A comparison of the effect of alendronate and You-Gui-Wan on osteoporosis in female rats with kidney-yang deficiency

Background:In traditional Chinese medicine,You-Gui-Wan(YGW)is typically used to treat osteoporosis associated with kidney-yang deficiency.However,there have been few mechanistic studies on the effectiveness of kidney-yang deficiency-type osteoporosis with YGW.To further clarify the role of YGW in the effect of osteoporosis with kidney-yang deficiency,the study analyzed the therapeutic advantages of YGW by comparing the therapeutic effects of YGW and alendronate(ALN)on osteoporosis with kidney-yang deficiency.Methods:SPF female SD rats were randomly divided into control,osteoporosis,osteoporosis with kidney-yang deficiency,osteoporosis with kidney-yang deficiency+YGW and osteoporosis with kidney-yang deficiency+ALN groups.Except for the control group,osteoporosis was induced by the removal of bilateral ovaries.After 12 weeks,rats with osteoporosis in the kidney-yang deficiency group had kidney-yang deficiency syndrome triggered by hydrocortisone for 14 days.Rats were treated with YGW or ALN for 12 weeks.The weights of rats were recorded.Hematoxylin-eosin staining staining was used to observe pathological changes in bone trabeculae,liver,spleen,and kidneys of rats.Depletion of the growth plate cartilage of rats in different groups was observed by safranine-O staining.The expression of osteoclast key indices(ACP)and osteoblast key indices(ALP)in the bone tissue of rats in the different groups was observed by immunohistochemical staining.The expression of bone resorption-related indicators(TRAP and NXT-1),bone formation-related indicators(BALP,BGP,and P1NP),and major indicators of kidney-yang deficiency(ACTH,T3,T4,cAMP,and cGMP)were observed using an ELISA detection kit.The expression levels of the main indices of liver function(ALT and AST)were detected in different groups.Results:The differences between the osteoporosis with kidney-yang deficiency group and osteoporosis group were that the weight of rats and the expression of ACTH,T3,T4,and cAMP decreased significantly,and the expression of cGMP increased in the osteoporosis with kidney-yang deficiency group.Moreover,both YGW and ALN effectively improved the symptoms of osteoporosis,including the injury of bone trabeculae and growth plates,as well as the expression of bone metabolism-related indicators.However,unlike ALN,YGW simultaneously ameliorated the expression of key indicators of kidney-yang deficiency and prevented weight loss in rats.In addition,YGW caused no obvious damage to the liver,spleen,or kidney,whereas ALN led to liver cirrhosis.Conclusion:The results reveal that YGW plays a crucial part in osteoporosis with kidney-yang deficiency,increases bone mineral density,and improves bone metabolism indicators,and is safe and efficient for the efficacy of osteoporosis with kidney-yang deficiency.YGW might have a better therapeutic effect on osteoporosis in patients with kidney-yang deficiency.Therefore,alendronate should be used cautiously in patients with osteoporosis and poor liver function.

Bisphosphonates Zoledronate and Alendronate for the Management of Postmenopausal Osteoporosis

Bisphosphonates are among the most frequently used antiresorptive drugs for the management of postmenopausal osteoporosis. We review here two of the commonly used bisphosphonates zoledronate and alendronate.

A Case Report of Alendronate Treatment over 20 Years on Osteoporosis and Literature Review

Osteoporosis is commonly seen in aged people, but not much attention is paid to it. Patient compliance is challenged by many factors, including long-time treatment and high rates of fatality and disability caused by fragility fractures. With age-related changes, the treatment will last for a lifetime. A clinical case of postmenopausal patient who had received incontinuous treatment of alendronate for 20 years was studied in this article. As the level of compliance varied in different treatment phases, the curative outcome of this patient was altered. This study also presented a literature review to discuss the current situation, treatment and compliance of osteoporosis in China and the corresponding influences on bone mineral density (BMD) and prognosis. Hopefully, this study can increase physicians’ awareness of osteoporosis in clinical treatment and its pharmacotherapy and treatment course.

