男性原发性骨质疏松症中医证型的实质探讨  

Study on the Essential of Senile Primary Osteoporosis Diagnosed in Traditional Chinese Medicine

作　　者：张俐[1] 王占朝[1] 张安桢[1] 

机构地区：[1]福建中医学院骨伤系,福建福州350003

出　　处：《中国中医骨伤科杂志》2004年第3期1-5,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：福建省自然基金项目 ;编号 :C960 45

摘　　要：目的 :探讨男性原发性骨质疏松症中医证型的实质。方法 :男性原发性骨质疏松症患者按中医临床辩证分型为肾阳虚型、肾阴虚型和非肾虚型。采用回归和判别分析法来研究骨密度、血清激素、血生化、血清微量元素、尿生化等指标与中医证型的相关性 ,探讨其中医证型的实质。结果 :男性原发性骨质疏松症患者睾酮 (T)、血清降钙素 (CT)、铜 (Cu)值显著降低 ;肾阴虚组、肾阳虚组骨钙素 (BGP)值均显著高于对照组和非肾虚组 ;CT值于各组之间差别显著 ,其中非肾虚组CT值显著低于正常对照组 ,肾阴虚组、肾阳虚组CT值均非常显著低于对照组 ;甲状旁腺激素的羧基端片段 (PTH -c)值于各组之间差别显著 ,肾阴虚组、肾阳虚组PTH -c值均非常显著低于对照组和非肾虚组 ,其中肾阳虚组还显著低于肾阴虚组 ;雌二醇 (E2 )值于各组差别显著 ,其中非肾虚组显著低于正常对照组 ,肾阴虚组、肾阳虚组非常显著低于对照组。结论 :男性原发性骨质疏松症患者钙丢失、骨丢失明显加快 ,而骨形成并没有加快。肾虚与非肾虚划分的生化基础为T和尿钙 /肌酐 (Ca/Cr) ;男性原发性骨质疏松症的中医证型与骨代谢生化指标有密切相关 ,骨代谢生化指标的改变是辩证分型的基础。Objective:To establish different diagnosis of Traditional Chinese Medicine on senile primary osteoporosis and to examine relative biochemical indexes for essential of it. Methods:56 cases of senile patients suffering primary osteoporosis are differentially diagnosed as deficiency of kidney-yang, deficiency of kidney-yin and no asthenia of kidney. 16 cases are as controls. Serum AKP、Ca、Mg、P、Cu、BGP、CT、PTH-c、E2、T、 urinous Ca and Cr are examined in all cases. The diagnostic equation and relative biochemical indexes of bone metabolism will be further established for the differential diagnosis of senile primary osteoporosis. Results:1.There are significantly differences in serum T、CT、Cu among senile primary osteoporosis (P<0.01). 2. Serum BGP increased significantly among patients with deficiency of kidney-yin and yang (P<0.01). 3.There is significantly difference with serum CT among all patients (P<0.01). Conclusions:1. Senile osteoporosis is mainly relative to the degenerative function of organ and also to the decrease of male hormone. 2.There are significantly decreases with serum Ca and bone density but no further bone formation among senile primary osteoporosis patients. 3.The biochemical basic of senile osteoporosis are serum T and urinous Ca / Cr. 3.The biochemical factors of bone metabolism are important for diagnosis、differential diagnosis and category by differentiation of symptoms and signs in order to prevent osteoporosis and treatment.

关 键 词：男性原发性骨质疏松症 中医证型 骨密度 血清激素/微量元素 血/尿生化 

分 类 号：R681[医药卫生—骨科学]