补肾中药片对围绝经期妇女骨质疏松代谢的影响

Clinical Study on Bone Metabolism and Chinese Medicinal Treatment of Menopausal Osteoporosis

为探讨围绝经期骨质疏松的发生及中西药物的防治作用,对48例围绝经期妇女测定了血清雌酮(E_o)、雌二醇(E_2)、钙(Ca)、磷(P)、碱性磷酸酶(ALP)和空腹尿Ca/肌酐(Cr)比值,以及右侧桡骨骨密度(DMD)值。又将绝经后妇女随机分为补肾中药片治疗组和己烯雌酚治疗组,进行治疗前后自身对照研究。结果表明:绝经后血清E_o、E_2及桡骨BMD值显著降低,血清Ca、ALP及空腹尿Ca/Cr比值升高。补肾中药片治疗组使血清E_o下降E_2升高,己烯雌酚治疗组使血清ALP及空腹尿Ca/Cr比值下降。提示:雌激素缺乏是引起绝经后妇女骨质疏松的主要原因,补肾中药片具有预防和治疗骨质疏松的作用,己烯雌酚具有预防作用,而无治疗作用。

48 perimenopausal women were divided into premenopausal (PrM) and postmenopausal (PoM)groups, which were sub-divided into Chinese medicinal herbs (CM) and DES treatment groups, and 12 middle aged women were served as control. E_0, E_2, T, GH, Ca, P and ALP in the serum and the ratio of Ca/Cr in fasting urine as well as the BMD of right radius was measured. Results showed The E_0, E_2 of the PoM were significantly lower than those of the PrM and control groups (P<0.05, P<0.01), with no remarkable difference in GH; the T value of PoM was lower than that ofcontrol (P<0.01). Serum Ca and ALP and the ratio of Ca/Cr in fasting urine of the PoM were much higher than those of the control (P<0.01); the serum Ca and urinary Ca/Cr of the PrM were higher than those of the control (P<0.05, P<0.01 respectively). The BMD value of the radius of both PoM and PrM groups were much lower than that of control (P<0.01), the BMD of the PoM was lower than that of PrM (P<0.01). The BMD value of the PoM treated with CM for one month rose significantly (P<0.05), the serum E_0 reduced (P<0.05), E_2 and the serum P rose (P<0.05), there were no remarkable differences in serum Ca, ALP and urinary Ca/Cr ratio; In group taken DES, the serum ALP and the ratio of urinary Ca/Cr significantly dropped (P<0.01) and no striking differ-ences in radius BMD value and serum GH, E_0, E_2, and T. Therefore estrogen deficiency was the primary cause of PoM osteoporosis. Serum ALP and the a/Cr ratio in fasting urine could serve as the indexes for early prediagnosis of osteoporosis. Besides, CM could prevent and cure osteopor-osis while DES could prevent but not cure osteoporosis.