左归丸联合阿法骨化醇、替勃龙对绝经后骨质疏松症患者骨密度及内分泌激素的影响
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摘要
目的观察左归丸联合阿法骨化醇、替勃龙对绝经后骨质疏松症患者骨密度及内分泌激素的影响。方法将80例绝经后骨质疏松症患者随机分为观察组和对照组,对照组40例给予阿法骨化醇联合替勃龙治疗,观察组40例在对照组治疗基础上加服左归丸治疗。治疗6个月后,统计2组临床疗效,观察2组治疗前后骨密度指标(股骨颈骨密度、腰椎正位骨密度、Wards三角区骨密度)、骨代谢指标[骨钙素(BGP)、骨碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶(TRACP)]、内分泌激素[雌二醇(E2)、促卵泡激素(FSH)、促黄体生成素(LH)]水平变化情况。结果观察组治疗后总有效率为87. 5%,显著高于对照组的67. 5%(P <0. 05); 2组治疗后股骨颈、腰椎正位、Wards三角区的骨密度及E2水平均显著升高(P均<0. 05),BALP、BGP、TRAC、FSH、LH水平均显著降低(P均<0. 05),且观察组治疗后上述指标改善情况均显著优于对照组(P均<0. 05)。结论左归丸联合阿法骨化醇、替勃龙治疗绝经后骨质疏松症能够增加骨密度,降低骨转换,有效调节患者内分泌激素水平。
Objective It is to observe the effects of Zuogui Pill combined with alphacalcidol and tibolone on bone density and endocrine hormone in postmenopausal osteoporosis patients. Methods Eighty patients with postmenopausal osteoporosis were randomly divided into observation group and control group. 40 patients in the control group were treated with alfacalcidol combined with tibolone. 40 patients in the observation group were treated with Zuogui Pil on the basis of the control group. After 6 months of treatment,the clinical efficacy of the two groups was assessed,the changes of bone density indexes(femoral neck bone density,lumbar vertebrae bone density,Wards triangle bone density) and bone metabolic index[osteocalcin(BGP),bone alkaline phosphatase(BALP),tartrate-resistant acid phosphatase(TRACP) ],endocrine hormones [estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH) ]were observed before and after treatment. Results The total effective rate of the observation group was 87. 5%,which was significantly higher than that of the control group(67. 5%)(P < 0. 05). The bone density of femoral neck,lumbar vertebrae,Wards triangle and E2 level were significantly increased after treatment(P < 0. 05),the levels of BALP,BGP,TRAC,FSH,LH were significantly decreased(P < 0. 05),and the improvements of the above indicators in the observation group were significantly better than those in the control group(P < 0. 05). Conclusion Zuogui Pill combined with alfacalcidol and tibolone can increase bone mineral density,reduce bone turnover,and effectively regulate endocrine hormone levels in patients with postmenopausal osteoporosis.
Objective It is to observe the effects of Zuogui Pill combined with alphacalcidol and tibolone on bone density and endocrine hormone in postmenopausal osteoporosis patients. Methods Eighty patients with postmenopausal osteoporosis were randomly divided into observation group and control group. 40 patients in the control group were treated with alfacalcidol combined with tibolone. 40 patients in the observation group were treated with Zuogui Pil on the basis of the control group. After 6 months of treatment,the clinical efficacy of the two groups was assessed,the changes of bone density indexes(femoral neck bone density,lumbar vertebrae bone density,Wards triangle bone density) and bone metabolic index[osteocalcin(BGP),bone alkaline phosphatase(BALP),tartrate-resistant acid phosphatase(TRACP) ],endocrine hormones [estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH) ]were observed before and after treatment. Results The total effective rate of the observation group was 87. 5%,which was significantly higher than that of the control group(67. 5%)(P < 0. 05). The bone density of femoral neck,lumbar vertebrae,Wards triangle and E2 level were significantly increased after treatment(P < 0. 05),the levels of BALP,BGP,TRAC,FSH,LH were significantly decreased(P < 0. 05),and the improvements of the above indicators in the observation group were significantly better than those in the control group(P < 0. 05). Conclusion Zuogui Pill combined with alfacalcidol and tibolone can increase bone mineral density,reduce bone turnover,and effectively regulate endocrine hormone levels in patients with postmenopausal osteoporosis.
