“抗骨松冲剂”防治绝经后骨质疏松的临床研究
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摘要
目的：探讨绝经后妇女施以“抗骨松冲剂”对骨量、骨代谢生化指标的影响。方法：将56例绝经后妇女随机分为2组，即“抗骨松冲剂”组和尼尔雌醇组。用药12周后，进行腰椎骨密度(BMD)测定和血生化及放免指标检测。结果：与实验前自身比较，(1)“抗骨松冲剂”组，BMD明显增加(P＜O.01)，而代表骨形成及骨吸收指标下降(P＜0.05)，雌二醇(E_2)增加(P＜0.05)。(2)尼尔雌醇组，BMD明显增加(P＜0.01)，雌二醇(E_2)明显增加(P＜0.01)。同时，“抗骨松冲剂”组与尼尔雌醇组比较，BMD增加(P＜0.05)，雌二醇(E_2)明显下降(P＜0.01)。结论：抗骨松冲剂与尼尔雌醇均能阻止绝经后妇女的骨量丢失，且“抗骨松冲剂”在促进骨形成、增加骨量方面优于尼尔雌醇，而无尼尔雌醇的致子宫内膜增生等副作用，是一种较理想的治疗绝经后骨质疏松症的药物。
Objective: To observe the influence in bone mass and the values representing bone metabolic biochemistry after postmenopausal women are treated with Kang Gu Song Granule. Methods: fifty six postmenopausal women were randomly divided into two groups i. e. Group I : treated with Kang Gu Song Granule. Group II: treated with Nylestriol. In the twelfth week, such items were measured as bone density(BMD) of abdominal vertebrae^ biochemistry> radioimmuoassay.
Results: Compared with themselves before twelve weeks, (l)Kang Gu Song Granule group, the bone density increased significantly while the values representing bone form and bone absorption decreased, the content of estradiol increased. (2)Nylestriol group, the bone density increased distinctly, the content of estradiol increased significantly. At the same time, Comparing Kang Gu Song Granule group with Nylestriol group, the bone density increased, the content of estradiol decreased significantly.
Conclusions: Both Kang Gu Song Granule and Nylestriol can prevent bone loss of postmenopausal women while Kang Gu Song Granule was superior to Nylestriol in promoting bone form and increasing bone mass and bearing no side effects of endometrial proliferation which may be induced by Nylestriol, so it is a promising drug for the treatment of postmenopausal osteoporosis.
Objective: To observe the influence in bone mass and the values representing bone metabolic biochemistry after postmenopausal women are treated with Kang Gu Song Granule. Methods: fifty six postmenopausal women were randomly divided into two groups i. e. Group I : treated with Kang Gu Song Granule. Group II: treated with Nylestriol. In the twelfth week, such items were measured as bone density(BMD) of abdominal vertebrae^ biochemistry> radioimmuoassay.
Results: Compared with themselves before twelve weeks, (l)Kang Gu Song Granule group, the bone density increased significantly while the values representing bone form and bone absorption decreased, the content of estradiol increased. (2)Nylestriol group, the bone density increased distinctly, the content of estradiol increased significantly. At the same time, Comparing Kang Gu Song Granule group with Nylestriol group, the bone density increased, the content of estradiol decreased significantly.
Conclusions: Both Kang Gu Song Granule and Nylestriol can prevent bone loss of postmenopausal women while Kang Gu Song Granule was superior to Nylestriol in promoting bone form and increasing bone mass and bearing no side effects of endometrial proliferation which may be induced by Nylestriol, so it is a promising drug for the treatment of postmenopausal osteoporosis.
