补肾调冲方治疗绝经后肾虚血瘀型骨质疏松疗效及对患者细胞因子、骨生化标志物的影响

Efficacy of tonifying kidney and regulating Chong receipt on kidney asthenia with blood stasis type of postmenopausal osteoporosis and the influence in cytokines and bone biochemical markers of patients

目的探讨补肾调冲方治疗绝经后肾虚血瘀型骨质疏松(postmenopausal oeteoporosis,PMO)的临床疗效及对患者骨生化标志物的影响。方法选取2015年1月至2016年9月我院门诊106例PMO患者,根据随机数字表法均分为两组。对照组采取西医常规治疗,观察组予补肾调冲方治疗。记录比较两组临床疗效,治疗前后血清性激素、细胞因子及骨生化标志物水平。结果治疗6个月后,观察组总有效率为92.5%,对照组总有效率为75.5%,差异有统计学意义( P <0.05)。与治疗前比较,治疗6个月后,观察组血清睾酮(testosterone,T)、雌二醇(estradiol,E 2)水平显著升高,差异有统计学意义( P <0.01),对照组以上指标未有明显改善( P >0.05);两组治疗前后血清促卵泡生成素(follicle-stimulating hormone,FSH)水平无明显变化,差异无统计学意义( P >0.05)。治疗6个月后,两组血清肿瘤坏死因子(tumor necrosis factor,TNF-ɑ)、白介素-6(interleukin-6,IL-6)水平显著低于治疗前,差异有统计学意义( P <0.01),且观察组下降更明显( P <0.01)。与治疗前比较,治疗6个月后,两组血清总骨I型前胶原氨基酸延长链(type I procollagen N-terminal propeptide,PINP)、血清Ⅰ型胶原羧基末端交联肽(c-terminal telopeptide region of collagen type 1,β-CTX)、骨钙素(bone carboxyglutamic protein,BGP)水平显著下降,差异有统计学意义( P <0.01),骨碱性磷酸酶(bone alkine phosphatase,B-ALP)水平显著升高( P <0.01),且观察组改善更明显( P <0.01)。结论 PMO患者应用补肾调冲方治疗更有助于缓解其症状体征,改善机体高骨转换状态,维持骨代谢平衡,增强骨质密度,且综合疗效更显著。

Objective To investigate the clinical efficacy of tonifying kidney and regulating Chong receipt in the treatment of postmenopausal osteoporosis (PMO) and its effect on bone biochemical markers. Methods One hundred and six patients with PMO admitted to the outpatient in our hospital from January 2015 to September 2016 were selected and divided into two groups, according to the random number table method. Patients in the control group received routine Western medicine treatment. Patients in the observation group received tonifying kidney and regulating Chong receipt. The comprehensive clinical efficacy, the serum levels of sex hormones, cytokines, and bone biochemical markers before and after the treatment were recorded and compared between the two groups. Results After 6 months of the treatment, the total effective rate in the observation group was 92.5%, which increased significantly compared to that in the control group (75.5%, P <0.05). Compared with those before the treatment, serum levels of testosterone (T) and estradiol (E 2) in the observation group increased significantly after 6 months of the treatment ( P <0.01). However, the indicators in the control group didn't improve significantly ( P >0.05). Serum level of follicle-stimulating hormone (FSH) was constant before and after the treatment in both groups ( P >0.05). After 6 months of the treatment, the levels of serum tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) were significantly lower than those before the treatment in both groups ( P <0.01), and they decreased more significantly in the observation group ( P <0.01). Compared with those before the treatment, the serum levels of type I procollagen N-terminal propeptide (PINP), c-terminal telopeptide region of collagen type 1 (β-CTX), and bone carboxyglutamic protein (BGP) decreased significantly in both groups after 6 months of the treatment ( P <0.01), but bone alkaline phosphatase (B-ALP) level increased significantly ( P <0.01), and it improved more significantly in the observation group ( P <0.01). Conclusion The application of tonifying kidney and regulating Chong receipt is more helpful to relieve the symptoms and signs of PMO patients. It relieves the state of high bone turnover, maintains the balance of bone metabolism, and increases bone mineral density. The effect of comprehensive therapy is more significant.