Objectives： To investigate the mechanism of Liuwei Dihuang Pill （六味地黄丸, LDP） in treating postmenopausal osteoporosis （PMOP） with Shen （Kidney） yin deficiency. Methods： In this study, 205 cases of PMOP wer...Objectives： To investigate the mechanism of Liuwei Dihuang Pill （六味地黄丸, LDP） in treating postmenopausal osteoporosis （PMOP） with Shen （Kidney） yin deficiency. Methods： In this study, 205 cases of PMOP were divided into the PMOP Shen-yin deficiency group （Group A）, PMOP Shen-yang deficiency group （Group B）, PMOP without Shen deficiency group （Group C）, and control group （Group N）. Real-time polymerase chain reaction （RT-PCR） and Western blot techniques were used to observe the effects of LDP treatment on the cardiotrophin-like cytokine factor 1 （CLCF1）, ankyrin repeat and SOCS box containing 1 （ASB1）, and proldneticin 2 （PROK2） genes and the Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway. Results： The mRNA （P〈0.05） and protein （P〈0.01） expression levels of the CLCF1 gone in Group A were significantly lower than the corresponding levels in Group N. After LDP treatment for 3 months, the mRNA expression levels of the CLCF1 gone were obviously up-regulated （P〈0.01）. After 6-month treatment, the expression levels of CLCF1 mRNA and protein were significantly up-regulated （both P〈0.01）, and the average bone density of the top femur had significantly increased （P〈0.05）. In vitro, CLCF1 overexpression resulted in a significant increase in the total protein and phosphorylated protein levels of JAK2 and STAT3. Conclusions： The CLCF1 gone is an important gone associated with PMOP Shen-yin deficiency and the therapeutic effects of LDP may be mediated by up-regulation of CLCF1 gone expression and activation of the JAK/STAT signaling pathway.展开更多
Primary osteoporosis （POP） is one of the most common diseases in the elderly people resulting in high risk of fracture and poor quality of life. In addition to the pathological changes in bone mass, most of the POP ...Primary osteoporosis （POP） is one of the most common diseases in the elderly people resulting in high risk of fracture and poor quality of life. In addition to the pathological changes in bone mass, most of the POP patients also suffer from Chinese medicine （CM） syndromes of Shen （Kidney） essence deficiency. Shen essences are highly related to bone. Shen essence deficiency plays an important part in the development of POP and a better diagnosis of POP could be made by combining CM syndromes with Western medicine risk factors. Treatments of POP should aim at both increasing the bone mass and relieving the syndromes of Shen essence deficiency. Clinical study confirmed that treating POP patients with Shen-tonifying herbs could increase the bone mass and relieve the CM syndromes of POP patients. Basic researches clarified the mechanism by which Shen-tonifying herbs increased bone mass in animal models. The mechanisms by which Shentonifying herbs relieve the CM syndromes are still in investigation.展开更多
绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)是女性绝经后由于雌激素分泌不足引起的代谢性骨病。诊断骨质疏松症的金标准是骨密度(Bone Mineral Density BMD)。双膦酸盐、降钙素、雌激素等药物是现代临床治疗PMOP的主力军,但...绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)是女性绝经后由于雌激素分泌不足引起的代谢性骨病。诊断骨质疏松症的金标准是骨密度(Bone Mineral Density BMD)。双膦酸盐、降钙素、雌激素等药物是现代临床治疗PMOP的主力军,但不良反应和药物服用周期存在争议。甘肃省天水市中医医院马小军主任医师认为,肾虚是PMOP发生的重要内在基础,肝肾阴虚是发病的关键。中医将肾奉为“先天之本”,元阴元阳贮藏于肾,肾之阴阳为人体阴阳之本,能够濡养和温煦全身脏腑,且肾主骨生髓。女子以肝为先天,肝肾阴虚导致女子“天癸”亏虚,肝肾同源,久病及肾,肾虚则导致骨失濡养,日久则导致骨质疏松。肝肾阴虚作为本病发病的关键,滋补肝肾应贯穿本病发展始终。基于以上理论,马小军主任医师自拟枸地健骨汤滋补肝肾,益精填髓;在对PMOP症状的缓解和减少复发方面均有较好的临床疗效。本文以案例的形式介绍马小军主任医师临诊PMOP的经验,希望为临床提供依据。展开更多
