中药龟丝补骨片对绝经后早期妇女骨转换指标和骨密度的影响

Changes in biochemical markers of bone turnover and bone mass density in early postmenopausal women before and after treatment with GuiSiBu Tablet

目的 从中医“肾虚”理论出发 ,观察中药龟丝补骨片对绝经后早期妇女骨转换指标和骨密度的影响。方法 将 6 3例 4 0岁以上的自然绝经 1年以上但不超过 5年的健康妇女 ,先完成中医肾虚证症状量化表调查、并采用DEXA测量BMD ,根据骨密度值T score低于 2 0为标准分为绝经后骨质疏松症组 (OP)和非骨质疏松症组 (NO) ,依就诊次序按 1∶2比率序贯进入尼尔雌醇组 (n)和龟丝补骨片组 (g)。单盲观察尼尔雌醇和龟丝补骨片的治疗作用 6个月。成功随访率达 93 6 5 %。治疗前和后第 3、6个月分别检测骨转换标志物血清BGP和尿Dpd/Cr,治疗结束时复查BMD。结果 采用龟丝补骨片治疗后 ,第 6个月无论NO组还是OP组 ,血清BGP水平均显著升高 ;尿Dpd/Cr比值更早、更显著地降低 ,在OP组治疗第 3、6个月时降低分别有显著和极显著性意义 ,OP g组尿Ca2 + /Cr排出明显下降。干预治疗第 6个月 ,龟丝补骨片和尼尔雌醇都有增加骨量的作用 ,各组BMD都有不同程度的升高 ;且发现对治疗的反应性似乎骨质疏松者比非骨质疏松者好 ,腰椎较股骨好 ,其中椎体部分最好 ,股骨颈最差。结论 龟丝补骨片具有保护绝经早期妇女的骨丢失作用 ,我们认为 ,这一保护作用主要与抑制骨吸收、促进骨形成有关。

Objective To study the effectiveness of GuiSiBu tablet(Tab.GSB), a traditional Chinese herb preparation,on biochemical markers of bone turnover and bone mass density(BMD) in early postmenopausal women.Methods Sixty-three early postmenopausal women aged 40-55 years were selected to participate in bone mass detection by DEXA,and completed a questionnaire of SHEN-XUN scale(QSXS),and divided randomly into 4 groups according to the T-Score <2.0 SD:non-osteoporosis treated with nylestriol(NO-n), non-osteoporosis treated with Tab.GSB(NO-g), osteoporosis treated with nylestriol (OP-n),osteoporosis treated with Tab.GSB(OP-g). Serum levels of bone Gla protein(BGP) and urinary excretion of deoxypyridinoline(Dpd) were measured before and after 3, 6 months of medication, respectively,and lumbar spinal and femoral BMD were examined again after 6 months treatment.Results Tab.GSB significantly decreased urinary Dpd/Cr in NO-g and OP-g groups (P<0.05, 0.01, respectively), and increased markedly serum BGP level (P<0.05) after 6 months of treatment. Otherwise, Tab.GSB significantly increased the BMD at LatL2-4 of spinal (P<0.05-0.005) and at Total of femur(P<0.05), and had a tendency to increase the BMD at other sites or only increased markedly in group OP-g. Conclusion Tab. GSB could prevent bone loss by decreasing bone turnover in early postmenopausal osteoporotic women.