引文
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[10]任艳玲,李娅玲,吕海波.左归丸对卵巢骨质疏松大鼠肾脏TGF-β1/Smad4 mRNA表达的影响[J].中国实验方剂学杂志,2012,18(10):190-194
[11]李乃谦.熟地黄活性成分药理作用的研究进展[J].中国处方药,2017,15(1):14-15
[12]杨明明,袁晓旭,赵桂琴,等.山茱萸化学成分和药理作用的研究进展[J].承德医学院学报,2016,33(5):398-400
[13]孙洋,梅伦方.山药药理作用研究进展[J].亚太传统医药,2013,9(3):50-51
[14]余新建,陈素红,吕圭源.龟甲“滋阴补肾”药效相关研究概况[J].当代医学,2009,15(10):15-17
[15]鲍悦,高久堂,孙佳明,等.中药鹿角胶的研究进展[J].吉林中医药,2016,36(2):173-175; 204
[16]郭敏,乌兰托雅,李刚.枸杞多糖药理作用的研究进展[J].华西药学杂志,2013,28(6):633-635
[17]沈舒,王琼,李友宾.牛膝的化学成分和药理作用研究进展[J].海峡药业,2011,23(11):1-6
[2]赵光,沈霖,杨艳萍.青娥丸对绝经后骨质疏松症患者骨密度、血清MMP-2水平及骨代谢指标的影响[J].中西医结合研究,2012,4(3):113-117
[3]中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊治指南[J].中华骨质疏松和骨矿盐疾病杂志,2011,4(1):2-17
[4]国家中医药管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:356-360
[5]中国健康促进基金会骨质疏松防治中国白皮书编委会.骨质疏松症中国白皮书[J].中华健康管理学杂志,2009,3(3):148-154
[6]马春燕,王振国.女性内分泌与骨质疏松[J].中国骨质疏松杂志,2013,19(8):889-891
[7] Li MZ,Zhou S,Li G. Research status of osteoporosis mechanism and treatment of selective estrogen receptor modulators after menopause[J]. Chin J Clin Pharmacol Ther,2008,13(2):213-219
[8]刘梅洁,鞠大宏,赵宏艳.肾主骨的机理研究·左归丸含药血清对破骨细胞分化调控因子OPG、RANKL蛋白表达的影响[J].中国中医基础医学杂志,2009,15(3):184-187
[9] Liu MJ,Li Y,Pan JH. Effects of Zuo gui Pill on writ singal transduction in rats with glucorticoid-induced osteoporosis[J]. J Traditional Chinese Medicine,2011,31(2):98-102
[10]任艳玲,李娅玲,吕海波.左归丸对卵巢骨质疏松大鼠肾脏TGF-β1/Smad4 mRNA表达的影响[J].中国实验方剂学杂志,2012,18(10):190-194
[11]李乃谦.熟地黄活性成分药理作用的研究进展[J].中国处方药,2017,15(1):14-15
[12]杨明明,袁晓旭,赵桂琴,等.山茱萸化学成分和药理作用的研究进展[J].承德医学院学报,2016,33(5):398-400
[13]孙洋,梅伦方.山药药理作用研究进展[J].亚太传统医药,2013,9(3):50-51
[14]余新建,陈素红,吕圭源.龟甲“滋阴补肾”药效相关研究概况[J].当代医学,2009,15(10):15-17
[15]鲍悦,高久堂,孙佳明,等.中药鹿角胶的研究进展[J].吉林中医药,2016,36(2):173-175; 204
[16]郭敏,乌兰托雅,李刚.枸杞多糖药理作用的研究进展[J].华西药学杂志,2013,28(6):633-635
[17]沈舒,王琼,李友宾.牛膝的化学成分和药理作用研究进展[J].海峡药业,2011,23(11):1-6