引文
[1] 刘建立．绝经后骨质疏松症的防治进展．中华妇产科杂志，1997；32(9)：517-519
[2] 万谷文男，等．医学，1990；5：329
[3] Alsenbrey JA.Phys Ther,1987;7:1100
[4] 王洪复，刘建立整理．中华医学会老年医学分会第三次代谢性骨病研讨会纪要．中华老年医学杂志，1997；163(3)：133-135
[5] 林守清，徐苓．女性生殖内分泌性激素补充疗法．北京医学科大学、中国协和医科大学联合出版社，1999；3：第一版
[6] 林丽香．老年人骨质疏松．实用内科杂志，1991；12(11)：638
[7] 王震宇．中华外科杂志，1996；34(5)：315-318
[8] Pacifici R, Rifas L, McCracken R, et al. Ovarian steroid treatment blocks a postmenopausal increase in blood monocyte interleukin 1 release. Proc Natl Acad Sci USA, 1989;86:2398
[9] Pacifici R, Brown C, Puseck E, et al. Effect of surgical menopause and estrogen replacement on cytokine release from human blood mononuc lear cells, Proc Natl Acad Sci USA, 1991;88:5134
[10] Roodman GD. Role of cytokines in the regulation of bone resorption Calcif Tissue Int 1993;53:94
[11] Horo witz MC. Cytokmes and estrogens in bone: anti-osteoporotic effects, Science, 1993;260:626
[12] 国际学术动态．中华内分泌代谢杂志，1993；9(4)：246-248
[13] 邢淑敏．绝经后骨质疏松症．中华妇产科杂志，1993：28(1)：51-53
[14] Compston JE骨质疏松．国外医学内科学分册．1992；19(2)：77—79
[15] 陈大蓉．绝经后骨质疏松症诊断和治疗新进展．重庆医学，1993；22(3)：252-254
[16] 王维力主编《骨矿疾病》天津科技翻译出版公司，1997；8：第一版
[17] 朱宪彝土编《临床内分泌学》天津科学技术出版社，1993；8：第一版
[18] Erikse EF. Evidence of estrogen receptors in normal human osteoblastlike cells. Science, 1998;241:84
[19] Christiansen C, et al. Prevention of early postmenopausal bone loss: controlled 2-year study in 315 normal females. Eur J Clin Int 1980;10:273
[20] 邹亢植，等．老年病学．北京人民卫生出版社，1981，第一版
[21] 李代强．厚发性骨质疏松症的相关激素及受体研究《国外医学生理、病理科学与临床分册》，1998；18(2)：170-173
[22] Turner CH, Sato M, Bryant HU. Raloxifene preserves bone strength and bone mass in ovariectomized rats. Endocrinology, 1994,135:2001-2005
[23] Black LJ, Sato M, Rowley ER, et al. Raloxifene(LY139481 HCI) prevents bone loss and reduces serum cholesterol without causing uterine hypertrophy in ovariectomized rats. J Clin Invest, 1994;93:63-69
[24] 孟迅吾．密息钙治疗原发性骨质疏松症22例．中华医学杂志，1992；72(10)：624
[25] 孙清．老年妇女骨质疏松的防治．中国实用妇科与产科杂志，1999；15(2)：70—71
[26] 陈少华，等．老年学杂志，1993；13(2)：91
[27] Samaan SA, Crawford MH. Estrogen and cardiovascular function after menopause. JACC, 1995;26:1432-1440
[28] Campos H. McNAmara JR, Wilson PWF, et al. Differences in low density lipoprotein subfractions and apolipoproteins in premenopausal and postmenopausal woman. J Clin Endocrin Metab, 1988:67:30
[29] Gambrell RD. Use of progestrogen in postmenopausal woman Iht J Fertil, 1989;34:315
[30] 《中药大辞典》上海科技出版社，1986：5：第一版
[31] 黄泰康《常用中药成分与药理手册》中国医学科技版社，1994：4：第一版
[32] 王本祥．《现代中药药理学》天津科学技术出版社出版，1997；1：第一版
[33] 梅全喜．《现代中药药理学手册》中国中医药出版社，1998；10：第一版
[34] 雷载权《中药学》上海科学技术出版社出版、发行1995；6：第一版
[35] 黄艳红．补肾中药片对围绝经期妇女骨质疏松代谢的影响．中国中西医结合杂志．1993；13(9)：522-524
[36] 丁桂芝．补肾健骨胶囊治疗绝经后骨质疏松症疗效分析．中国中西医结合杂志，1995；15(7)：392-394