Alendronate阻止牙槽骨骨吸收的实验研究

目的 评价双膦酸盐Alendronate抑制牙槽骨骨吸收的作用。方法 建立骨质疏松及牙槽骨吸收动物模型 ,建模术后六周 ,给实验组皮下注射Alendronate每周 3次 ,共 6周 ;用血生化指标骨生物力学、骨密度测量、组织形态学等方法进行药效评价。结果 股骨骨密度对照组与用药组相比明显降低 (P <0 .0 1) ;血清碱性磷酸酶对照组与用药组相比明显升高 (P <0 .0 1) ;骨生物力学各项指标实验组与对照组也有明显差异。组织形态学 :实验组牙龈轻度炎症 ,牙槽骨水平吸收与对照组相比明显减少 ;对照组牙龈乳突炎症明显 ,上皮钉突增生 ,炎细胞浸润 ,牙槽骨明显水平吸收。结论 Alendronate治疗骨质疏松有明显的疗效 ,能够增加骨量 ,阻止骨丢失 ;

Local treatment of osteoporosis with alendronate-loaded calcium phosphate cement

Background A new treatment strategy is to target specific areas of the skeletal system that are prone to clinically significant osteoporotic fractures.We term this strategy as the ＂local treatment of osteoporosis＂.The study was performed to investigate the effect of alendronate-loaded calcium phosphate cement （CPC） as a novel drug delivery system for local treatment of osteoorosis.Methods An in vitro study was performed using CPC fabricated with different concentrations of alendronate （ALE,0,2,5,10 weight percent （wt％））.The microstructure,setting time,infrared spectrum,biomechanics,drug release,and biocompatibility of the composite were measured in order to detect changes when mixing CPC with ALE.An in vivo study was also performed using 30 Sprague-Dawley rats randomly divided into six groups：normal,Sham （ovariectomized （OVX） ＋ Sham）,CPC with 2％ ALE,5％ALE,and 10％ ALE groups.At 4 months after the implantation of the composite,animals were sacrificed and the caudal vertebrae （levels 4-7） were harvested for micro-CT examination and biomechanical testing.Results The setting time and strength of CPC was significantly faster and greater than the other groups.The ALE release was sustained over 21 days,and the composite showed good biocompatibility.In micro-CT analysis,compared with the Sham group,there was a significant increase with regard to volumetric bone mineral density （BMD） and trabecular number （Tb.N） in the treated groups （P ＜0.05）.Trabecular spacing （Tb.Sp） showed a significant increase in the Sham group compared to other groups （P ＜0.01）.However,trabecular thickness （Tb.Th） showed no significant difference among the groups.In biomechanical testing,the maximum compression strength and stiffness of trabecular bone in the Sham group were lower than those in the experimental groups.Conclusions The ALE-loaded CPC displayed satisfactory properties in vitro,which can reverse the OVX rat vertebral trabecular bone microarchitecture and biomechanical properties in vivo.

Association of farnesyl diphosphate synthase polymorphisms and response to alendronate treatment in Chinese postmenopausal women with osteoporosis

Background Genetic factors are important in the pathogenesis of osteoporosis,but less is known about the genetic determinants of osteoporosis treatment.We aimed to explore the association between the gene polymorphisms of key enzyme farnesyl diphosphate synthase （FDPS） in mevalonate signaling pathway of osteoclast and response to alendronate therapy in osteoporotic postmenopausal women in China.Methods The study group comprised 639 postmenopausal women aged （62.2＆#177;7.0） years with osteoporosis or osteopenia who had been randomly assigned to low dose group （70 mg/2w） or standard dose group （70 mg/w） of alendronate in this 1-year study.We identified allelic variant of the FDPS gene using the polymerase chain reaction and restriction enzyme Faul.Before and after treatment,serum levels of calcium,phosphate,alkaline phosphatase （ALP）,cross linked C-telopeptide of type Ⅰ collagen （β-CTX） were detected.Bone mineral density （BMD） at lumbar spine and proximal femur was measured.The association was analyzed between the polymorphisms of FDPS gene and the changes of BMD,bone turnover biomarkers after the treatment.Results The FDPS rs2297480 polymorphisms were associated with baseline BMD at femoral neck,and patients with CC genotype had significantly higher baseline femoral neck BMD （（733.6＆#177;84.1） mg/cm2） than those with AC genotypes （（703.0＆#177;86.9） mg/cm2） and AA genotypes （（649.8＆#177;62.4） mg/cm2） （P 〈0.01）.No significant difference in BMD at lumbar spine was observed among different genotypes of FDPS.The percentage change of serum ALP level was significantly lower in patients with CC genotype （-22.9%） than that in those with AC genotype （-24.1%） and AA genotype （-29.8%） of FDPS after 12 months of alendronate treatment （P 〈0.05）.Neither percentage change of BMD nor β-CTX level after alendronate treatment had association with FDPS genotype.Conclusions FDPS gene was probably a candidate gene to predict femoral neck BMD at baseline.FDPS gene alleles could predict change percentage of ALP after treatment of alendronate,but possibly had no significant relationship with the responsiveness of BMD to alendronate therapy.

