温肾健脾、通络壮骨法治疗慢性阻塞性肺疾病继发骨质疏松症疗效观察

Observation of Wenshen Jianpi and Tongluo Zhuanggu therapy on chronic obstructive pulmonary Disease with secondary osteoporosis

目的观察温肾健脾、通络壮骨法治疗慢性阻塞性肺疾病(COPD)继发骨质疏松症(OP)的疗效及对骨密度、肺功能、细胞因子、血钙、血磷、碱性磷酸酶的影响,探讨该法治疗COPD继发骨质疏松症的机制。方法将84例COPD继发骨质疏松症患者随机分为2组,对照组给予氧疗、化痰、解痉平喘、碳酸钙D3片和鲑鱼降钙素常规治疗,治疗组在常规治疗基础上加用温肾健脾、通络壮骨的肉丹汤治疗,观察2组的临床疗效及治疗前后骨密度、肺功能、细胞因子(LI-6、TNF-α)、血钙、血磷、碱性磷酸酶(AKP)的变化。结果治疗组有效率明显高于对照组(P<0.05)。治疗后2组IL-6及血钙水平与治疗前比较差异无统计学意义(P>0.05);2组肺功能及TNF-α、AKP水平均较治疗前明显改善(P均<0.05),且治疗组上述各指标改善情况均明显优于对照组(P均<0.05)。结论温肾健脾、通络壮骨的肉丹汤治疗COPD继发骨质疏松症疗效好,可增加骨密度、改善肺功能,降低TNF-α和血清AKP水平可能是其发挥临床治疗效果的作用机制。

Objective It is to observe the effect of Wenshen Jianpi and Tongluo Zhuanggu therapy on chronic obstructive pulmonary disease（ COPD） with secondary osteoporosis（ OP）,and on bone mineral density and pulmonary function,cellular factor,blood calcium,phosphorus,alkaline phosphatase（ AKP）,thus to explore the possible treatment mechanism for COPD with OP. Methods 84 patients with COPD and secondary OP were randomly divided into control group and treatment group,the control group was given routine medication（ oxygen therapy,expectorant,antispasmodic and asthma,calcium D3 tablets and salmon calcitonin）,the treatment group was given Wenshen Jianpi and Tongluo Zhuanggu therapy on the basis of treatment in control group. The clinical efficacy and the changes of bone mineral density and pulmonary function,IL-6,TNF-α,serum calcium,phosphorus,AKP before and after treatment in both groups were observed. Results The effective rate in the treatment group was higher than that in the control group（ P0. 05）. The levels of IL-6 and blood calcium didn＇t change much after treatment compared with that before treatment in both groups,the differences were not significant（ P0. 05）. Pulmonary function and the levels of TNF-α and AKP were significantly improved after treatment in both groups,and the improvements of every indexes in treatment group were better than those in control group（ P0. 05）. Conclusion Wenshen Jianpi and Tongluo Zhuanggu therapy has a good curative effect on COPD with secondary OP,which can increase bone density and improve lung function,reducing the levels of cytokine TNF-α and serum AKP and etc,and these effects may be one important mechanism of its clinical effects.