自拟补肾潜阳汤联合阿仑膦酸钠维D3治疗骨质疏松症疗效及对骨代谢和TMAO-NF-κB/NFATc1通路影响分析  

Analysis of Efficacy of Self-Formulated Bushen Qianyang Decoction Combined with Alendronate Sodium and Vitamin D3 in Treating Osteoporosis and Its Effect on Bone Metabolism and TMAO-NF-κB/NFATc1 Pathway

作　　者：林伟 章建卫[1] 黄志明[1] LIN Wei;ZHANG Jianwei;HUANG Zhiming(Taizhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenling 317500 Zhejiang,China)

机构地区：[1]台州市中西医结合医院,浙江温岭317500

出　　处：《广州中医药大学学报》2025年第1期108-115,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:82004433);浙江省温岭市科技计划项目(编号:2019S0180036)。

摘　　要：【目的】分析自拟补肾潜阳汤联合阿仑膦酸钠维D3治疗骨质疏松症(osteoporosis,OP)的疗效及其对骨代谢和氧化三甲胺(TMAO)-核因子κB(NF-κB)/活化T细胞核因子c1(NFATc1)通路的影响。【方法】将2021年1月至2023年1月在台州市中西医结合医院就诊的102例脾肾阳虚型OP患者按随机数字表法随机分为观察组和西药组,每组各51例。西药组给予阿仑膦酸钠维D3治疗,观察组在西药组的基础上给予自拟补肾潜阳汤治疗,疗程为12周。观察2组患者治疗前后中医证候积分、Oswestry功能障碍指数(ODI)评分、疼痛程度视觉模拟量表(VAS)评分、骨代谢指标及TMAO-NF-κB/NFATc1通路相关因子水平的变化情况,评价2组患者的临床疗效和用药安全性。【结果】(1)治疗12周后,观察组的总有效率为96.08%(49/51),西药组为78.43%(40/51),组间比较(χ^(2)检验),观察组的疗效明显优于西药组(P<0.01)。(2)治疗后,2组患者的腰背冷痛、酸软乏力、少气懒言、头昏目眩等中医证候积分均较治疗前降低(P<0.05),且观察组的降低幅度均明显优于西药组(P<0.01)。(3)治疗后,2组患者的ODI评分和疼痛程度VAS评分均较治疗前降低(P<0.05),且观察组的降低幅度均明显优于西药组(P<0.01)。(4)治疗后,2组患者的血清骨钙素(BGP)水平均较治疗前升高(P<0.05),血清总Ⅰ型原胶原氨基端延长肽(PINP)、β胶原降解产物(β-CTX)水平均较治疗前降低(P<0.05),且观察组对血清BGP水平的升高幅度及对血清PINP、β-CTX水平的降低幅度均明显优于西药组(P<0.01)。(5)治疗后,2组患者的血清TMAO、NF-κB、NFATc1水平均较治疗前降低(P<0.05),且观察组的降低幅度均明显优于西药组(P<0.01)。(6)观察组的不良反应总发生率为5.88%(3/51),西药组为9.80%(5/51),组间比较,差异无统计学意义(P>0.05)。【结论】自拟补肾潜阳汤联合阿仑膦酸钠维D3治疗脾肾阳虚型OP患者疗效确切,可有效缓解腰背冷痛�Objective To analyze the efficacy of self-formulated Bushen Qianyang Decoction combined with alendronate sodium and vitamin D3 in treating osteoporosis(OP)and to observe its effect on bone metabolism and trimethylamine oxide(TMAO)-nuclear factorκB(NF-κB)/activated T nuclear factor c1(NFATc1)pathway.Methods A total of 102 cases of patients with OP of spleen and kidney yang deficiency type who admitted to Taizhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to January 2023 were randomly divided into an observation group and a western medicine group according to the random number table method,51 cases in each group.The western medicine group was treated with alendronate sodium and vitamin D,and the observation group was treated with self-formulated Bushen Qianyang Decoction on the basis of treatment for the western medicine group,and the course of treatment covered for 12 weeks.The changes of traditional Chinese medicine(TCM)syndrome score,Oswestry Disability Index(ODI)score,pain visual analogue scale(VAS)score,bone metabolism indicators,and levels of TMAO-NF-κB/NFATc1 pathway related factors before and after treatment in the two groups were observed.Moreover,the clinical efficacy and medication safety of the two groups were evaluated.Results(1)After 12 weeks of treatment,the total effective rate of the observation group was 96.08%(49/51),and that of the western medicine group was 78.43%(40/51).The intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the western medicine group(P<0.01).(2)After treatment,the two groups presented the decreased scores of TCM symptoms such as cold pain in the lower back,soreness and fatigue,shortness of breath and reluctance to talk,vertigo and dizziness when compared with those before treatment(P<0.05),and the decrease of TCM syndrome scores in the observation group was significantly superior to that in the western medicine group(P<0.01).(3)After treatment,the ODI

关 键 词：自拟补肾潜阳汤 阿仑膦酸钠维D3 骨质疏松症 骨代谢 氧化三甲胺 核因子κB 活化T细胞核因子c1 TMAO-NF-κB/NFATc1通路 

分 类 号：R274.9[医药卫生—中西医结合]