Benefit period using alendronate to increase bone mineral density in women with osteoporosis?

Background Alendronate, a nitrogen-containing bisphosphonate is a specific inhibitor of bone resorption and now in the forefront of treatment of osteoporosis. In this study, we reported a significant increase in bone mineral density (BMD) of the spine and the hip in postmenopausal women taking alendronate at 10 mg/d for 1, 2 and 3 years. Methods Participants had received daily, oral, 10 mg dose of alendronate for one to three years and placed into one of three groups according to alendronate treatment duration: 41 women received alendronate for 1 year (group Ⅰ), 46 received alendronate for 2 years (group Ⅱ), and 30 received alendronate for 3 years (group Ⅲ). Measurements of bone density had been made by dual energy X-ray absorbtiometry once each year. Results The differences in L2-L4, L2, L4, femoral neck and trochanter BMD values before and after treatment for first group were significantly different. In second group, significant differences between initial and after treatment were found at the other sites except at the Ward’s triangle. In the third group, only a significant increase in the L2-L4, L2, L3, L4, trochanter BMD values between before treatment and at the end of third year was found. Comparisons between groups were performed with Student’s t test. ANOVA was used to test the age, menopause age, menopause duration and initial BMD values between the three groups. Calculated P values of less than 0.05 were considered statistically significant. Conclusions Alendronate had increased BMD significantly at the spine and hip in postmenopausal women over three years. Increases of BMD in third group were significant during the first and second years. However, continued therapy with alendronate had been required to maintain the gain in BMD over the third year.

Comparison of Strontium Ranelate and Alendronate Sodium Treatment among Post-Menopausal Women

Growing rates of osteoporosis in the whole world is a serious health problem. As the “expected lifetime” is prolonged, population of elderly women with chronic diseases who require long-term treatment increases. This study aimed to compare antiresorptive treatment—that has become a classic treatment in the light of Canadian Guideline for osteoporosis—with the antiresorptive plus osteoblastic activity inducing treatment modality. The clinical and laboratory results of patients treated with a single dose of 2 mg Strontium ranelate sachet (Protelos &reg) or alendronate sodium used weekly 70 mg tablet (Fosamax &reg once a week tablet) for 12-months were compared. Treatment compliance has been questioned. A hundred women in post-menopausal period were included in this study. Patient satisfaction survey among the group of strontium ranelate was unsatisfactory. Among patients using alendronate sodium the ease of use in this sense obtained a rate of 91% satisfaction from patients.

Effectiveness associated with different therapies for senile osteoporosis: a network Meta-analysis

OBJECTIVE:The aim of this study was to evaluate the effectiveness of Chinese herbal medicines for invigorating the kidney(CHMIK)on senile osteoporosis.METHODS:We searched for studies in English-language databases(Pub Med,the Cochrane Library,and Web of Science)and Chinese-language databases(China National Knowledge Infrastructure,Wan Fang Data,VIP Chinese periodical service platform),and China Biology Medicine disc from their inception to September 2017.Randomized controlled trials comparing the effectiveness of Traditional Chinese Medicine therapies(alone or in combination)and conventional clinical medicine therapies among older adult patients with osteoporosis were identified.We conducted a network Meta-analysis with a Bayesian hierarchical random-effects model using RStudio software,Version 3.4.1.RESULTS:Forty-three randomized controlled trials assessing the differences between Traditional Chinese Medicine and conventional clinical medicine were identified,including 15 treatments and involving 3316 patients.The results of the network Meta-analysis indicated that alendronate(odds ratio[OR]=0.20,95%confidence interval[CI]:0.047-0.73)and calcium(OR=0.18,95%CI:0.11-0.30)are significantly more effective if combined with oral CHMIK.CHMIK alone is significantly more effective than both alendronate(OR=0.34,95%CI:0.10-1.0)and calcium(OR=0.13,95%CI:0.056-0.28).Moreover,CHMIK+tuina+calcium is more effective than CHMIK+calcium+vitamin D+alendronate(OR=18.0,95%CI:1.1-2.7 e+02).CONCLUSION:The present network Meta-analysis found that alendronate and calcium are more effective if combined with oral CHMIK and that oral CHMIK alone may be more effective than alendronate or calcium.Tuina may have an advantage over oral medicines.Oral CHMIK and calcitonin show the most potential for treating senile osteoporosis.

