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投稿时间:2023-04-07 网络发布日期:2023-12-20
投稿时间:2023-04-07 网络发布日期:2023-12-20
中文摘要: 目的 分析补肾健脾方对绝经后骨质疏松症(PMOP)患者血清破骨、成骨相关因子及肠道菌群的影响。
方法纳入广州中医药大学第三附属医院2021年3月至2022年12月收治的80例PMOP患者,使用简单随机化法分为联合组和对照组,各40例。对照组给予碳酸钙D3片治疗,联合组加用补肾健脾方,两组治疗均持续8周。检测两组治疗前后血清破骨、成骨相关因子[Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、Ⅰ型前胶原氨基端前肽(P1NP)]水平变化,评估其治疗前后中医症状评分变化,并比较其肠道菌群水平变化。
结果 两组治疗8周后β-CTX、P1NP均较治疗前下降;联合组治疗8周后β-CTX、P1NP均低于对照组,差异有统计学意义(P<0.05)。两组治疗8周后腰背疼痛、腰膝酸软无力、下肢抽筋、步履艰难、持重困难评分均较治疗前下降,且联合组低于对照组,差异有统计学意义(P<0.05)。治疗8周后,联合组总有效率为92.50%,高于对照组的75.00%,差异有统计学意义(P<0.05)。两组治疗8周后粪便双歧杆菌、乳酸杆菌数量均较治疗前升高,大肠杆菌数量较治疗前下降;联合组治疗8周后粪便双歧杆菌、乳酸杆菌数量高于对照组,其大肠杆菌数量低于对照组,差异有统计学意义(P<0.05)。两组治疗期间均未见明显不良反应。
结论 对于PMOP患者而言,在补充钙剂的基础上给予补肾健脾方有助于调节血清破骨、成骨相关因子及肠道菌群水平,改善患者临床症状并进一步提高治疗效果,且安全性良好。
中文关键词: 补肾健脾方 绝经后骨质疏松症 破骨因子 成骨因子 Ⅰ型前胶原氨基端前肽 Ⅰ型胶原羧基端肽β特殊序列 中医证候 肠道菌群 碳酸钙D3片 骨痿
Abstract:Objective To analyze the effect of Bushen Jianpi prescription on serum osteoclast, osteogenesis related factors and intestinal flora in postmenopausal osteoporosis (PMOP).
Methods Eighty patients with PMOP admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2021 to December 2022 were randomly divided into combined group and control group by simple randomization method, with 40 patients in each group. The control group was treated with calcium carbonate vitamin D3 tablets, while the combined group was supplemented with Bushen Jianpi prescription on the basis of the control group. The treatment of both groups lasted for 8 weeks. The changes of serum osteoclast and osteogenesis-related factors [β-isomer of C-terminal telopeptide of type Ⅰ collagen(β-CTX), procollagen type Ⅰ Nterminal propeptide (P1NP)]in the two groups before and after treatment were detected, and the changes of Chinese medicine symptom score before and after treatment were evaluated, and the changes of intestinal flora were compared.
Results After 8 weeks of treatment, β-CTX and P1NP in both groups decreased compared with those before treatment,and in the combined group were lower than those in the control group, and the difference was statistically significant (P<0.05). After 8 weeks of treatment, the scores of symptoms of low back pain, weakness of waist and knees, lower limb cramps, difficulty in walking and difficulty in carrying weight in both groups decreased compared with those before treatment,and in the combined group were lower than those in the control group, the difference was statistically significant (P<0.05). After 8 weeks of treatment, the total effective rate of the combined group was 92.50%, which was higher than that of the control group (75.00%) (P<0.05). After 8 weeks of treatment, the number of Bifidobacterium and Lactobacillus in feces in both groups increased compared with that before treatment, while the number of Escherichia coli decreased compared with that before treatment. After 8 weeks of treatment, the number of Bifidobacterium and Lactobacillus in feces of the combined group was higher than that of the control group, and the number of Escherichia coli was lower than that of the control group (P<0.05). There was no obvious adverse reactions in both groups during treatment.
Conclusion For patients with PMOP, Bushen Jianpi prescription on the basis of calcium supplementation is helpful to regulate the levels of serum osteoclast, osteogenesis-related factors and intestinal flora, improve the clinical symptoms of patients and further improve the therapeutic effect, and it is safe.
keywords: Bushen Jianpi prescription Postmenopausal osteoporosis Osteoclast factor Osteogenic factor Procollagen type Ⅰ N-terminal propeptide Beta-isomer of C-terminal telopeptide of type Ⅰ collagen Chinese medicine syndrome Intestinal flora Calcium carbonate vitamin D3 tables Bone paralysis
文章编号: 中图分类号:R271.9 文献标志码:B
基金项目:国家自然科学基金 (82205139);广东省基础与应用基础研究基金项目(2021A1515011463)
引用文本:
罗坤灵,吴志方,唐咏,等.补肾健脾方对绝经后骨质疏松症患者血清破骨和成骨相关因子及肠道菌群的影响[J].中国临床研究,2023,36(12):1866-1870.
罗坤灵,吴志方,唐咏,等.补肾健脾方对绝经后骨质疏松症患者血清破骨和成骨相关因子及肠道菌群的影响[J].中国临床研究,2023,36(12):1866-1870.