中药膏方联合火针治疗绝经后骨质疏松症的临床疗效及对血清白细胞介素6、骨保护素水平的影响

Observation of TCM mastic combined with heat- needle on the treatment of postmenopausal osteoporosis and its effects on serum interleukin 6 and osteoprotegerin

目的观察中药膏方联合火针治疗绝经后骨质疏松症(PMOP)的临床疗效及对血清白细胞介素6(IL-6)、骨保护素(OPG)水平的影响,探讨其作用机制。方法将90例PMOP患者随机分为3组。联合组30例,予中药膏方联合火针治疗;膏方组30例,单纯予中药膏方治疗;对照组30例,予碳酸钙D3片治疗。3组均以1个月为1个疗程,共治疗3个疗程后统计疗效。观察比较3组治疗前及治疗1、3个月后视觉模拟疼痛评分法(VAS)变化,治疗前及治疗3个月后骨密度T值及血清IL-6、OPG水平变化。结果联合组总有效率93.3%,膏方组总有效率86.6%,对照组总有效率60.0%,膏方组及联合组总有效率均高于对照组(P<0.05),膏方组与联合组之间疗效相当(P>0.05);3组治疗1、3个月后VAS评分较本组治疗前均降低(P<0.05),治疗3个月后降低更明显(P<0.05),且膏方组及联合组评分均低于对照组同期(P<0.05),膏方组与联合组之间VAS评分相当(P>0.05);3组治疗3个月后骨密度T值较本组治疗前均升高(P<0.05),IL-6及OPG水平下降(P<0.05),且膏方组及联合组治疗3个月后骨密度T值均高于对照组(P<0.05),IL-6及OPG水平低于对照组(P<0.05),膏方组与联合组之间骨密度T值相当(P>0.05),但联合组IL-6及OPG水平较膏方组更低(P<0.05)。结论中药膏方联合火针治疗PMOP临床疗效确切,可明显改善患者的临床症状,缓解疼痛,提高骨密度,其作用机制可能与降低血清IL-6及OPG水平有关。

Objective To observe the clinical effects of traditional Chinese medicine（ TCM） mastic combined with heat- needle on the treatment of postmenopausal osteoporosis（ PMOP） and its effects on serum interleukin6（ IL- 6） and osteoprotegerin（ OPG）,and to investigate the action mechanism. Methods 90 PMOP patients were randomly divided into three groups. 30 patients in combination group were treated by TCM mastic combined with heat- needle. 30 patients in mastic group were treated by TCM mastic,and 30 patients in control group were treated by calcium carbonate D3 tablets. The treatment course was one month in three groups,and the curative effect was evaluated after three courses. The visual analogue scale（ VAS） before,one and three months after treatment were observed in three groups,as well as the T values of bone mineral density（ BMD） and the levels of serum IL- 6 and OPG before and three months after treatment. Results The total effective rate in combination,mastic and control group was 93. 3%,86. 6% and 60. 0%,respectively. The total effective rate in combination and mastic group was higher than that in control group（ P 〈 0. 05）,and the combination group and mastic group had same efficacy（ P 〉0. 05）. The scores of VAS one and three months after treatment were decreased in three groups as compared with those in before treatment（ P 〈 0. 05）,and the decrease in three months after treatment was more obvious（ P 〈 0. 05）.The VAS scores of in mastic and combination group were lower than those in control group at the same period（ P 〈0. 05）,and the combination group and mastic group had same scores（ P 〉 0. 05）. The T values of BMD three months after treatment were increased in three groups（ P 〈 0. 05）,and the increase in combination and mastic group was higher than that in control group（ P 〈 0. 05）,the combination and mastic group had same T values（ P 〉 0. 05）. The levels of IL- 6 and OPG were decreased after three months in three groups（ P 〈 0. 05）,and the decrease in combination and mastic group was lower than that in control group（ P 〈 0. 05）. The levels of IL- 6 and OPG in combination group were lower than those in mastic group（ P 〈 0. 05）. Conclusion TCM mastic combined with heat- needle has exact effect on PMOP,can significantly improve the clinical symptoms,relieve pain and enhance BDM,which may related with the decrease of serum IL- 6 and OPG.