Alendronate loaded graphene oxide functionalized collagen sponge for the dual effects of osteogenesis and anti-osteoclastogenesis in osteoporotic rats

Graphene Oxide(GO)-related hydrogels have been extensively studied in hard tissue repair,because GO can not only enhance the mechanical properties of polymers but also promote osteogenic differentiation of mesenchymal stem cells.However,simple GO-related hydrogels are not ideal for the repair of osteoporotic bone defects as the overactive osteoclasts in osteoporosis.Alendronate(Aln)is known to inhibit osteoclasts and may bind to GO through covalent connection.Therefore,delivering Aln in GO-related hydrogels may be effective to repair osteoporotic bone defects.Here,we developed a control-released system which is constructed by collagen(Col)-GO sponges loaded with Aln(Col-GO-Aln)for osteoporotic bone defect repair.In vitro,Col-GO-Aln sponges prolonged the release period of Aln,and the sponge containing 0.05%(w/v)GO released Aln faster than sponge with 0.2%GO.Furthermore,tartrate-resistant acid phosphatase(TRAP)and F-actin staining demonstrated that Col-GO-Aln sponges effectively inhibited osteoclastogenesis of monocyte-macrophages.In vivo,micro-CT scan showed that the volume of newborn bone in defect site by 0.05%GO sponge was nearly three times larger than that of other groups.Moreover,the CT and histological examinations of rat femur proved that Col-GO-Aln sponges decreased the number of osteoclasts and suppressed the systemic bone loss in osteoporotic rats.These findings reveal that the application of GO as carriers of anti-osteoporosis drugs is a viable treatment for osteoporosis.The results also underscore the potential of GO-related hydrogels with Aln-releasing capacity for bone regeneration in osteoporosis.

阿仑膦酸钠干预去卵巢大鼠骨质疏松的腰椎代谢组学分析

背景:研究报道,阿仑膦酸钠的摄入能显著提高骨质疏松症患者的骨密度。目的:利用色谱-质谱技术分析比对阿仑膦酸钠干预去卵巢大鼠模型前后代谢物变化,进一步探索阿仑膦酸钠治疗骨质疏松症的具体机制及作用靶点。方法:选择雌性SD大鼠36只,随机分为骨质疏松症组、阿仑膦酸钠组及假手术组,前两组采用去卵巢法建立骨质疏松症模型。造模4周后,阿仑膦酸钠组大鼠给予阿仑膦酸钠灌胃;假手术组和骨质疏松症组分别给予等体积生理盐水灌胃。连续灌胃12周后,通过色谱-质谱技术分析腰椎代谢物,得出共同差异代谢物,对其进行京都基因与基因组百科全书通路等生物信息学分析。结果与结论:①3组共得到17种共同显著性差异代谢物;②通过京都基因与基因组百科全书富集分析表明,阿仑膦酸钠可能调节不饱和脂肪酸生物合成、亚油酸代谢等通路保护去卵巢模型大鼠;③结果提示,阿仑膦酸钠可能通过干预不饱和脂肪酸生物合成代谢和亚油酸代谢发挥其抗骨质疏松作用,从而达到预防骨质疏松症的目的。

