加味青娥丸对绝经后骨质疏松症患者的骨密度、骨代谢标志物及血清MGP水平的影响

Effects of Modified Qing'e Pills on Bone Mineral Density,Bone Metabolic Markers and Serum MGP Level in Postmenopausal Osteoporosis Women

目的:观察加味青娥丸对绝经后骨质疏松症(PMOP)患者基质gla蛋白(MGP)水平、骨密度(BMD)及骨代谢指标的影响。方法:选择PMOP患者108例,随机分为A组(安慰剂对照组)、B组(加味青娥丸低剂量组)及C组(加味青娥丸高剂量组),治疗24周。另取26名BMD正常绝经妇女作为正常组。分别在治疗前与治疗24周后,采用酶联免疫吸附实验(ELISA)测定MGP水平,通过聚合酶链式反应(PCR)检测血清MGP mRNA水平,化学发光检测血清Ⅰ型胶原羧基端肽(β-CTX)、血清Ⅰ型前胶原N-端前肽(P1NP)水平,双能X线吸收法(DEXA)测定腰椎正位、股骨颈、Ward's三角和大粗隆的BMD。结果:治疗后C组与B组均能增加血清MGP水平及MGPmRNA的表达(P<0.05或P<0.01),而A组和正常组指标变化不明显(P>0.05)。治疗后C组与B组BMD均有不同程度的提高(P<0.05),C组对股骨颈及Ward’s三角的效果更为显著,A组和正常组BMD均下降,差异无统计学意义(P>0.05)。C组能显著降低血清中的骨代谢标志物(PINP,CTX)(P<0.01),而B组仅对β-CTX有降低作用(P<0.05);A组则无明显作用(P>0.05)。结论:加味青娥丸能够提高血清MGP水平及MGP mRNA的表达,增加PMOP的BMD,降低患者骨代谢标志物,并且其效果跟用药剂量正相关。

Objective：To study the effects of Modified Qing＇e Pills on serum MGP level,bone mineral density and bone metabolic markers in women with postmenopausal osteoporosis.Methods：108postmenopausal osteoporosis patients were randomly divided into group（Placebo control group）,B group（Modified Qing＇e Pills lower dose group）and C group（Modified Qing＇e Pills higher dose group）.All the patients in three groups received treatment for 24 weeks.Another 26 women with normal BMD were assigned to normal group.Before and after the treatment for 24 weeks,serum MGP was measured by enzyme-linked immunosorbent assay（ELISA）while MGP mRNA was measured by Fluorescent real-time quantitative polymerase chain reaction（PCR）.The serum levels ofβ-CTX、P1NP were measured by electrochemiluminescence（ECL）.BMD was analyzed by dual energy X-ray absorptiometry（DXA）.Results：After 24 weeks treatment,MGP and MGP mRNA were improved obviously in C group and B group（P〈0.05 or P〈0.01）,while no obvious changes of MGP and MGP mRNA in normal group and A group（P〈0.05）.The BMD of C group and B group were all improved significantly（P〈0.05）,and the BMD of C group in femoral neck and Ward＇s triangle increased more significantly（P〈0.01）.The BMD of normal group and A group were decreased.All the bone metabolism markers of C group reduced obviously（P〈0.05）,whereas only the bone absorption markerβ-CTX decreased in B group（P〈0.05）.The normal group and A group had no obvious clinical effects（P〈0.05）Conclusion：Modified Qing＇e Pills can benefit postmenopausal osteoporosis patients through improving the serum MGP levels and MGP mRNA expression,increasing bone mineral density and inhibiting bone metabolism.