[2] 万谷文男，等．医学，1990；5：329
[3] Alsenbrey JA.Phys Ther,1987;7:1100
[4] 王洪复，刘建立整理．中华医学会老年医学分会第三次代谢性骨病研讨会纪要．中华老年医学杂志，1997；163(3)：133-135
[5] 林守清，徐苓．女性生殖内分泌性激素补充疗法．北京医学科大学、中国协和医科大学联合出版社，1999；3：第一版
[6] 林丽香．老年人骨质疏松．实用内科杂志，1991；12(11)：638
[7] 王震宇．中华外科杂志，1996；34(5)：315-318
[8] Pacifici R, Rifas L, McCracken R, et al. Ovarian steroid treatment blocks a postmenopausal increase in blood monocyte interleukin 1 release. Proc Natl Acad Sci USA, 1989;86:2398
[9] Pacifici R, Brown C, Puseck E, et al. Effect of surgical menopause and estrogen replacement on cytokine release from human blood mononuc lear cells, Proc Natl Acad Sci USA, 1991;88:5134
[10] Roodman GD. Role of cytokines in the regulation of bone resorption Calcif Tissue Int 1993;53:94
[11] Horo witz MC. Cytokmes and estrogens in bone: anti-osteoporotic effects, Science, 1993;260:626
[12] 国际学术动态．中华内分泌代谢杂志，1993；9(4)：246-248
[13] 邢淑敏．绝经后骨质疏松症．中华妇产科杂志，1993：28(1)：51-53
[14] Compston JE骨质疏松．国外医学内科学分册．1992；19(2)：77—79
[15] 陈大蓉．绝经后骨质疏松症诊断和治疗新进展．重庆医学，1993；22(3)：252-254
[16] 王维力主编《骨矿疾病》天津科技翻译出版公司，1997；8：第一版
[17] 朱宪彝土编《临床内分泌学》天津科学技术出版社，1993；8：第一版
[18] Erikse EF. Evidence of estrogen receptors in normal human osteoblastlike cells. Science, 1998;241:84
[19] Christiansen C, et al. Prevention of early postmenopausal bone loss: controlled 2-year study in 315 normal females. Eur J Clin Int 1980;10:273
[20] 邹亢植，等．老年病学．北京人民卫生出版社，1981，第一版
[21] 李代强．厚发性骨质疏松症的相关激素及受体研究《国外医学生理、病理科学与临床分册》，1998；18(2)：170-173
[22] Turner CH, Sato M, Bryant HU. Raloxifene preserves bone strength and bone mass in ovariectomized rats. Endocrinology, 1994,135:2001-2005
[23] Black LJ, Sato M, Rowley ER, et al. Raloxifene(LY139481 HCI) prevents bone loss and reduces serum cholesterol without causing uterine hypertrophy in ovariectomized rats. J Clin Invest, 1994;93:63-69
[24] 孟迅吾．密息钙治疗原发性骨质疏松症22例．中华医学杂志，1992；72(10)：624
[25] 孙清．老年妇女骨质疏松的防治．中国实用妇科与产科杂志，1999；15(2)：70—71
[26] 陈少华，等．老年学杂志，1993；13(2)：91
[27] Samaan SA, Crawford MH. Estrogen and cardiovascular function after menopause. JACC, 1995;26:1432-1440
[28] Campos H. McNAmara JR, Wilson PWF, et al. Differences in low density lipoprotein subfractions and apolipoproteins in premenopausal and postmenopausal woman. J Clin Endocrin Metab, 1988:67:30
[29] Gambrell RD. Use of progestrogen in postmenopausal woman Iht J Fertil, 1989;34:315
[30] 《中药大辞典》上海科技出版社，1986：5：第一版
[31] 黄泰康《常用中药成分与药理手册》中国医学科技版社，1994：4：第一版
[32] 王本祥．《现代中药药理学》天津科学技术出版社出版，1997；1：第一版
[33] 梅全喜．《现代中药药理学手册》中国中医药出版社，1998；10：第一版
[34] 雷载权《中药学》上海科学技术出版社出版、发行1995；6：第一版
[35] 黄艳红．补肾中药片对围绝经期妇女骨质疏松代谢的影响．中国中西医结合杂志．1993；13(9)：522-524
[36] 丁桂芝．补肾健骨胶囊治疗绝经后骨质疏松症疗效分析．中国中西医结合杂志，1995；15(7)：392-394