics in the senile osteoporosis. Methods:One hundred and fifty-four patients with osteoporosis meeting the inclusion criteria were selected and examined with bone markers. The included patients according to TCM syndromes were divided into five groups,qi stagnation and blood stasis group,spleen qi deficiency group,liver-kidney yin deficiency group,deficiency of the kidney-yang group,kidney-essence deficiency group. The levels of C-telopeptide of type Ⅰ collagen(CTX-Ⅰ),procollagen type I N-terminal propeptide(PINP),bone Gla-protein(BGP) and bone-specific alkaline phosphatase(BALP)in each group were measured. Results:Qi stagnation and blood stasis group and Deficiency of the kidney-yang group were significantly higher than other groups on the CTX-Ⅰ level(P<0.01). Qi stagnation and blood stasis group and liver-kidney yin deficiency group were higher than other groups on the PINP levels(P<0.01). No significant difference between groups on the BGP levels(P> 0.05). Qi stagnation and blood stasis group was significantly higher than other groups on the BALP levels(P<0.01).Spleen qi deficiency group and kidney-essence deficiency group were at low levels on each markers. Conclusions:Qi stagnation and blood stasis group is of a high level of bone metabolism,mostly high-turnover status,followed by deficiency of the kidney-yang group and liver-kidney yin deficiency group. Spleen qi deficiency group and kidney-essence deficiency group are of a low level of bone metabolism,and usually of low-turnover status.