补肾健脾方联合钙尔奇D对绝经后乳腺癌合并骨质疏松患者骨密度和骨代谢的影响

Effects of the Bushen Jianpi Formula and Caltrate D on Bone Mineral Density and Bone Metabolism in the Patients of Postmenopausal Breast Cancer and Osteoporosis

目的探讨补肾健脾方联合钙尔奇D对绝经后乳腺癌合并骨质疏松患者骨密度和骨代谢的影响。方法自2015年1月—2016年1月,前瞻性收集我院收治的绝经后乳腺癌合并骨质疏松患者100例,将患者随机分为治疗组和对照组,每组各50例。治疗组给予补肾健脾方联合钙尔奇D治疗,对照组仅给予钙尔奇D治疗。观察两组患者股骨颈骨密度、降钙素、碱性磷酸酶、骨钙素、抗酒石酸酸性磷酸酶5b、转化生长因子-β1和Ⅰ型胶原羧基末端肽治疗前后变化情况。结果两组患者治疗前骨密度水平差异无统计学意义(P=0.729)。与对照组比较,治疗3个月和6个月后治疗组骨密度显著增加(P=0.016)。两组患者治疗前、后碱性磷酸酶、转化生长因子-β1和Ⅰ型胶原羧基末端肽等差异均无统计学意义(P>0.05)。两组患者治疗前降钙素、骨钙素和抗酒石酸酸性磷酸酶5b等差异无统计学意义(P>0.05)。但与对照组比较,治疗后6个月时治疗组患者降钙素显著增加(P=0.005);骨钙素显著增加(P=0.000);抗酒石酸酸性磷酸酶5b显著降低(P=0.000)。结论与对照组比较,补肾健脾方联合钙尔奇D有助于改善绝经后乳腺癌合并骨质疏松患者骨密度和骨代谢相关指标。

Objective To discuss the effects of bushen jianpi formula and Caltrate D on bone mineral density and bone metabolism in the patients of postmenopausal breast cancer and osteoporosis. Methods From January 2015 through to January 2016,100 patients of postmenopausal breast cancer and osteoporosis were collected prospectively in the hospital. They were randomized into a treatment group and a control group,50 cases in each one. In the treatment group,the combined medication of bushen jianpi formula and Caltrate D was used. In the control group,Caltrate D was prescribed. The density of femoral neck,calcitonin,osteocalcin,alkaline phosphatase（ AKP）,tartrate resistant acid phosphatase 5 b（ TRACP-5 b）,TGF β-1 and collagen carboxy terminal peptide of type I（ CTX） were observed before and after treatment in the two groups. Results The difference was not significant in bone density before treatment between the two groups（ P = 0. 729）. Compared with the control group,after 3-month and 6-month treatment,the bone density was increased significantly in the treatment group（ P = 0. 016）. Before and after treatment,AKP,TGF β-1 and CTX were different significantly in the two groups（ P 0. 05）. The differences in calcitonin,osteocalcin and TRACP-5b were not significant before treatment between the two groups（ P 0. 05）. Compared with the control group,after 6-month treatment,calcitonin and osteocalcin were increased significantly in the treatment group（ P = 0. 005,P = 0. 000）. TRACP-5b was reduced significantly（ P = 0. 000）. Conclusion Compared with the control group,the combined medication of bushen jianpi formula and Caltrate D contributes to the improvements in the relevant indexes of bone mineral density and bone metabolism in the patients of postmenopausal breast cancer and osteoporosis.