硫辛酸联合基础抗骨质疏松药物治疗原发性骨质疏松症的疗效及对炎症反应的影响

Effect of lipoic acid combined with basic anti-osteoporosis drugs on inflammatory response in patients with primary osteoporosis

目的:探讨硫辛酸联合基础抗骨质疏松药物治疗原发性骨质疏松症(osteoporosis,OP)的疗效及对炎症反应、氧化应激的影响。方法:选取2019年1月至2021年3月安阳市人民医院收治的原发性OP患者96例为研究对象,随机分为对照组(n=48)与观察组(n=48)。对照组予以碳酸钙D3片、骨化三醇胶丸治疗,观察组在对照组基础上予以硫辛酸辅助治疗。比较两组临床疗效,于治疗前和治疗后3个月、6个月行骨代谢指标[I型前胶原氨基端前肽(type I procollagen propeptide,PINP)、I型胶原交联C-末端肽(type I C-tenninal cross linked peptide,CTX-1)和骨钙素(bone gla protein,BGP)]、氧化应激指标[丙二醛(malondialdehyde,MDA)和高级氧化蛋白产物(advanced oxidation protein product,AOPP)]、炎症细胞因子[肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、白细胞介素-6(interleukin-6,IL-6)]的测定。结果:观察组治疗总有效率为95.83%,显著高于对照组的77.08%,差异有统计学意义(P<0.05)。治疗后,观察组疼痛评分显著低于对照组(P<0.05),生活质量评分和股骨颈、腰椎L2~4骨密度显著高于对照组(P<0.05)。治疗后6个月,观察组血清BGP水平显著高于对照组(P<0.05),PINP、CTX-1显著低于对照组(P<0.05)。治疗后3个月和6个月时,观察组血清MDA、AOPP、TNF-α、IL-6水平显著低于对照组(P<0.05)。结论:硫辛酸辅助基础抗骨质疏松药物治疗原发性OP疗效显著,可能通过减轻氧化应激和炎症反应,从而改善患者骨密度、骨代谢和疼痛症状,提高患者生活质量。

Objective:To investigate the efficacy of lipoic acid combined with basic anti-osteoporosis drugs in the treatment of primary osteoporosis(OP)and its effects on inflammatory response and oxidative stress.Methods:A total of 96 patients with primary OP admitted to our hospital from January 2019 to March 2021 were selected and randomly divided into a control group(n=48)and an observation group(n=48).The control group was treated with calcium carbonate D3 chewable tablets and calcitriol capsules,and the observation group was treated with lipoic acid on the basis of the control group.The clinical efficacy was compared between the 2 groups.Bone metabolism indexes[procollagen type I N-terminal propeptide(PINP),type Ⅰ C-tenninal cross linked peptide(CTX-1)and osteocalcin(BGP)],oxidative stress indicators[malondialdehyde(MDA)and advanced oxidation protein products(AOPP)]and inflammatory indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]were measured before and 3 and 6 months after treatment.Results:The total effective rate of the observation group was 95.83%,which was significantly higher than 77.08%of the control group,the difference was statistically significant(P<0.05).After treatment,the pain score in the observation group was significantly lower than that in the control group(P<0.05),and the quality of life score and bone mineral density of femoral neck and lumbar spine L2-4 were significantly higher than those in the control group(P<0.05).After 6 months of treatment,the serum BGP level in the observation group was significantly higher than that in the control group(P<0.05),PINP and CTX-1 were significantly lower than those in the control group(P<0.05).At 3 and 6 months after treatment,the levels of serum MDA,AOPP,TNF-αand IL-6 in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Lipoic acid assisted basic anti-osteoporosis drugs are effective in the treatment of primary OP,which may improve bone mineral density,bone metabolism and pain symptoms and improve the quality of life of patients by reducing oxidative stress and inflammatory response.