强骨膏治疗Ⅰ型原发性骨质疏松症的临床与实验研究

Clinical and experimental study of Qianggu soft extract in treatment of type Ⅰ primary osteoporosis

目的 观察强骨膏对Ⅰ型原发性骨质疏松症 (PMO)的疗效及对实验性去卵巢大鼠骨质疏松的影响。方法 临床选择自然绝经 5年以上 ,骨密度 (BMD)低于同性别峰值骨量 1 3 %以上且不伴合并症 ,未经治疗的 1 1 8例PMO患者。随机分为观察组、对照组、空白对照组。观察组 78例连服 6个月强骨膏 ,对照组 2 1例连服 6个月葡萄糖酸钙片 ,空白对照组 1 9例不服用任何药物。各组治疗前后检测股骨颈BMD和骨代谢相关指标。实验选用健康 6月龄雌性Wistar大鼠 70只 ,随机分为假手术组、卵巢切除组 (模型组 )和强骨膏组 ,并以葡萄糖酸钙片及龙牡壮骨冲剂作为对照物 ,观察其对骨密度、生物力学 ,血E2 、Ca水平的影响。另选 50只小白鼠 ,以阿斯匹林作对照 ,观察强骨膏对疼痛的影响。结果 临床研究表明 ,强骨膏能显著缓解PMO患者的骨痛 ,治疗前后BMD平均提高 5 93 % ,E2 、ALP、Ca增高 ,PYD下降 ,总有效率为 94.87% ,以上指标明显优于对照及空白对照组。实验研究发现各剂量组强骨膏能明显提高去卵巢大鼠的BMD(P <0 0 5)及E2 、Ca水平 (P <0 .0 5 ,P<0 0 1 ) ,中、高剂量组显著提高大鼠股骨的最大载荷、最大应力和屈服点值 (均P <0 0 5 ,均P <0 0 1 )。强骨膏还具有镇痛作用。结论 强骨膏治疗PMO疗效较好 ,提示其具有临?

Objective\ To observe the therapeutic effect of Qianggu soft extract(QGE,extract of traditional Chinese madicinal herbs)in treating type Ⅰ primary osteoporosis(postmenopausal osteoporosis,PMO) and its effects on experimental osteoporosis in ovariectomized rats. Methods\ 118 PMO patients with menopause duration over 5 years were divided into three groups:observed group(n=78) were given QGE orally for 6 months, positive control group(n=21) were given calcium gluconate orally for 6 months,and blank control group (n=19) were untreated.Bone mineral density(BMD) of femoral neck and indexes of bone metabolism were determined before and after treatment.PMO rats model was built by bilateral ovariectomy.70 six\|month\|old female Wistar rats were randomly divided into seven groups:sham\|operated,bilaterally ovariectomized(model group) treated with QGE(three groups),and compared with calcium gluconate,with Longmu Zhuanggu granules.BMD and the indexes related to biomechanics were measured,levels of serum estradiol(E\-2)and calcium were determined,and were compared between the groups.Other 50 rats were given aspirin to observe the analgesic effect as controls. Results\ QGE could markedly relieve PMO patients from osteoalgia,while the average BMD increased by 5 93% after treatment.The total effective rate was 94 87%.The indexes in the QGE\|treated groups were better than those in the control groups.QGE could significantly increase BMD in postmenopausal rats,moderate and high doses of QGE increased maximum load,maximum stress and YP\|load of femora,and had definite analgesic effect. Conclusion\ QGE has good effect on both PMO patients and PMO model rats,suggesting that it is worth further studying and clinical application.\;