自拟补肾清心汤与结合雌激素片联用对围绝经期骨质疏松症患者骨密度与骨代谢标志物的影响

Bushen-Qingxin decoction combined conjugated estrogen tablets for perimenopausal women osteoporosis in patients with bone mineral density and bone metabolic markers

目的探讨自拟补肾清心汤联合标准剂量结合雌激素片对女性围绝经期骨质疏松症(osteoporosis, OP)患者骨密度与骨代谢标志物的影响。方法将符合入选标准的160例OP患者采用随机数字表法分为2组,每组80例。对照组每日服用标准剂量的结合雌激素片,观察组在对照组基础上加服自拟补肾清心汤。2组均治疗12个月。采用ELISA法检测血清骨特异性碱性磷酸酶(bone-specific alkaline phosphatase, BALP)、Ⅰ型胶原C末端肽(C-terminal cross linked peptide, CTX-Ⅰ)、抗酒石酸酸性磷酸酶-5b(tartrate resistant acid phosphatase-5b, TRACP-5b)水平,采用双能X射线吸收测定法检测骨密度值,评价临床疗效。结果观察组总有效率为91.3%(73/80)、对照组为78.8%(63/80),2组比较差异有统计学意义(χ^2=3.971,P=0.046)。治疗后,观察组血清BALP水平[(88.55±10.33)U/L比(80.47±8.67)U/L,t=5.399]高于对照组(P<0.01),CTX-Ⅰ[(130.09±17.55)ng/ml比(164.71±19.45)ng/ml,t=11.928]、TRACP-5b[(501.31±35.77)pg/L比(538.51±37.69)pg/L,t=6.498]水平低于对照组(P<0.01)。观察组治疗后腰椎L2~4骨密度值较同组治疗前升高(t=3.396,P=0.010)。结论自拟补肾清心汤与结合雌激素片联用可升高围绝经期OP患者的骨密度值与血清BALP水平,降低血清TRACP-5b、CTX-Ⅰ水平。

Objective Bushen-Qingxin decoction combined conjugated estrogen tablets of modulation perimenopausal women osteoporosis patients, explore the impact of bone mineral density and bone metabolic markers. Methods A total of 160 female patients were recruited in our hospital by the random number table method, and were divided into the control group 80 cases and the observation group 80 cases. The control group was treated with standard dose of conjugated estrogen tablets, while the observation group was treated with Bushen Qingxin decoction on the basis of the control group. Both groups were treated 3 period with 28 days per period. The enzyme-linked immunity analyzer was used to detect serum bone-specific alkaline phosphatase (BALP), C-terminal cross linked peptide (CTX-Ⅰ), tartrate resistant acid phosphatase -5b (TRACP-5b) level, and the dual-energy X-ray absorptiometry measurement method was used to detect bone mineral density values. The clinical curative effect was compared between two groups. Results The total effective rate of the observation group was 91.3%, while the control group was 78.8%, which showed the difference was statistically significant (χ^2=3.971, P=3.971). After treatment, the serum BALP levels (88.55 ± 10.33 U/L vs. 80.47 ± 8.67 U/L, t=5.399) of the observation group were significantly higher than this of the control group (P<0.01). After treatment, the serum TRACP-5b (501.31 ± 35.77 pg/L vs. 538.51 ± 37.69 pg/L, t=6.498), CTX-Ⅰ(130.09 ± 17.55 ng/ml vs. 164.71 ± 19.45 ng/ml, t=11.928) of the observation group were significantly lower than those of the control group (P<0.01). After treatment, the bone mineral density of the observation group rose up from the baseline (t=3.396, P=0.010). Conclusions The Bushen-Qingxin decoction combined conjugated estrogen tablets can increase on women in the menopausal transition of osteoporosis in patients with bone mineral density values and serum BALP levels, reduce serum TRACP-5b, CTX-Ⅰ level.