补肾通痹汤对绝经后女性骨质疏松症患者骨代谢及血清Ⅰ型胶原羧基端肽β特殊序列、β胶原降解产物的影响  

Effect of Bushen Tongbi Decoction on Bone Metabolism and Serumβ-CTX andβ-Crosslaps in Patients with Osteoporosis

作　　者：李冬萍 包小燕 山永仪 田立 安改芳 LI Dongping;BAO Xiaoyan;SHAN Yongyi;TIAN Li;AN Gaifang(Department of Endocrinology and Metabolic Diseases,The First People's Hospital of Xining,Xining,Qinghai 810001)

机构地区：[1]青海省西宁市第一人民医院内分泌与代谢性疾病科,青海西宁810001

出　　处：《河北中医》2023年第8期1297-1301,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：青海省基础研究计划项目(编号:2020-ZJ-930)。

摘　　要：目的观察补肾通痹汤对绝经后女性骨质疏松症患者骨代谢及血清Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、β胶原降解产物(β-Crosslaps)的影响。方法将88例女性骨质疏松症患者按照随机数字表法分为2组,对照组44例予常规西药治疗,治疗组44例在对照组治疗基础上联合补肾通痹汤中西结合治疗,2组均治疗3个月。比较2组治疗前后腰椎骨密度水平、疼痛分级情况及血清碱性磷酸酶(ALP)、总Ⅰ型胶原氨基酸延长肽(TP1NP)、血清钙(Ca)、骨钙素(OC)、Ⅰ型胶原交联C端肽(CTX-1)、β-CTX及β-Crosslaps、甲状旁腺激素(PTH)、活性维生素D水平的变化,统计治疗期间骨折发生情况。结果2组治疗期间骨折发生率比较差异无统计学意义(P>0.05)。治疗组治疗后L 2、L 3、L 4骨密度水平均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。治疗组治疗后疼痛分级情况较治疗前明显改善(P<0.05),且治疗组治疗后改善情况优于对照组(P<0.05)。治疗组治疗后血清Ca、ALP、TP1NP水平及对照组Ca均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后血清CTX-1、β-CTX、β-Crosslaps水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05),2组治疗后血清OC水平均升高(P<0.05),且治疗组治疗后高于对照组(P<0.05)。2组治疗后血清PTH水平均较本组治疗前降低(P<0.05),且治疗组治疗后低于对照组(P<0.05),2组治疗后血清活性维生素D水平均升高(P<0.05),且治疗组治疗后高于对照组(P<0.05)。结论补肾通痹汤对改善绝经后女性骨质疏松症患者骨代谢情况和疼痛情况具有较好作用,且其血清β-CTX、β-Crosslaps水平与骨代谢水平密切相关,可为临床治疗提供可靠指导依据。Objective To observe the effects of Busshen Tongbi Decoction on bone metabolism,serum type I collagen carboxy-terminal peptideβsequence(β-CTX)andβcollagen degradation products(β-Crosslaps)in female osteoporosis patients.Methods Totally88 female osteoporosis patients were randomized 1∶1 to receive conventional western medicine(control group)or Bushen Tongbi decoction combined with Western medicine(the treatment group)for 3 months.The changes of serum alkaline phosphatase(ALP),total typeⅠcollagen amino acid prolongating peptide(TP1NP),serum calcium(Ca),osteocalcin(OC),typeⅠcollagen cross-linked C-terminal peptide(CTX-1),β-CTX andβ-Crosslaps before and after treatment were compared between the two groups.Results There was no significant difference in the incidence of fracture between groups during treatment(P>0.05).After treatment,the bone mineral density levels of lumbar spine L 2,L 3,and L 4 in the observation group were significantly improved compared with before treatment,and which in the observation group were better than those in the control group(P<0.05).The pain grading in the observation group was significantly improved compared with before treatment,and which was significantly better than the control group(P<0.05).After treatment,the serum ALP,Ca and TP1NP levels in the observation group were significantly lower than before treatment,and the decrease was more significant compared with the control group(P<0.05).The serum CTX-1 andβ-CTX levels of the two groups of patients were significantly lower than before treatment,and which in the observation group were significantly lower than the control group(P<0.05).The serum OC of the two groups were significantly higher than before treatment,and which in the observation group were significantly lower than the control group(P<0.05).The serumβ-Crosslaps and PTH levels in the two groups were significantly lower than before treatment,and the active vitamin D levels were increased.There were significant statistical differences between the two groups in th

关 键 词：补肾 骨质疏松 中药疗法 

分 类 号：R681.405.31[医药卫生—骨科学]