阿仑膦酸钠联合基础用药预防绝经女性乳腺癌术后依西美坦所致骨丢失的临床研究

目的探讨阿仑膦酸钠联合基础用药预防绝经女性乳腺癌术后依西美坦所致骨丢失的临床疗效。方法回顾性选取2018年6月至2022年6月于首都医科大学附属北京友谊医院因乳腺癌行依西美坦治疗、门诊根据骨密度结果诊断为骨量减少的绝经女性患者45例。根据治疗方案不同分为两组:联合用药组(n=24)和基础治疗组(n=21)。联合用药组给予阿仑膦酸钠75 mg+钙+活性维生素D治疗,基础治疗组给予钙+活性维生素D治疗。比较两组患者治疗初始时、治疗后1年、治疗后2年的骨密度(腰椎骨密度、髋部骨密度);比较两组患者治疗初始时及治疗后2年的骨代谢指标,包括血清骨钙素、全段甲状旁腺素;并记录两组患者骨质疏松性骨折及泌尿系统结石的发生情况。结果联合用药组患者治疗后1年及治疗后2年的腰椎及髋部骨密度较治疗初始时均无明显变化,差异均无统计学意义(P>0.05);基础治疗组患者治疗后1年及治疗后2年的腰椎及髋部骨密度较治疗初始时均显著降低,差异均有统计学意义(P<0.05)。治疗初始时、治疗后1年,两组患者的腰椎及髋部骨密度比较,差异均无统计学意义(P>0.05);治疗后2年,联合用药组腰椎及和髋部骨密度分别为-1.91±0.23、-1.93±0.31,均明显高于基础用药组(-2.21±0.30、-2.15±0.18),差异均有统计学意义(P<0.05)。联合用药组患者治疗后2年骨钙素和全段甲状旁腺素水平均较治疗初始时明显降低,差异均有统计学意义(P<0.05);基础治疗组患者治疗后2年骨钙素水平较治疗初始时明显降低,差异有统计学意义(P<0.05),而全段甲状旁腺素水平与治疗初始时比较,差异无统计学意义(P>0.05)。两组患者治疗初始时与治疗后2年骨钙素、全段甲状旁腺素比较,差异均无统计学意义(P>0.05)。两组患者治疗后2年内均无骨质疏松性骨折的发生,无泌尿系统结石的变化。结论采用依西美坦治疗的乳腺癌术后患者,骨密度诊断骨量减少,早期应用阿仑膦酸钠,能够有效减缓骨流失的进程。

利拉鲁肽联合阿仑膦酸钠治疗2型糖尿病合并骨质疏松症的效果

目的观察利拉鲁肽联合阿仑膦酸钠对2型糖尿病(type 2 diabetes mellitus,T2DM)合并骨质疏松症(osteoporosis,OP)患者血糖水平和骨代谢指标的影响。方法以T2DM合并OP患者80例作为研究对象,用随机数字表法分为研究组和对照组,每组40例。对照组患者给予阿仑膦酸钠治疗,研究组在对照组治疗的基础上加用利拉鲁肽。比较2组的临床疗效、治疗前后的血糖水平[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 hours postprandial plasma glucose,2 hPG)和糖化血红蛋白(glycated hemoglobin,HbA1c)]、骨代谢指标[骨钙素(bone gla protein,BGP)、骨特异性碱性磷酸酶(bone-specific alkaline phosphatase,BAP)、血清Ⅰ型胶原交联C末端肽(serum collagen type-Ⅰcrosslinked C-peptide,s-CTX)、Ⅰ型前胶原氨基端肽原(typeⅠprocollagen amino terminal peptidogen,PINP)]、骨密度(bone mineral density,BMD)及不良反应的发生情况。结果治疗后,研究组的总有效率(92.50%)高于对照组(75.00%),P<0.05。2组患者的FBG、2 hPG、HbA1c和s-CTX水平均较治疗前降低,且研究组均低于对照组(P<0.05)。2组患者的BGP、BAP、PINP水平和前臂BMD较治疗前均升高,且研究组高于对照组(P<0.05)。治疗期间2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论利拉鲁肽联合阿仑膦酸钠治疗T2DM合并OP的疗效确切,能有效改善患者的血糖与骨代谢指标水平。

骨化三醇联合甲巯咪唑及阿仑膦酸钠治疗甲亢性骨质疏松症患者的临床研究

目的 探讨骨化三醇联合甲巯咪唑及阿仑膦酸钠治疗甲亢性骨质疏松症患者的临床效果。方法 选取2020年6月至2022年6月我院收治的78例甲亢性骨质疏松症患者,随机分为两组各39例。对照组采用甲巯咪唑和阿仑膦酸钠治疗,观察组在对照组基础上采用骨化三醇治疗,比较两组的疼痛程度、骨密度以及血清骨钙素、骨碱性磷酸酶水平。结果 治疗后,观察组的NRS评分以及血清骨钙素、骨碱性磷酸酶水平均明显低于对照组,骨密度值明显高于对照组(P <0.05)。结论 骨化三醇联合甲巯咪唑及阿仑膦酸钠治疗可明显减轻甲亢性骨质疏松症患者的疼痛程度,改善患者的骨密度及血清骨钙素、骨碱性磷酸酶水平。

