双歧杆菌四联活菌联合淫羊藿对骨质疏松患者骨代谢指标的影响  

The effect of Bifidobacterium quadruplex live bacteria combined with Epimedium on bone metabolism indicators in patients with osteoporosis

作　　者：向鹏月 周静娴 吴秋霞 张华[1] 刘璟 马玉婷 XIANG Peng-yue(Jing Men People’s Hospital,Jingchu University of Technology Affiliated Jing Meng People’s Hospital,Jingmen 448000,Hubei,China)

机构地区：[1]荆门市人民医院,荆楚理工学院附属荆门市人民医院,湖北荆门448000

出　　处：《牡丹江医科大学学报》2025年第2期61-66,共6页Journal of Mudanjiang Medical University

基　　金：荆门市科学技术局引导性科研计划项目(2023YDKY016)。

摘　　要：目的评估双歧杆菌四联活菌片联合淫羊藿对骨质疏松症患者骨代谢指标的影响。方法选取2023年8月至2024年8月在荆门市人民医院内分泌科门诊检查或住院的骨质疏松症患者200例,采用随机数字表法随机分为对照组50例及实验A组、B组和C组各50例。对照组患者仅接受常规补钙及维生素D治疗;试验A组患者给予补充钙剂及维生素D基础上加用双歧杆菌四联活菌片治疗;试验B组给予补充钙剂及维生素D基础上加用淫羊藿治疗;试验C组给予补充钙剂及维生素D基础上加用双歧杆菌四联活菌片及淫羊藿治疗。比较四组患者临床疗效、治疗前及治疗6、12个月的骨密度(Bone Mineral Density,BMD)变化、数字评定量表(NRS评分)、骨代谢指标[N-端骨钙素(N-terminal Osteocalcin,N-OC)、总1型胶原氨基端延长肽(total procollagen type I N-peptide,tPINP)、β-胶原特殊序列(β-CrossLaps,β-CTX)、25-羟基维生素D(25-Hydroxyvitamin D,25(OH)D)、骨保护素(Osteoprotegerin,OPG)]、钙磷代谢指标(血钙、血磷)的变化及JAK/STAT信号通路指标[干扰素调节因子1(Interferon Regulatory Factor 1,IRF1)、杨氏蛋白1(Yin Yang 1,YY1)、干扰素γ(Interferon Gamma,IFNG)及催乳素受体(Prolactin Receptor,PRLR mRNA)]。结果实验C组有效率(98%)显著高于对照组(78%),BMD(0.95±0.27)较对照组(0.80±0.28)升高,NRS评分(3.51±0.28)较对照组(5.12±0.48)下降,均有显著差异(P<0.05);在骨代谢指标中实验C组N-OC(14.11±4.13)较对照组(15.88±5.28)下降,tPINP(73.80±2.78)较对照组(64.99±2.08)升高,β-CTX(0.24±0.17)较对照组(0.28±0.18)下降,25(OH)D(19.55±4.33)较对照组(16.31±3.38)升高,OPG(230.68±40.15)较对照组(145.91±31.08)升高,均有显著差异(P<0.05);实验C组血磷(1.27±0.27)较对照组(1.04±0.28)升高,血钙(2.28±0.78)较对照组(2.02±0.68)升高,均有显著差异(P<0.05);在JAK/STAT信号通路指标中实验C组IRF1 mRNA(2.15±0.37)较对照组(1.53±0.28)升高,YY1 mRNA(0.68�Objective To evaluate the effect of Bifidobacterium quadruplex live bacterial tablets combined with Epimedium on bone metabolism indicators in patients with osteoporosis.Methods A total of 200 osteoporosis patients who underwent examination or hospitalization in the endocrinology department of Jingmen People's Hospital from August 2023 to August 2025 were randomly divided into a control group of 50 cases and three experimental groups(A,B,and C)with 50 cases in each group.The control group only received routine calcium supplementation and vitamin D treatment.Experimental Group A received Bifidobacterium quadruplex live bacterial tablets in addition to calcium and vitamin D.Experimental group B received Epimedium in addition to calcium and vitamin D.Experimental group C received both Bifidobacterium quadruplex live bacterial tablets and Epimedium,in addition to calcium and vitamin D.The clinical efficacy,changes in Bone Mineral Density(BMD)before treatment and at 6 and 12 months of treatment,Numerical Rating Scale(NRS)scores,bone metabolism indicators[N-terminal Osteocalcin(N-OC),total collagen type I N-peptide(tPINP),β-CrossLaps(β-CTX),25 hydroxyvitamin D(25(OH)D),osteoprotegerin(OPG)],calcium and phosphorus metabolism indicators(serum calcium,serum phosphorus),and JAK/STAT signaling pathway indicators[Interferon Regulatory Factor 1(IRF1),Yin Yang 1(YY1),interferonγInterferon Gamma(IFNG)and Prolactin Receptor(PRLR mRNA)were compared among the four groups.Results The total effective rate in Experimental Group C reached 98%,with improvements in BMD and NRS scores,bone metabolism indicators(including N-OC,tPINP,β-CTX,25(OH)D,OPG),serum phosphorus and calcium,as well as the expression of JAK/STAT signaling pathway indicators(IRF1,YY1,IFNG and PRLR)showed significant differences compared to other groups(P<0.05).Specifically,the effective rate in Group C(98%)was significantly higher than in the control group(78%).BMD(0.95±0.27)was higher in Group C compared to the control group(0.80±0.28),and NRS scores(3.51±0.28

关 键 词：双歧杆菌四联活菌 淫羊藿 骨质疏松 骨代谢 维生素D 骨保护素 

分 类 号：R259[医药卫生—中西医结合]