基于“肝肾同源”理论探究杜仲-续断药对治疗绝经后骨质疏松症的临床疗效  

Exploration on the clinical efficacy of Duzhong-Xuduan Medicinal Pair in the treatment of postmenopausal osteoporosis based on theory of‘liver-kidney homology’

作　　者：郭德华[1] 夏自成 吴成林 许洋 舒志敏 张国福[2] GUO De-hua;XIA Zi-cheng;WU Cheng-lin;XU Yang;SHU Zhi-min;ZHANG Guo-fu(Jiangxi University of Chinese Medicine,Nanchang,Jiangxi,330004 China;Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang,Jiangxi,330006 China)

机构地区：[1]江西中医药大学,江西南昌330004 [2]江西中医药大学附属医院,江西南昌330006

出　　处：《时珍国医国药》2023年第11期2688-2690,共3页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金地区项目(81860856);江西省科学技术厅省临床研究中心项目(20212BCG74004);江西中医药大学校级研究生创新专项资金项目(JZYC21S23);江西省研究生创新专项资金项目(YC2021-S524)。

摘　　要：目的基于“肝肾同补”理论探究杜仲-续断药对治疗绝经后骨质疏松症的临床疗效及其作用机制。方法采用随机对照的临床设计方案,选取120例PMOP患者,按随机数字表法分为对照组57例及观察组63例。对照组运用基础治疗(阿法骨化醇片0.5μg,qd;阿仑磷酸钠片70mg/片,qw;结合运动治疗),观察组在在对照组的基础上加服含“杜仲-续断”药对的中药颗粒剂。治疗3个月后,根据腰椎及髋部骨密度、骨代谢指标和炎症因子评价其两组患者的临床疗效。结果观察组总有效率81%(51/63),显著高于对照组65%(37/57),差异有统计学意义(χ^(2)=3.937,P=0.047)。治疗后,两组患者腰椎及髋部骨密度(Bone Mineral Density,BMD),骨钙素(Bone Gla Protein,BGP)、Ⅰ型原胶原氨基端延长肽(Procollagen I N-Terminal Propeptide,PINP)、胰岛素样生长因子结合蛋白-3(Insulin-like Growth Factor Binding Protein-3,IGFBP-3)水平均显著高于治疗前,观察组以上指标较对同期照组均显著增加,差异均有统计学意义(P<0.05)。治疗后,两组患者Ⅰ型胶原羧基端肽β特殊序列(TypeⅠcollagen Carboxy-Terminal peptideβ-specific sequence,β-CTx)、超敏C反应蛋白(high-sensitivity C-Reactive Protein,hs-CRP)、趋化因子配体3(Chemokine Ligand 3,CCL3)水平均显著低于治疗前,观察组以上指标较对同期对照组均显著下降,差异均有统计学意义(P<0.05)。结论“杜仲-续断”药对治疗PMOP可提高临床疗效,改善患者BMD,可能通过抑制骨吸收、加快骨形成以及降低炎症反应发挥作用。Objective To explore the clinical efficacy and mechanism of Duzhong-Xuduan Medicinal Pair in the treatment of postmenopausal osteoporosis based on theory of‘liver-kidney homology’.Methods 120 patients with PMOP were randomly divided into control group(57 cases)and observation group(63 cases).The control group was treated with basic treatment(alfacalcidol tablets 0.5μg,qd;sodium alendronate tablets 70 mg/tablet,qw;combined with exercise therapy).On the basis of the control group,the observation group was given Chinese medicine granules containing Duzhong-Xuduan Medicinal Pair.After 3 months of treatment,the clinical efficacy of the two groups was evaluated according to bone mineral density of lumbar spine and hip,bone metabolism indexes and inflammatory factors.Results The total effective rate in the observation group was 81%(51/63)higher than that in the control group(65%(37/57)),with statistical significant(χ^(2)=3.937,P=0.047).Compared with before treatment,the levels of BMD,BGP,PINP,IGFBP-3 were significantly increased in both groups after treatment.The a bove indexes in the observation group were significantly higher than those in the control group at the same time,with statistical significant(P<0.05).Compared with before treatment,the levels ofβ-CTx,hs-CRP and CCL3 in the two groups were significantly decreased.The above indexes in the observation group were significantly lower than those in the control group,with statistical significant(P<0.05).Conclusion Duzhong-Xuduan Medicinal Pair can improve the clinical efficacy and BMD of patients with PMOP,which may play a role by inhibiting bone resorption,accelerating bone formation and reducing inflammatory response.

关 键 词：杜仲 续断 骨密度 骨代谢 炎症因子 绝经后骨质疏松 

分 类 号：R285.6[医药卫生—中药学]