维、汉族绝经后妇女骨质疏松症中医辨证分型与骨密度相关分析

Correlation between TCM differentiation syndrome and BMD in Xinjiang Uyghur and Han

目的探讨不同中医证型间维吾尔族和汉族绝经后妇女的一般情况及骨密度(BMD)水平是否存在差异。方法 2011年1月-2013年2月,选择在新疆地区长期居住的绝经后汉族和维吾尔族妇女,经骨密度检测和临床表现确诊为绝经后骨质疏松症患者为研究对象共计346例,汉族178例,维吾尔族168例。中医辨证分为肾虚血瘀型、非肾虚血瘀型两大证型,其中将非肾虚血瘀型再分为脾肾两虚、肝肾阴虚、肾精亏虚型3型。分别测量身高、体质量,计算体质指数,进行腰椎正侧位骨密度检测,并进行分析。结果维吾尔族女性绝经后骨质疏松症患者绝经年龄及发病年龄小于汉族患者,体质指数及生育数均大于汉族患者(P<0.05);两者骨密度T值评分差异无统计学意义(P>0.05)。中医分型:肾虚血瘀型及非肾虚血瘀型绝经后骨质疏松患者年龄、体质指数、绝经年龄、生育数、骨密度值差异均无统计学意义(P>0.05),进一步分为肾虚血瘀和非肾虚血瘀型(肾精亏虚、脾肾两虚、肝肾阴虚)4型后,年龄、体质指数、绝经年龄、生育数、骨密度值等分布差异亦均无统计学意义(P>0.05)。结论新疆维、汉族绝经后骨质疏松症患者骨密度水平无差异,中医证型分布中,以肾虚血瘀型患者为多,而肾虚血瘀与非肾虚血瘀患者间BMD无明显差异,尚不能简单地通过BMD的测定值作为中医辨证分型的依据。

Objective To explore the differences in general condition and level of bone mineral density in TCM syndrome types between Uyghur and Han postmenopausal women. Methods To choose 346 Han and Uyghur women after menopause who have lived in Xinjiang for a long time from January 2011--Febru- ary 2013. Having detected the bone density and undergone diagnosis of clinical performance,these patients with postmenopausal osteoporosis were identified as the research object. Then they were given a series of tests, such as measuring weight, calculating body mass index, testing the positive and side of the lumbar bone mineral density and the data was to be recorded for further analysis. Results The menopausal age and age of occurrence of Uyghur female patients with postmenopausa｜ osteoporosis were younger than the their Han counterparts, Body mass index （BMI） and births were greater than the Han patients （P d0. 05） ; The bone mineral density T value score was no statistical difference （P ~0.05）. Classification： From TCM different syndromes, they were divided into two groups-the Kidney deficiency and blood stasis type and the Kidney and blood stasis type. There was no significant statistical difference （P ~0.05） in age, body mass index, age of menopause, births number, the bone mineral density values between the two groups. When they were further divided into another two groups-Kidney deficiency and blood stasis and Kidney and blood stasis type （Kidney essence deficiency, Spleen and kidney deficiency, Liver and kidney deficiency）, age, body mass index, age of menopause, birth number and density had no significant statisti- cal difference either （P ~ 0.05）. Conclusion There was no difference in bone density level between Uyghur and Han women with postmenopausal osteoporosis. The other differences, influenced by the re- gion, sports, genetic factors remain to be further probed. In this study, kidney and blood stasis type was the main TCM syndrome type, and between kidney deficiency and blood stasis and kidney and blood stasis patients, there was no statistically significant difference. Furthermore, BMD measurement can not simply be served as the basis of the type-identification of traditional Chinese medicine.