目的探讨六味地黄汤加减对肝肾阴虚型2型糖尿病绝经后女性患者骨密度影响。方法选取某院2022年5月~2023年5月收治的204例肝肾阴虚型2型糖尿病绝经后女性患者,随机分为两组。对照组102例使用常规控制血糖及补钙对症治疗,观察组102例患者...目的探讨六味地黄汤加减对肝肾阴虚型2型糖尿病绝经后女性患者骨密度影响。方法选取某院2022年5月~2023年5月收治的204例肝肾阴虚型2型糖尿病绝经后女性患者,随机分为两组。对照组102例使用常规控制血糖及补钙对症治疗,观察组102例患者在对照组基础上联合使用六味地黄汤加减治疗。两组患者均治疗6个月。比较两组患者治疗前后血糖情况[糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹血糖(fasting plasma glucose,FPG)]、腰椎L2~4及左侧股骨颈骨密度(bone mineral density,BMD)、骨代谢标志物[总型胶原氨基酸延长肽(Total type I collagen amino terminal lengthening peptide,PINP)、β-胶原特殊序列(β-Crosslaps,β-CTX)]、中医证候积分。结果两组患者入院时血糖情况、腰椎及股骨颈骨密度、骨代谢标志物及中医证候积分差异无统计学意义(P>0.05)。治疗后,两组患者各指标均有好转(P<0.05),观察组患者HbA1c、FPG、PINP、β-CTX水平、中医证候积分较低(P<0.05),腰椎L2~4及左侧股骨颈骨BMD值较高(P<0.05)。结论肝肾阴虚型2型糖尿病绝经后女性患者使用常规治疗联合六味地黄汤加减可改善患者中医证型积分,有效控制患者血糖控制情况,提升患者骨密度,改善骨代谢标志物水平。展开更多
目的观察复方补肾活血颗粒对绝经后非老年骨质疏松症患者视觉模拟评分(Visual Analog Scale,VAS)和骨密度(Bone Mineral Density,BMD)的影响。方法研究对象选自2015年6月-2015年12月在本院诊治的肾虚血瘀证绝经后非老年骨质疏松症患者60...目的观察复方补肾活血颗粒对绝经后非老年骨质疏松症患者视觉模拟评分(Visual Analog Scale,VAS)和骨密度(Bone Mineral Density,BMD)的影响。方法研究对象选自2015年6月-2015年12月在本院诊治的肾虚血瘀证绝经后非老年骨质疏松症患者60例,将患者按照随机函数随机分为两组(对照组和治疗组),每组30例。两组均给予一般治疗,对照组予仙灵骨葆胶囊治疗,治疗组予复方补肾活血颗粒。两组观察时限均为6个月,治疗前后需按照研究方案定期计算中医证候积分,BMD和VAS等指标。结果临床观察表明,复方补肾活血颗粒治疗组中医证候有效率为90%,对照组为60%,与对照组相比,疗效明显优于对照组(P<0.01)。治疗组中医证候积分为7.96±3.86分,对照组为10.16±3.85分,两组比较具有统计学差异。治疗后治疗组BMD和VAS分别为2.24±0.55 g/cm^2、1.96±1.47分,对照组为2.50±0.41 g/cm^2、2.86±1.79分,治疗组改善情况优于对照组。结论复方补肾活血颗粒能显著改善绝经后非老年骨质疏松症患者中医临床症状、BMD和VAS,未见不良事件的发生,复方补肾活血颗粒治疗绝经后非老年骨质疏松症是安全有效的。展开更多
基金Supported by National Natural Science Foundation of China(Nos.81173280,81302995,81403420)Fujian Medical Innovation project(No.2011-CX-30)+1 种基金Science and Technology Department of Fujian Province autonomous non-profit research institutes topics project(No.2011R1038-5)Fujian Academy of Traditional Chinese autonomous topics Project(No.2012fjzyyk-5)
文摘Objectives： To investigate the mechanism of Liuwei Dihuang Pill （六味地黄丸, LDP） in treating postmenopausal osteoporosis （PMOP） with Shen （Kidney） yin deficiency. Methods： In this study, 205 cases of PMOP were divided into the PMOP Shen-yin deficiency group （Group A）, PMOP Shen-yang deficiency group （Group B）, PMOP without Shen deficiency group （Group C）, and control group （Group N）. Real-time polymerase chain reaction （RT-PCR） and Western blot techniques were used to observe the effects of LDP treatment on the cardiotrophin-like cytokine factor 1 （CLCF1）, ankyrin repeat and SOCS box containing 1 （ASB1）, and proldneticin 2 （PROK2） genes and the Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway. Results： The mRNA （P〈0.05） and protein （P〈0.01） expression levels of the CLCF1 gone in Group A were significantly lower than the corresponding levels in Group N. After LDP treatment for 3 months, the mRNA expression levels of the CLCF1 gone were obviously up-regulated （P〈0.01）. After 6-month treatment, the expression levels of CLCF1 mRNA and protein were significantly up-regulated （both P〈0.01）, and the average bone density of the top femur had significantly increased （P〈0.05）. In vitro, CLCF1 overexpression resulted in a significant increase in the total protein and phosphorylated protein levels of JAK2 and STAT3. Conclusions： The CLCF1 gone is an important gone associated with PMOP Shen-yin deficiency and the therapeutic effects of LDP may be mediated by up-regulation of CLCF1 gone expression and activation of the JAK/STAT signaling pathway.
