补肾蠲痹汤联合西医治疗对绝经后骨质疏松症患者骨代谢和氧化应激产物水平的影响  

Effect of Bushen Juanbi decoction combined with western medicine on bone metabolism and levels of oxidative stress products in postmenopausal osteoporosis

作　　者：刘玉兰[1] 徐鸿雁[1] 龙森[1] 权兴苗[1] 徐立伟[1] 芦丽[1] 高慧[1] LIU Yulan;XU Hongyan;LONG Sen(Department of Traditional Chinese Medicine, Affiliated Hospital of Chengde Medical College, Chengde, Hebei 067000)

机构地区：[1]承德医学院附属医院中医科

出　　处：《河北中医》2019年第6期827-832,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(编号:2015048157)

摘　　要：目的观察补肾蠲痹汤联合西医治疗对绝经后骨质疏松症(PMOP)患者骨代谢和氧化应激产物水平的影响。方法将116例PMOP患者按照随机数字表法分为2组。对照组58例予阿仑膦酸钠片、碳酸钙D3片治疗;治疗组58例在对照组治疗基础上加用补肾蠲痹汤治疗。2组均治疗3个月统计临床疗效,并观察2组治疗前后骨代谢指标Ⅰ型前胶原氨基端前肽(PⅠNP)、骨碱性磷酸酶(BALP)、骨钙素(BGP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX),氧化应激产物单胺氧化酶A(MAOA)、高级氧化蛋白产物(AOPP)、总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD),第2~4腰椎(L2~L4)、左侧股骨颈、左侧股骨大粗隆、左侧Ward's三角区骨密度(BMD),以及中医证候积分情况。结果治疗后2组PⅠNP、BALP、BGP、β-CTX均降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后2组MAOA、AOPP均降低(P<0.05),T-AOC、SOD均升高(P<0.05),且治疗组改善优于对照组(P<0.05)。治疗后2组L2~L4、左侧股骨颈、左侧股骨大粗隆、左侧Ward's三角区BMD均升高(P<0.05),且治疗组高于对照组(P<0.05)。治疗后2组腰背疼痛、腰膝痠软、耳鸣、下肢痿弱、头晕目眩、肢体麻木评分及总分均下降(P<0.05),且治疗组低于对照组(P<0.05)。结论补肾蠲痹汤能增加PMOP患者骨密度,促进骨形成,抑制骨吸收,改善氧化应激,从而改善症状,提高疗效。Objective To observe the effects of Bushen Juanbi decoction combined with western medicine on bone metabolism and levels of oxidative stress products in postmenopausal osteoporosis (PMOP) patients. Methods 116 patients with PMOP were divided into two groups according to random number table method. 58 cases in control group were treated by alendronate sodium tablets and calcium carbonate D 3 tablets. 58 cases in treatment group were treated by Bushen Juanbi decoction on the basis of the control group. After 3 months of treatment, the clinical efficacy of the two groups was evaluated. The bone metabolic indexes such as type Ⅰ procollagen amino-terminal propeptide (PⅠNP), bone alkaline phosphatase (BALP), bone gla protein (BGP), type Ⅰ collagen carboxy-terminal peptide β special sequence (β-CTX), oxidative stress product monoamine oxidase A (MAOA), advanced oxidative protein product (AOPP), and total antioxidant capacity (T-AOC), superoxide dismutase (SOD), the 2nd to 4th lumbar vertebrae (L 2~L 4), left femoral neck, left femoral trochanter, left Ward's triangle bone mineral density (BMD), and Chinese medicine syndrome score were observed between the two groups before and after treatment. Results After treatment, PⅠNP, BALP, BGP and β-CTX in both groups were decreased ( P <0.05), and the treatment group was lower than the control group ( P < 0.05 ). After treatment, MAOA and AOPP were decreased in both groups ( P <0.05), T-AOC and SOD were increased ( P <0.05), and the improvement of treatment group was better than that of control group ( P < 0.05 ). After treatment,L 2~L 4, left femoral neck, left femoral trochanter and left Ward's triangle BMD were increased in both groups ( P <0.05), and the treatment group was higher than the control group ( P <0.05). After treatment, the scores of lumbar back pain, lumbar and knee weakness, tinnitus, lower limb weakness, dizziness, limb numbness and total scores of the two groups were decreased ( P <0.05), and the treatment group was lower than the control group ( P

关 键 词：骨质疏松症 绝经后 骨代谢 氧化应激产物 骨密度 补肾蠲痹汤 中西医结合疗法 

分 类 号：R681.405.8[医药卫生—骨科学]