阿法骨化醇软胶囊联合阿仑膦酸钠维D3片治疗老年骨质疏松症的临床效果分析

目的探讨老年骨质疏松症(Osteoporosis,OP)采用阿法骨化醇软胶囊联合阿仑膦酸钠维D3片治疗的临床效果。方法选取2021年4月—2023年4月北京积水潭医院贵州医院收治的116例老年OP患者为研究对象,以随机数表法分成研究组(n=58,阿法骨化醇软胶囊联合阿仑膦酸钠维D3片治疗)和对照组(n=58,阿仑膦酸钠维D3片治疗),比较两组临床疗效、骨密度、视觉模拟评分法(Visual Analogue Scales,VAS)、Oswestry功能障碍指数(Oswestry Disability Index,ODI)评分。结果研究组治疗总有效率为96.55%(56/58),较对照组的84.48%(49/58)更高,差异有统计学意义(χ^(2)=4.921,P<0.05)。治疗后,两组骨密度增加,且研究组较对照组更高,差异有统计学意义(P均<0.05);治疗后两组VAS、ODI评分下降,且研究组低于对照组,差异有统计学意义(P均<0.05)。结论老年OP患者采用阿法骨化醇软胶囊与阿仑膦酸钠维D3片联合治疗,能够促进临床疗效提高,改善其骨密度水平,降低疼痛程度,提高活动能力。

阿仑膦酸钠辅助碳酸钙D3片对老年2型糖尿病合并骨质疏松患者的临床效果观察

目的:探讨2型糖尿病合并骨质疏松老年患者应用阿仑膦酸钠辅助碳酸钙D3片治疗的临床效果。方法:抽签法将2021年2月至2022年2月期间我科老年2型糖尿病合并骨质疏松患者95例分为两组,均采用控制血糖等基础治疗外,对照组47例口服碳酸钙D3,观察组48例口服碳酸钙D3加阿仑膦酸钠,持续治疗1 y后,采用临床疗效、血清激素水平、骨密度、骨代谢指标及药物安全性评价两组治疗临床效果。结果:观察组总有效率93.75%(45/48)高于对照组的总有效率78.72%(37/47),与治疗前比较,两组25-羟基维生素D、Wards三角区、股骨粗隆、股骨颈、腰椎L1~4部位骨密度均明显增加,甲状旁腺素、β-胶原片段、骨钙素及骨碱性磷酸酶水平均明显下降(P<0.05),其中观察组变化值均较对照组更为显著,差异有统计学意义(P<0.05)。两组不良反应无明显差异(P>0.05)。结论:2型糖尿病合并骨质疏松老年患者应用阿仑膦酸钠辅助碳酸钙D3片口服治疗,可有效调节其血清激素水平、骨密度和骨代谢指标,安全且疗效较好。

叶酸联合阿仑膦酸钠对绝经后骨质疏松患者骨密度、骨代谢指标和纤维细胞生长因子水平的影响

目的:探讨绝经后骨质疏松患者采用叶酸与阿仑膦酸钠联合治疗对其纤维细胞生长因子、骨代谢及骨密度指标的影响。方法:采用抽签法将2020年4月至2022年6月我科收治的绝经后骨质疏松患者106例随机分为两组(n=53),对照组口服阿仑膦酸钠10 mg、硫辛酸0.6 g,1次·d^(-1),观察组口服阿仑膦酸钠10 mg、叶酸2片,1次·d^(-1),治疗6 m后采用骨密度测定器测定股骨大转子、股骨颈、股骨干及第二腰椎-第四腰椎(L2-L4)骨密度,采用酶联免疫吸附法测定保护素(Osteoprotegerin,OPG)、核因子кB受体激活因子配体(Receptor activator of NFKB ligand,RANKL)、I型胶原交联C-末端肽(type I C-tenninal cross linked peptide,CTX-1)和纤维细胞生长因子(Fibroblast growth facto,FGF)水平,采用电化学发光免疫分析法检测骨钙素(Bone glaprotein,BGP)水平,采用随访法观察各患者不良反应。结果:与治疗前相比,各治疗组的股骨大转子、股骨颈、股骨干及L2-L4骨密度、OPG及BGP明显升高(P<0.05),其中观察组升高更显著(P<0.05);与治疗前比,各治疗组RANKL、CTX-1、FGF-23和FGF-21明显降低(P<0.05),其中观察组降低更明显(P<0.05),两组各不良反应无统计学差异(P>0.05)。结论:绝经后骨质疏松患者口服阿仑膦酸钠联合叶酸治疗,可有效调节其FGF水平,改善其骨代谢和骨密度情况,不良反应较少。