基金Supported by the National Basic Research Program of China(973 Program,No.2010CB530400)Program for Innovative Research Team in University(No,IRT1270),National Natural Science Foundation of China(No.81403239)+1 种基金Shanghai Natural Science Foundation(No.12ZR1450400)085 Project of Shanghai University of Traditional Chinese Medicine(No.085ZY1204)
文摘Primary osteoporosis （POP） is one of the most common diseases in the elderly people resulting in high risk of fracture and poor quality of life. In addition to the pathological changes in bone mass, most of the POP patients also suffer from Chinese medicine （CM） syndromes of Shen （Kidney） essence deficiency. Shen essences are highly related to bone. Shen essence deficiency plays an important part in the development of POP and a better diagnosis of POP could be made by combining CM syndromes with Western medicine risk factors. Treatments of POP should aim at both increasing the bone mass and relieving the syndromes of Shen essence deficiency. Clinical study confirmed that treating POP patients with Shen-tonifying herbs could increase the bone mass and relieve the CM syndromes of POP patients. Basic researches clarified the mechanism by which Shen-tonifying herbs increased bone mass in animal models. The mechanisms by which Shentonifying herbs relieve the CM syndromes are still in investigation.
文摘绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)是女性绝经后由于雌激素分泌不足引起的代谢性骨病。诊断骨质疏松症的金标准是骨密度(Bone Mineral Density BMD)。双膦酸盐、降钙素、雌激素等药物是现代临床治疗PMOP的主力军,但不良反应和药物服用周期存在争议。甘肃省天水市中医医院马小军主任医师认为,肾虚是PMOP发生的重要内在基础,肝肾阴虚是发病的关键。中医将肾奉为“先天之本”,元阴元阳贮藏于肾,肾之阴阳为人体阴阳之本,能够濡养和温煦全身脏腑,且肾主骨生髓。女子以肝为先天,肝肾阴虚导致女子“天癸”亏虚,肝肾同源,久病及肾,肾虚则导致骨失濡养,日久则导致骨质疏松。肝肾阴虚作为本病发病的关键,滋补肝肾应贯穿本病发展始终。基于以上理论,马小军主任医师自拟枸地健骨汤滋补肝肾,益精填髓;在对PMOP症状的缓解和减少复发方面均有较好的临床疗效。本文以案例的形式介绍马小军主任医师临诊PMOP的经验,希望为临床提供依据。
文摘目的探讨六味地黄汤加减对肝肾阴虚型2型糖尿病绝经后女性患者骨密度影响。方法选取某院2022年5月~2023年5月收治的204例肝肾阴虚型2型糖尿病绝经后女性患者,随机分为两组。对照组102例使用常规控制血糖及补钙对症治疗,观察组102例患者在对照组基础上联合使用六味地黄汤加减治疗。两组患者均治疗6个月。比较两组患者治疗前后血糖情况[糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹血糖(fasting plasma glucose,FPG)]、腰椎L2~4及左侧股骨颈骨密度(bone mineral density,BMD)、骨代谢标志物[总型胶原氨基酸延长肽(Total type I collagen amino terminal lengthening peptide,PINP)、β-胶原特殊序列(β-Crosslaps,β-CTX)]、中医证候积分。结果两组患者入院时血糖情况、腰椎及股骨颈骨密度、骨代谢标志物及中医证候积分差异无统计学意义(P>0.05)。治疗后,两组患者各指标均有好转(P<0.05),观察组患者HbA1c、FPG、PINP、β-CTX水平、中医证候积分较低(P<0.05),腰椎L2~4及左侧股骨颈骨BMD值较高(P<0.05)。结论肝肾阴虚型2型糖尿病绝经后女性患者使用常规治疗联合六味地黄汤加减可改善患者中医证型积分,有效控制患者血糖控制情况,提升患者骨密度,改善骨代谢标志物水平。
文摘目的观察复方补肾活血颗粒对绝经后非老年骨质疏松症患者视觉模拟评分(Visual Analog Scale,VAS)和骨密度(Bone Mineral Density,BMD)的影响。方法研究对象选自2015年6月-2015年12月在本院诊治的肾虚血瘀证绝经后非老年骨质疏松症患者60例,将患者按照随机函数随机分为两组(对照组和治疗组),每组30例。两组均给予一般治疗,对照组予仙灵骨葆胶囊治疗,治疗组予复方补肾活血颗粒。两组观察时限均为6个月,治疗前后需按照研究方案定期计算中医证候积分,BMD和VAS等指标。结果临床观察表明,复方补肾活血颗粒治疗组中医证候有效率为90%,对照组为60%,与对照组相比,疗效明显优于对照组(P<0.01)。治疗组中医证候积分为7.96±3.86分,对照组为10.16±3.85分,两组比较具有统计学差异。治疗后治疗组BMD和VAS分别为2.24±0.55 g/cm^2、1.96±1.47分,对照组为2.50±0.41 g/cm^2、2.86±1.79分,治疗组改善情况优于对照组。结论复方补肾活血颗粒能显著改善绝经后非老年骨质疏松症患者中医临床症状、BMD和VAS,未见不良事件的发生,复方补肾活血颗粒治疗绝经后非老年骨质疏松症是安全有效的。
