中药肉苁蓉治疗骨质疏松症及调控骨代谢组学的临床观察  

Clinical observation of Chinese medicine Cistanche deserticola in treating osteoporosis and regulating bone metabolomics

作　　者：吴泱 张翔[1] 张鸿振[1] 王萧枫[1] 赵小迎 姚憬 WU Yang;ZHANG Xiang;ZHANG Hongzhen;WANG Xiaofeng;ZHAO Xiaoying;YAO Jing(Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Zhejiang University of Traditional Chinese Medicine, Wenzhou 325000, China)

机构地区：[1]浙江中医药大学附属温州市中西医结合医院,浙江温州325000

出　　处：《中国现代医生》2019年第6期120-124,共5页China Modern Doctor

基　　金：浙江省中医药科学研究基金项目(2014ZA104);浙江省温州市中医药科研项目(2018ZA005)

摘　　要：目的通过观察中药肉苁蓉治疗骨质疏松症的临床疗效及调控骨代谢组学的相关研究,探讨肉苁蓉防治骨质疏松症的作用机制及临床应用价值。方法选取2015年6月～2017年6月在我院中医内科、中医骨伤科门诊诊治的70例原发性骨质疏松患者,随机分为治疗组35例和对照组35例。治疗组采取单味肉苁蓉15 g煎汤口服,每日2次;对照组采用口服钙尔奇D片,600 mg/次,每日1次。并于治疗前、治疗3个月和治疗6个月时分别检测骨钙素(BGP)及Ⅰ型胶原羧基端肽(ⅠCTP)水平、血清碱性磷酸酶(ALP)、血钙(Ca)、血磷(P)的水平,同时检测骨密度,并记录中医症状分级及计分,评定临床疗效。结果治疗组BMD值分别为(0.76±0.04)g/cm2(L2-4)、(0.69±0.06)g/cm2(股骨颈)、(0.51±0.07)g/cm2(大转子),两组治疗前指标比较差异无统计学意义(P>0.05),指标较治疗前明显改善,同时比对照组改善效果更佳。治疗3个月后,治疗组ALP(58.50±18.27)mmol/L、c(Ca)(2.51±0.51)mmol/L、 c(P)(1.23±0.01)mmol/L;治疗6个月后,ALP (69.23±16.11)mmol/L、c(Ca)(2.94±0.53)mmol/L、c(P)(1.30±0.38)mmol/L,较对照组各项指标均有明显改善(P<0.05)。治疗组治疗3个月、6个月后BGP为(5.48±0.25)μg/L、(7.68±0.10)μg/L,较治疗前升高,且较同期对照组改善更加显著(P<0.05)。治疗组治疗3个月、6个月后ⅠCTP为(6.16±0.37)μg/L、(5.40±0.18)μg/L较治疗前降低,同时较同期对照组降低更为明显(P<0.05)。经6个月治疗后,治疗组取得57.1%的显著疗效,总有效率91.4%。结论中药肉苁蓉具有双向调节骨形成和骨吸收的作用,改善血清碱性磷酸酶、钙、磷代谢,提高骨密度,能够有效抗骨质疏松。Objective To investigate the clinical mechanism and clinical application of Cistanche deserticola in the treatment of osteoporosis by observing the clinical efficacy of Cistanche deserticola in the treatment of osteoporosis and the related research on the regulation of osteometabolism. Methods 70 patients with primary osteoporosis who were diagnosed and treated in our department of Traditional Chinese Medicine and Traditional Chinese Medicine and Orthopedics in our hospital from June 2015 to June 2017 were randomly divided into treatment group (35 cases) and control group (35 cases). The treatment group was treated with single-flavored Cistanche 15 g decoction orally twice a day;and the control group was treated with oral Calcium D tablets, 600 mg/time, once a day. Osteocalcin(BGP) and type Ⅰcollagen carboxy terminal peptide (ICTP) levels, serum alkaline phosphatase (ALP), and calcium (Ca), phosphorus (P) were measured before treatment, at 3 months and 6 months of treatment. The level of bone density was simultaneously detected. The classification and score of TCM symptoms was recorded, and the clinical efficacy was assessed. Results The BMD values of the treatment group were (0.76±0.04 ) g/cm^2 (L2-4),(0.69±0.06 ) g/cm^2(femoral neck), and (0.51±0.07) g/cm^2 (large trochanter). The difference between the two groups before treatment was not statistically significant (P>0.05). The improvement of the above indicators was obvious than before, and was better than that of the control group After 3 months of treatment, the ALP in the treatment group was (58.50±18.27 )mmol/L, c(Ca) was (2.51±0.51) mmol/L, and c (P) was (1.23±0.01) mmol/L. After 6 months of treatment, the ALP was (69.23±16.11)mmol/L, c(Ca) was (2.94±0.53) mmol/L, and c(P) was (1.30±0.38)mmol/L, which were significantly improved compared with those of the control group (P<0.05). After 3 months and 6 months of treatment, the BGP was (5.48±0.25) ug/L and (7.68±0.10) ug/Lrespectively, which was higher than that before treatment, and it was more

关 键 词：肉苁蓉 骨质疏松症 骨代谢组学 骨钙素 Ⅰ型胶原羧基端肽 

分 类 号：R587.1[医药卫生—内分泌] R580[医药卫生—内科学]