补肾壮骨汤治疗原发性骨质疏松症的临床疗效

目的:分析补肾壮骨汤治疗原发性骨质疏松症(OP)的临床疗效。方法:选取2023年3月至2024年3月东莞市东部中心医院收治的60例原发性OP患者为研究对象。以随机数字表法将其分为观察组与对照组,各30例。对照组患者给予常规西药治疗,观察组患者给予常规西药联合补肾壮骨汤治疗。比较两组患者的临床疗效、中医证候积分、骨转化标志物及关节功能。结果:观察组患者治疗总有效率为96.67%,高于对照组的70.00%,差异具有统计学意义(P<0.05);治疗后观察组患者中医证候各项积分均低于对照组,差异具有统计学意义(P<0.05);治疗后观察组患者血清Ⅰ型前胶原氨基末端前肽(PINP)、Ⅰ型胶原羧基端肽β特殊序列(β–CTX)水平均低于对照组,血清骨钙素(OC)水平高于对照组,差异具有统计学意义(P<0.05);治疗后观察组患者Oswestry功能障碍指数(ODI)评分低于对照组,差异具有统计学意义(P<0.05)。结论:对原发性OP患者治疗时,在原有西药治疗的基础上,联合应用补肾壮骨汤能有效增加治疗效果,并能降低中医证候积分和改善骨代谢指标、关节功能。

阿仑膦酸钠治疗骨质疏松模型大鼠机制的串联质量标签蛋白质组学分析

背景:目前关于阿仑膦酸钠治疗骨质疏松症的作用机制及作用靶点,仍需深入研究。目的:探究阿仑膦酸钠调节骨质疏松模型大鼠骨代谢的作用机制,并进行差异表达蛋白生物信息学分析。方法:雌性SD大鼠随机分为模型组、阿仑膦酸钠组、假手术组,每组12只,前两组均采用去卵巢法建立骨质疏松症模型,造模4周后阿仑膦酸钠组大鼠予阿仑膦酸钠灌胃;另外两组予等体积生理盐水。连续灌胃12周后测定胫骨骨密度,采用串联质量标签联合液相色谱-串联质谱法联用技术对大鼠腰椎进行蛋白质组学分析,筛选出差异表达蛋白,并进行基因本体、京都基因和基因组百科全书通路及蛋白相互作用网络分析。结果与结论:①筛选出阿仑膦酸钠组与模型组组间上调/下调差异表达蛋白分别为32个/51个;②基因本体富集分析结果显示,差异表达蛋白主要参与结合、催化活性等分子功能以及细胞过程、代谢过程等生物过程;③京都基因和基因组百科全书富集分析结果显示,阿仑膦酸钠组/模型组组间差异表达蛋白功能主要参与泛酸和辅酶A的生物合成过程;④蛋白相互作用分析结果表明,阿仑膦酸钠组/模型组组间共同差异表达蛋白中Hspa1l、Enpp3、Unc45a、Myh9、Cant1位于蛋白互作网络节点并与骨代谢密切相关;⑤结果显示,阿仑膦酸钠可能通过调控差异表达蛋白及泛酸和辅酶A生物合成过程来调节骨质疏松模型大鼠的骨代谢。

阿仑膦酸钠治疗重症骨折继发骨质疏松临床疗效观察

目的探讨阿仑膦酸钠治疗重症骨折继发骨质疏松的临床疗效。方法选取医院收治的重症骨折继发骨质疏松患者60例,采用抽签法分为对照组和观察组,各30例。对照组患者开展常规治疗,观察组患者在对照组基础上加用阿仑膦酸钠治疗。比较两组患者的临床疗效及骨代谢标志物、骨密度、骨碱性磷酸酶指标。结果观察组患者的治疗有效率显著高于对照组(P<0.05);观察组患者的骨代谢指标显著优于对照组,骨密度显著高于对照组,骨碱性磷酸酶显著低于对照组(P<0.05)。结论阿仑膦酸钠治疗重症骨折继发骨质疏松的临床疗效良好,对病情的恢复有极大帮助。