独活寄生合剂治疗绝经后骨质疏松合并膝关节骨性关节炎对骨代谢的影响

Effect of Duhuo Jisheng Mixture on bone metabolism of postmenopausal osteoporosis combined with knee osteoarthritis

目的:观察独活寄生合剂治疗绝经后骨质疏松(Postmenopausal osteoporosis,PMOP)合并膝关节骨性关节炎(Knee-Osteoarthritis,KOA)对骨代谢的影响。方法:60例随机分成治疗组和对照组各30例。对照组予以碳酸钙D3片及盐酸氨基葡萄糖胶囊治疗,治疗组予以独活寄生合剂治疗,4周为一疗程,共2个疗程。观察治疗前后VAS评分、WOMAC评分、中医证候评分及骨代谢指标:抗酒石酸酸性磷酸酶5b(TRACP-5b)、骨碱性磷酸酶(BALP)、I型前胶原氨基端前肽(PINP)的变化。结果:对照组与治疗组总有效率比较差异无统计学意义(P=0.945)。两组VAS评分和WOMAC评分较治疗前均下降(P<0.01)。对照组中医证候积分治疗前后无明显变化,而治疗组治疗后明显下降(P<0.01)。治疗组WOMAC评分、中医证候积分改善明显优于对照组(P<0.01)。治疗后两组骨代谢相关指标TRACP-5b、BALP、PINP均下降(P<0.05),治疗组TRACP-5b、PINP下降更显著(P<0.01),对照组BALP下降更显著(P<0.05)。结论:独活寄生合剂治疗PMOP合并KOA可调节异常骨代谢。

Objective:To observe the effect of Duhuo Jisheng Mixture on bone metabolism of postmenopausal osteoporosis(PMOP)combined with knee osteoarthritis(KOA).Method:60 patients were randomly divided into a treatment group and a control group,with 30 cases in each group.The control group were treated with calcium carbonate D3 tablets and glucosamine hydrochloride capsules while the treatment group were treated with Duhuo Jisheng Mixture.4 weeks was a course of treatment and both groups were treated for a total of 2 courses.The changes of VAS score,WOMAC score,TCM syndrome score and bone metabolism indexes such as anti-tartrate acid phosphatase 5 b(TRACP-5 b),bone alkaline phosphatase(BALP),type I procollagen amino terminal propeptide(PINP)before and after treatment were observed.Result:There was no significant difference in the total effective rate between the control group and the treatment group(P=0.945).Both groups’VAS scores and WOMAC scores after treatment were lower than those before treatment(P<0.01).The TCM syndrome score of the control group had no significant change before and after treatment while that of the treatment group had a significant decrease after treatment(P<0.01).The improvement of WOMAC score and TCM syndrome score of the treatment group was significantly superior to that of the control group(P<0.01).After treatment,TRACP-5 b,BALP,and PINP were decreased in both groups(P<0.05).The TRACP-5 b and PINP of the treatment group decreased more significantly(P<0.01)and the BALP in the control group decreased more significantly(P<0.05).Conclusion:Duhuo Jisheng Mixture could regulate abnormal bone metabolism in the treatment of PMOP combined with KOA.