骨质疏松症患者破骨细胞相关细胞因子与中医证型的关系

目的?探讨骨质疏松症患者破骨细胞相关细胞因子巨噬细胞集落刺激因子（M-CSF）、核因子κB受体活化因子（RANKL）、肿瘤坏死因子-α(TNF-α)、白细胞介素-1α（IL-1α）的表达与中医证型的关联性。方法?将骨质疏松症患者按照中医证型进行辨证分类，随机收集肾阳虚组30例、脾胃虚弱组30例、肝肾阴虚组30例、气滞血瘀组30例，共120例。清晨空腹抽取血液样本，采用酶联免疫法检测M-CSF、RANKL、TNF-α、IL-1α水平。结果?在M-CSF和RANKL的蛋白水平表达上，肾阳虚组患者明显低于其余3组，P<0.01，4组患者在TNF-α和IL-1α蛋白表达水平无统计学差异。结论?可考虑将M-CSF、RANKL的蛋白表达水平作为区别骨质疏松症肾阳虚证与其它3组证型的鉴别方法之一。骨质疏松症在中医辨证分型上具有可被量化的客观依据。 

Relationship Between Osteoclast-related Cytokines in Patients with Osteoporosis and TCM Syndromes

OBJECTIVE?To explore the correlation between the expression of osteoclast-related cytokines like MCSF， RANKL， TNFα IL1αin patients with osteoporosis and TCM syndromes. METHODS?120 cases with osteoporosis were divided into the kidney yang deficiency group(30 cases)， deficiency of spleen and stomach group(30 cases)， liver-kidney yin deficiency group(30 cases) and qi stagnation and blood stasis group(30 cases) based on syndrome differentiation. Fasting blood samples early in morning were collected and the expression of four items including MCSF， RANKL， TNF and IL1αwere tested by applying euzymelinked immunosorbent assay method. RESULTS?Kidney yang deficiency group experienced evident lower expression of MCSF and RANKL than the other three groups， with significantly statistical differences， while no differences were noticed in the expression of TNFαand IL1αamong the four groups. CONCLUSION?Detection of MCSF and RANKL expression can be considered as an effective way to distinguish the kidney yang deficiency syndrome from the other three types. Hence， we believe that there exists quantified objective evidence for osteoporosis syndrome differentiation in TCM.