基于PI3K/Akt信号通路探讨益气温阳活血方对老年肾虚血瘀型骨质疏松患者骨代谢的影响  

Effects of Benefiting-Qi Warming-Yang Activating-blood Prescription on Bone Metabolism in Senile Patients with Renal Deficiency and Blood Stasis Pattern Osteoporosis Based on P13K/Akt Signal Pathway

作　　者：张斌[1] 秦永[1] 范道波 李中连[1] 冯冬前 刘立 李兰亚[1] 葛大伟 ZHANG Bin;QIN Yong;FAN Daobo;LI Zhonglian;FENG Dongqian;LIU Li;LI Lanya;GE Dawei(Orthopedics Department,Shuyang County TCM Hospital,Shuyang 223600,China;Orthopedics,Nanjing Hospital Affiliated to Nanjing Medical University)

机构地区：[1]沭阳县中医院骨伤科,江苏沭阳223600 [2]南京医科大学附属南京医院骨科

出　　处：《西部中医药》2022年第7期68-71,共4页Western Journal of Traditional Chinese Medicine

摘　　要：目的:基于PI3K/Akt信号通路探讨益气温阳活血方对老年肾虚血瘀型骨质疏松患者骨代谢的影响。方法:将老年肾虚血瘀型骨质疏松患者100例随机分为观察组与对照组各50例,对照组予钙尔奇+阿法骨化醇治疗,观察组在对照组治疗的基础上联合益气温阳活血方治疗。治疗前及治疗3个月后,采用双能X线仪检测骨密度(bone mineral density,BMD),酶联免疫吸附法检测骨代谢指标I型胶原羧基端肽β特殊序列(β-terminal cross-linked telopeptides of typeⅠcollagen,β-CTX)及I型前胶原氨基端延长肽(propeptide of type I NT-procollagen,PINP)含量,Western blot法检测外周血单个核细胞中磷酸化PI3K(phosphorylation PI3K,p-PI3K)、磷酸化AKT(phosphorylation AKT,p-AKT)表达量;观察治疗期间不良事件。结果:治疗后两组患者BMD较治疗前升高,观察组高于对照组(P<0.05);治疗后观察组血清β-CTX含量较治疗前及治疗后对照组降低、PINP含量较治疗前及对照组治疗后升高(P<0.05);治疗后观察组外周血p-PI3K、p-AKT表达量较治疗前及对照组治疗后升高(P<0.05),对照组治疗前后外周血p-PI3K、p-AKT表达量比较差异无统计学意义(P>0.05)。结论:益气温阳活血方联合钙尔奇、阿法骨化醇能够增加老年肾虚血瘀型骨质疏松患者骨密度,改善骨代谢,机制可能与激活PI3K/AKT通路有关。Objective:To explore the effects of benefiting-Qi warming-Yang activating-blood prescription on bone metabolism in senile patients with renal deficiency and blood stasis pattern osteoporosis on the foundation of P13K/Akt signal pathway.Methods:All 100 patients were randomized into the observation group and the control group with 50 cases in each group.The control group was treated by caltrate+alfacalcidol,and the observation group took benefiting-Qi warming-Yang activating-blood prescription orally based on the therapy the control group received.BMD was measured by dual-energy X-ray apparatus before treatment and after three months of treatment,the contents of bone metabolism markersβ-CTX and PINP were detected by ELISA method,the expressions of p-PI3K and p-AKT of mononuclear cell in peripheral blood were tested by Western blot,to observe the adverse events during therapeutic period.Results:BMD increased in both groups after the treatment compared with these before treatment,and the observation group was higher than the control group(P<0.05),the contents of serumβ-CTX lowered than before treatment,and the control group after the treatment,the contents of PINP raised compared with before treatment and the control group after the therapy(P<0.05);after the therapy,the expressions of p-PI3K and p-AKT in peripheral blood rose in the observation group compared with these before the treatment and the control group after the treatment(P<0.05),the difference had no statistical meaning in the expressions of p-PI3K and p-AKT in peripheral blood before and after treatment in the control group(P>0.05).Conclusion:Benefiting-Qi warming-Yang activating-blood prescription combined with caltrate and alfacalcidol could increase BMD and improve bone metabolism in senile patients with renal deficiency and blood stasis pattern osteoporosis,and its mechanism might be related to P13K/AKT pathway activation.

关 键 词：骨质疏松症 肾虚血瘀 骨密度 骨代谢 PI3K/AKT通路 益气温阳活血方 

分 类 号：R274[医药卫生—中医骨伤科学]