葛根素联合阿仑膦酸钠治疗绝经后骨质疏松症的效果观察

Observation on the effect of puerarin combined with alendronate in the treatment of postmenopausal osteoporosis

目的探索葛根素联合阿仑膦酸钠对绝经后骨质疏松症的影响。方法 148例绝经后骨质疏松症患者随机分为治疗组(n=74)和对照组(n=74)。对照组给予阿仑膦酸钠治疗,治疗组给予葛根素联合阿仑膦酸钠治疗,为期治疗6个月。检测治疗后两组患者髋部及腰椎的骨密度改变,同时测定血清雌二醇(estradiol,E2)、骨代谢指标[骨钙素(osteocalcin,BGP)、骨源性碱性磷酸酶(bone alkaline phosphatase,BALP)、抗酒石酸酸性磷酸酶-5b(tartrate-resistant acid phosphatase-5b,TRAP-5b)]、免疫因子[白细胞介素-6(interleukin-6,IL-6)、转化生长因子-β(transforming growth factor-β,TGF-β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)以及白细胞-10(IL-10)]水平的变化,并记录治疗期间出现的药物不良反应。结果治疗前,两组的骨密度、骨代谢指标和免疫因子比较差异无统计学意义(P>0.05)。治疗6个月后,两组髋部及腰椎骨密度都有不同程度的升高,其中治疗组骨密度变化更明显,和对照组比较差异有统计学意义(P<0.05);同时各组血清BALP、BGP、TRAP-5b、IL-10、IL-6和TNF-α水平均降低,TGF-β1及E2水平均升高,而治疗组改变更明显,两组比较差异有统计学意义(P<0.05)。两组患者治疗均未发现明显药物不良反应。结论葛根素联合阿仑膦酸钠可以通过降低骨转换率及减少免疫因子表达来改善绝经后女性骨质疏松患者髋部及腰部的骨密度,且安全性高。

Objective To investigate the effect of puerarin combined with alendronate on postmenopausal osteoporosis. Methods148 patients with postmenopausal osteoporosis were randomly divided into treatment group（n = 74） and control group（n = 74）.The control group was treated with alendronate,and the treatment group was treated with puerarin combined with alendronate for 6 months. After treatment,the changes of bone mineral density at hip and lumbar spine,the levels of serum estradiol（E2）,osteocalcin（BGP）,bone alkaline phosphatase（BALP）,tartrate-resistant phosphatase-5 b（TRAP-5 b）,interleukin-6（IL-6）,transforming growth factor-β（TGF-β）,tumor necrosis factor-α（TNF-α） and leukocyte-10（IL-10） were measured and the drug adverse reactions were recorded during treatment. Results Before treatment,bone mineral density,bone metabolic index and immune factor were compared between the two groups,and were not significantly different（P 〉 0. 05）. After 6 months of treatment,bone mineral density of hip and lumbar spine increased in different degrees,and the change of bone mineral density was greater in the treatment group than that in the control group（P 〈 0. 05）. The levels of serum BALP,BGP,TRAP-5 b,IL-10,IL-6 and TNF-α decreased and the levels of TGF-β1 and E2 increased in the treatment group,with statistical significance（P 〈 0. 05）.No adverse drug reactions were recorded for all patients during treatment. Conclusion Puerarin combined with alendronate could improve the bone mineral density of hip and lumbar spine in postmenopausal women with osteoporosis by reducing the bone turnover rate and the expression of immune factors,and the safety was good.