中西医结合疗法治疗老年骨质疏松症的临床应用效果  

Clinical Application Effect of Therapy Combined Traditional Chinese and Western Medicine for Senile Osteoporosis

作　　者：袁耀[1] 汤涛[2] 施松青[1] 王伟东[1] 

机构地区：[1]余姚市人民医院骨科,浙江余姚315400 [2]宁波市第二医院骨科,浙江宁波315010

出　　处：《中华中医药学刊》2014年第8期2014-2017,共4页Chinese Archives of Traditional Chinese Medicine

摘　　要：目的:分析补肾中药与西药联合疗法对老年骨质疏松症患者临床疗效和外周血骨代谢指标表达的影响,为其临床应用提供数据支撑。方法:采用前瞻性研究,选取老年骨质疏松患者80例,以随机数字表分为观察组和对照组各40例;对照组采用阿仑磷酸钠与碳酸钙D3进行治疗,观察组在此基础上加用补肾汤剂。用药6个月后对比临床疗效和骨密度(BMD),并采取患者空腹外周静脉血,分别采用RT-PCR和Westernblot检测外周血OPG/RANKL的mRNA及蛋白表达。结果观察组患者的临床总有效率和显效率均高于对照组,且显效率有统计学差异(χ2=5.208,P=0.022)。治疗前两组患者的骨密度无明显统计学差异;治疗后观察组股骨颈、腰椎L2-4和大转子骨密度均显著高于对照组(t=2.847、2.461、3.052;P=0.031、0.043、0.022)。治疗前,两组患者的OPG/RANKL表达水平无显著差异;治疗后,观察组OPG/RANKL mRNA及蛋白表达均显著高于对照组(t=8.524、6.872;P=0.000)。此外,OPG/RANKL mRNA及蛋白表达均与患者平均BMD呈直线正相关(R2(mRNA)=0.6503,R2(蛋白)=0.6563)。结论:补肾中药可调节骨质疏松患者OPG/RANKL/RANK轴,对促进骨生成、抑制骨吸收、增加骨密度有正向作用,与西药联合应用时能够增强临床疗效。Objective ： To analyze the clinical effect and bone metabolic marker expression levels of patients with senile osteoporosis in the treatment of therapy combined traditional Chinese and western medicine, so as to provide clinical data for its application. Methods ： 80 cases of senile patients with osteoporosis were selected and divided into two groups ran- domly. Patients in Group Control were given Alendronate and Calcium carbonate D3 for treatment, while patients in Group Observation were given Chinese herbal medicine which invigorated the kidney at the same time. Clinical effect and bone mineral density （BMD） were record after 6 months＇treatment. At the same time, Peripheral blood of patients was extracted before and after treatment to detect the OPG/RANKL mRNA and protein expression levels. Results：The effective rate and efficient rate of Group Observation were both higher than those of Group Control, and the efficient rate had statistical difference （ X2 = 5. 208, P = 0. 022 ）. Before treatment, there was no significant difference in BMD between groups ; while the BND of collum femoris, L2 -4 and trochanter of Group Observation were all higher than those of Group Control ＇after treatment （t =2. 847,2. 461,3. 052; P = 0. 031,0. 043,0. 022）. There was no significant difference in BMD between groups before treatment; while the mRNA and protein expression level of Group Observation were both higher than those of Group Control after treatment （t = 8. 524,6. 872; P = 0. 000）. Further more, both the OPG/RANKL mRNA and protein expression level had positive correlation property with average BMD of the patients （ R2 （mRNA = 0. 6503, R2 （蛋白） = 0. 6563 ）. Conclusion： Our research results shows that Chinese herbal medicine which invigorated the kidney has regulation effect on OPG/RANKL/RANK axis,which is benefit for osteogenesis and worth of clinical application.

关 键 词：补肾中药 老年 骨质疏松 OPG RANKL RANK轴 

分 类 号：R259[医药卫生—中西医结合]