不同中医体质体积骨密度及骨代谢指标的定量分析  

Quantitative Analysis of Volume Bone Density and Bone Metabolism Indexes of Different TCM Constitutions

作　　者：梁玉龙 陈涛 富斌[1] 吴梦玮[1] 郭鹏德[1] LIANG Yulong;CHEN Tao;FU Bin;WU Mengwei;GUO Pengde(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing China 100078)

机构地区：[1]北京中医药大学东方医院,北京100078

出　　处：《中医学报》2023年第8期1758-1764,共7页Acta Chinese Medicine

基　　金：北京慢性病防治与健康教育研究会资助项目(MB20220301)。

摘　　要：目的:定量分析9种单一中医体质的体积骨密度(volume bone mineral density,vBMD)及骨代谢指标差异,为骨量异常的临床管理提供参考。方法:纳入45~80周岁的健康体检受试者151例,采集中医体质、vBMD及骨代谢指标,包括骨钙素(osteocalcin,OC)、全段甲状旁腺激素(intact parathyroid hormone,iPTH)、25-羟维生素D 3[25-hydroxy vitamin D 3,25-(OH)D 3]、β-胶原降解产物(β-collagen degradation product,β-CTX)、总I型胶原氨基端延长肽(total typeⅠcollagen terminal extension peptide,Total-P1NP)等。使用倾向性评分匹配控制年龄及性别等混杂因素后,观察9种体质不同骨量的分布特点及vBMD、骨代谢指标的定量差异。结果:特禀质组vBMD高于于非特禀质组(P<0.05);平和质组OC、25-(OH)D 3、β-CTX、Total-P1NP低于非平和质组(P<0.05);阴虚质组iPTH低于非阴虚质组(P<0.05),Total-P1NP高于非阴虚质组(P<0.05);阳虚质组Total-P1NP高于非阳虚质组(P<0.05);血瘀质组OC高于非血瘀质组(P<0.05);特禀质组25-(OH)D 3低于非特禀质组(P<0.05)。相关分析显示:年龄与vBMD呈显著负相关(r s=-0.49,P<0.001),与25-(OH)D 3呈显著正相关(r s=0.31,P<0.001)。结论:平和质、阴虚质、阳虚质、血瘀质及特禀质vBMD及骨代谢指标存在定量差异。Objective:To quantitatively analyze the differences in volume bone mineral density(vBMD)and bone metabolism indexes of nine single TCM constitutions,and to provide reference for the clinical management of abnormal bone mass.Methods:A total of 151 healthy physical examination subjects aged 45-80 years old were enrolled,and TCM physique,vBMD and bone metabolism indexes[osteocalcin(OC),intact parathyroid hormone(iPTH),25-hydroxy vitamin D 3[25-(OH)D 3],β-collagen degradation products(β-collagen)were collected degradation product,β-CTX),Total type I.procollagen n-terminal propeptide[(Total-P1NP),etc.].After using propensity score to match and control for age and sex and other confounding factors,the distribution characteristics of different bone mass and quantitative differences of vBMD and bone metabolism indexes of nine constitutions were observed.Results:The vBMD of the idiotic group was higher than that of the non-endowment group(P<0.05).The flat plasmomes OC,25-(OH)D 3,β-CTX,and Total-P1NP were lower than those in the non-flat plastomics(P<0.05).iPTH was lower in the negative deficiency group than in the non-negative deficiency group(P<0.05),and Total-P1NP was higher than that in the non-negative deficiency group(P<0.05).The total-P1NP in the yang deficiency group was higher than that in the non-yang deficiency group(P<0.05).The OC of blood stasis group was higher than that of non-blood stasis group(P<0.05).The idiotic group 25-(OH)D 3 was lower than the non-specific group(P<0.05).Correlation analysis showed that age was significantly negatively correlated with vBMD(r s=-0.49,P<0.001)and 25-(OH)D 3(r s=0.31,P<0.001).Conclusion:There were quantitative differences in vBMD and bone metabolism indexes of peaceful quality,Yin deficiency,Yang deficiency,blood stasis and idiosyncratic substances.

关 键 词：骨质疏松 体积骨密度 骨代谢 中医体质 骨钙素 全段甲状旁腺激素 25-羟维生素D 3 β-胶原降解产物 总Ⅰ型胶原氨基端延长肽 

分 类 号：R274.39[医药卫生—中医骨伤科学]