补肾壮骨汤对膝骨关节炎患者t-PINP、β-CTX的影响  

Effects of Bushen Zhuanggu decoction on t-PINP andβ-CTX in patients with knee osteoarthritis

作　　者：邵旭华 陈志明 魏杰 许一帆 李少华 SHAO Xuhua;CHEN Zhiming;WEI Jie;XU Yifan;LI Shaohua(Department of Orthopedics and Traumatology,Hangzhou Linping District Hospital of Traditional Chinese Medicine,Hangzhou 311106,Zhejiang,China)

机构地区：[1]杭州市临平区中医院骨伤科,浙江杭州311106

出　　处：《中国现代医生》2025年第10期47-51,共5页China Modern Doctor

摘　　要：目的探讨补肾壮骨汤对膝骨关节炎(knee osteoarthritis,KOA)患者总Ⅰ型前胶原氨基端前肽(total N-terminal propeptide of typeⅠprocollagen,t-PINP)、β-Ⅰ型胶原C末端肽(β-C-terminal telopeptide of typeⅠcollagen,β-CTX)的影响。方法选取2021年6月至2024年4月于杭州市临平区中医院诊治的120例肝肾亏虚型KOA患者,根据随机数字表法将其分为研究组和对照组,每组60例。对照组患者给予依托考昔和奥美拉唑口服治疗,研究组患者在对照组基础上给予补肾壮骨汤口服治疗,两组患者均持续治疗1个月。比较两组患者的临床疗效、中医证候积分、血清t-PINP和β-CTX水平、t-PINP/β-CTX、西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and Mcmaster Universities osteoarthritis index,WOMAC)评分及治疗期间的不良反应。结果研究组患者的总有效率显著高于对照组(χ^(2)=4.513,P=0.034);治疗后,两组患者的中医证候积分、血清t-PINP和β-CTX水平、WOMAC各维度评分均显著低于本组治疗前,t-PINP/β-CTX均显著高于本组治疗前(P<0.05),研究组患者的中医证候积分、血清t-PINP和β-CTX水平、WOMAC各维度评分均显著低于对照组,t-PINP/β-CTX显著高于对照组(P<0.05)。两组患者的不良反应发生率比较差异无统计学意义(χ^(2)=0.686,P=0.408)。结论补肾壮骨汤可提高肝肾亏虚型KOA患者的临床疗效,缓解临床症状和疼痛,升高t-PINP/β-CTX,且不良反应发生率低。Objective To investigate the effects of Bushen Zhuanggu decoction on total N-terminal propeptide of typeⅠprocollagen(t-PINP)andβ-C-terminal telopeptide of typeⅠcollagen(β-CTX)in patients with knee osteoarthritis(KOA).Methods A total of 120 patients with liver-kidney deficiency KOA treated in Linping District Hospital of Traditional Chinese Medicine from June 2021 to April 2024 were selected and divided into study group and control group according to random number table method,with 60 cases in each group.The patients of control group was given oral treatment with etocoxib and omeprazole,and patients of study group was given oral treatment of Bushen Zhuanggu decoction on the basis of control group.Both groups were treated for one month.The clinical efficacy,TCM syndrome scores,serum t-PINP andβ-CTX leves,t-PINP/β-CTX,Western Ontario and Mcmaster Universities osteoarthritis index(WOMAC)scores and adverse reactions during treatment were compared between two groups.Results The total effective rate in study group was significantly higher than that in control group(χ^(2)=4.513,P=0.034).After treatment,the TCM syndrome scores,serum t-PINP andβ-CTX levels and WOMAC scores in two groups were significantly lower than before treatment,and t-PINP/β-CTX were significantly higher than before treatment(P<0.05).The TCM syndrome scores,serum t-PINP andβ-CTX levels and WOMAC scores in study group were significantly lower than those in control group,and t-PINP/β-CTX was significantly higher than that in control group(P<0.05).There was no significant difference in incidence of adverse reactions between two groups(χ^(2)=0.686,P=0.408).Conclusion Bushen Zhuanggu decoction can improve the clinical efficacy of KOA patients with liver-kidney deficiency,relieve clinical symptoms and pain,increase t-PINP/β-CTX,and reduce the incidence of adverse reactions.

关 键 词：膝骨关节炎 补肾壮骨汤 总Ⅰ型前胶原氨基端前肽 β-Ⅰ型胶原C末端肽 

分 类 号：R684.3[医药卫生—骨科学]