309名强直性脊柱炎患者骨密度、甲状旁腺激素水平及中药治疗前后分析

Investigation and analysis of Chinese medicine for 309 patients with ankylosing spondylitis in bone mineral density and parathyroid hormone

目的:研究强直性脊柱炎(AS)患者骨密度、炎症指标、甲状旁腺激素(PTH)的相关性及中药治疗强直性脊柱炎患者骨质疏松症的疗效评价。方法:研究309名AS患者的骨密度(BMD)、炎症指标、PTH及其相关性,并观察以补肾强督方治疗后各项指标的变化情况。结果:309名AS患者各部位的BMD与血沉(ESR)、C反应蛋白(CRP)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)均呈显著负相关(P<0.001,P<0.05,P<0.01),但未发现PTH与其它指标的相关性。经补肾强督方治疗后各部位骨密度增加(P<0.001,P<0.05),ESR、CRP、IgG、IgA、IgM、PTH均较前显著改善(P<0.001,P<0.01,P<0.05),达AS疗效评价标准(ASAS)20者为70.55%。结论:中药对于AS合并骨质疏松的治疗有效,PTH在AS骨代谢中的机制及作用途径有待于进一步研究。

Objective： To study the bone mineral density（BMD）,inflammatory indexes,PTH of 309 patients with ankylosing spondylitis（AS）,the efficacy evaluation after receiving Bushen Qiangdu Fang treatment,and attempt to provide a new way of TCM treatment of AS patients with osteoporosis.Methods： To study the correlation of BMD,inflammatory indexes,PTH of 309 patients with AS,and observe after application Bushen Qiangdu Fang,detection and evaluating after medication,the change of ASpatients BMD,PTH and CRP,ESR,IgG,IgA,IgM etc,verify the therapeutic effect.Results： The BMD,ESR,CRP,IgG,IgAand IgM of different part of 309 patients with AS are significantly negative correlation（P0.001,P0.05,P0.01）,but this research find no correlation between BMD and the other indexes.This research confirms that after treatment by use of Bushen Qiangdu Fang to patients,overall assessment,spinal pain,BASDAI,BASFI,BASMI significantly improved（P0.001,P0.05,P0.01）,the bone density of each part increase（P0.001,P0.05）,before and after treatment,ESR,CRP,IgG,IgA,IgM,PTH are more significant improvement（P0.001,P0.01,P0.05）.After treatment,it is for 70.55% that reaches ASAS20.Conclusion： The treatment of Chinese herbs is effective for AS with osteoporosis,and they need further study that the mechanism and function approach of PTH the metabolism of bone in AS.