中药龟丝补骨片对绝经后早期妇女性激素和钙调节激素的影响

Changes in sex hormones and calcium regulating hormones in early postmenopausal women before and after treatment with GuiSiBu tablet

目的 观察中药龟丝补骨片对绝经后早期妇女性激素和钙调节激素的影响 ,以中医“肾虚”理论探讨其防治绝经后骨质疏松症的作用机制。方法 将 6 3例 4 0岁以上的自然绝经 1年以上但不超过 5年的健康妇女 ,根据骨密度值T Score低于 - 2 0为标准分为绝经后骨质疏松症组(OP)和非骨质疏松症组 (NO) ,并依就诊次序按 1:2比率序贯进入尼尔雌醇组 (n)和龟丝补骨片组(g)。单盲观察尼尔雌醇和龟丝补骨片的治疗作用 6个月。治疗前和后第 3、6个月分别完成中医肾虚证症状量化表调查 ,并检测血清性激素、促性腺激素和钙调节激素。成功随访率达 93 6 5 %。结果 龟丝补骨片对肾阴虚证和肾气虚证均有较好的改善作用 ,且似乎对减轻肾阴虚证更有效。同时发现龟丝补骨片具有类似雌激素样作用 ,同尼尔雌醇相似 ,可显著提高E2 T比值 ;此外 ,龟丝补骨片对血清PTH和CT水平均有增加趋势 ,PTH CT比值于治疗后第 6个月时显著下降 ;血清 2 5 -OH -VD3和钙水平明显增加、ALP水平明显下降。结论 龟丝补骨片具有促进钙代谢、调整钙调节激素的作用 。

Objective\ To study the effectiveness of GuiSiBu tablet (GSB),a traditional Chinese herb preparation,in treating SHEN XU(insufficiency of kidney in traditional Chinese medicine)of early postmenopausal women. Methods\ Sixty three early postmenopausal women aged 40-55 years were selected to undergo bone mass detection by DEXA,completed a questionnaire of SHEN XU scale(QSXS),and were divided randomly into 4 groups accoridng to the T Score<2 0 SD :non osteoporosis treated with nylestriol(NO-n),non osteoporosis treated with GSB(NO g),osteoporosis treated with nylestriol(OP-n),and osteoporosis treated with GSB(OP-g).QSXS was assessed and serum levels of sex hormones including estradiol(E 2),testosterone(T),FSH,LH,and calcium regulating homones including calcitolnin(CT),parathyroid hormone(PTH),25 OH VD3 were measured before and after 3,6 months of medication,respectively. Results\ GSB significantly improved scale of SHEN XU,had estradiol like effects,and like nylestriol,increased E 2/T ratio in all groups.After 6 months of treatment,GSB significantly increased serum CT,25 OH VD 3 and Ca 2+ ,and decrased markedly serum PTH/CT ratio and ALP level. Conclusion\ GSB may have estradiol like effects,enhance Ca 2+ metabolism and accommodate calcium regulating hormones,and prevent postmenopausal osteoporosis.\;