固肾方对原发性骨质疏松症患者骨转换的影响  

Effect of Gushen Recipe on Bone Turnover in Osteoporosis Patients

作　　者：谢欣颖[1] 张文婧 余文雯[1] 杨小红[1] XIE Xin-Ying;ZHANG Wen-Jing;YU Wen-Wen;YANG Xiao-Hong(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2018年第5期805-809,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省自筹经费类科技计划项目(粤科规财字[2015]110号)

摘　　要：【目的】立足《黄帝内经》"治病求本"思想,观察固肾填精壮骨法对骨质疏松症的临床疗效。【方法】将符合入选标准的60例骨质疏松症患者随机分为治疗组和对照组,每组各30例。2组均给予维D钙咀嚼片、骨化三醇口服治疗,在此基础上,治疗组给予加服中药固肾方治疗,治疗3个月后评价2组患者的临床疗效及安全性,并观察2组患者治疗前后骨密度(BMD)和骨转换标志物如25羟维生素D[25(OH)_2VitD_3]、Ⅰ型胶原氨基端延长肽(PINP)、Ⅰ型胶原降解产物(CTX)、N-端骨钙素(N-MID)、碱性磷酸酶(ALP)等指标的变化情况。【结果】(1)治疗过程中,治疗组有1例患者因不能坚持服用中药而退出试验,对照组有1例患者因发生病理性骨折进展为严重骨质疏松而退出试验;(2)治疗3个月后,治疗组总有效率为90.00%,对照组为76.67%,治疗组疗效优于对照组(P<0.05);(3)治疗后,2组患者的BMD值均较治疗前显著提高(P<0.05),且治疗组在提高BMD值方面明显优于对照组(P<0.05);(4)治疗后,2组患者25(OH)_2VitD_3水平均较治疗前提高,PINP、CTX、N-MID、ALP水平均较治疗前降低(P<0.05),且治疗组在降低PINP、CTX水平方面明显优于对照组(P<0.05);(5)治疗期间,治疗组和对照组均未出现明显不良反应。【结论】运用固肾方治疗骨质疏松症,能有效抑制骨转换,提高骨密度,是骨质疏松症安全有效的治疗方法。Objective Based on the theory of‘treating disease from the root＇recorded in Huangdi＇s Canon of Medicine,we observed the clinical efficacy of Gushen Recipe,prescribed following the therapy of strengthening kidney,nourishing essence and strengthening bone,for the treatment of osteoporosis. Methods Sixty osteoporosis patients were randomly divided into treatment group and control group,30 cases in each group. The two groups were given calcium supplements of vitamin D chewable tablets and calcitriol,and additionally the treatment group was treated with oral administration of Gushen Recipe. After treatment for 3 months,the clinical efficacy and safety of the two groups were evaluated. During the period of treatment,we observed bone mineral density（BMD）and bone turnover markers such as 25-hydroxy vitamin D3[25（OH）2VitD3],procollagen type Ⅰ intact N-terminal propeptide（PINP）,type Ⅰ collagen C-telopeptide degradation product（CTX）,osteocalcin with N-terminal in the middle（N-MID）, and alkaline phosphatase（ALP）. Results（1）During treatment, one case from the treatment group dropped out for suspension of the medication of Chinese medicine,and one case from the control group dropped out for the pathological fracture developing into severe fracture.（2）The total effective rate of the treatment group was 90.00% and that of the control group was 76.67%,the difference being significant（P〈0.05）.（3）After treatment,BMD of the two groups was much increased（P〈0.05 compared with that before treatment）,and the increase of BMD in the treatment group was superior to that in the control group（P〈0.05）.（4）After treatment,25（OH）2VitD3 was increased,and PINP,CTX,N-MID and ALP were decreased in the two groups（P〈0.05 compared with those before treatment）,and the decrease of PINP and CTX in the treatment group was superior to that in the control group（P〈0.05）.（5）During treatment,no obvious adverse reaction was found in the two groups. Conclusion Gushen Recipe is

关 键 词：骨质疏松症 骨转换 骨密度 固肾方 固肾填精壮骨法 随机对照试验 

分 类 号：R274.9[医药卫生—中西医结合]