活血通络法对老年性骨质疏松症骨矿化的影响
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摘要
目的:
观察活血通络法对老年性骨质疏松症骨矿化的影响,并从临床角度探讨老年性骨质疏松症的发病机理与从瘀论治老年性骨质疏松症的机制,为临床应用提供科学理论依据。
方法:
选取60例老年性骨质疏松症患者,中医证型符合血瘀型诊断标准,随机分为两组,每组30例:治疗组(予中成药“活血通脉胶囊”+钙尔奇D 600咀嚼片);对照组(予钙尔奇D 600咀嚼片)。各组治疗前及治疗1年后分别对血瘀临床表现综合评分、甲襞微循环评分,血液流变学指标(全血高切粘度、全血低切粘度、血浆粘度、红细胞压积、红细胞聚集指数、红细胞变形指数、血沉、纤维蛋白原、红细胞电泳时间),腰_(2-4)椎体前后位骨矿物密度(BMD)、血中骨钙素(BGP)及骨源性碱性磷酸酶(BALP)进行评价。治疗前及治疗1年后,组间及各组治疗前后进行对比,观察活血通络法对老年性骨质疏松症骨矿化的影响并评价活血通络法治疗老年性骨质疏松症的临床效果。
结果:
1.治疗1年后,治疗组血瘀临床表现综合评分及甲襞微循环评分均较治疗前降低,并有显著性差异(P＜0.01);对照组血瘀临床表现综合评分及甲襞微循环评分均较治疗前降低,但无统计学意义(P＞0.05);组间比较均有显著性差异(P＜0.01)。表明活血通络法可明显改善老年性骨质疏松症患者的血瘀临床症状及微循环障碍。
2.治疗1年后,治疗组血液流变学各项指标较治疗前均降低,有显著性差异(P＜0.01);对照组较治疗前无显著性差异(P＞0.05);组间比较有显著性差异(P＜0.01)。表明活血通络法可明显改善老年性骨质疏松症患者的血液流变性。
3.治疗1年后,治疗组和对照组腰椎BMD较治疗前均增高,组内比较治疗组有显著性差异(P＜0.01);对照组无显著性差异(P＞0.05);组间比较有显著性差异(P＜0.01)。表明活血通络法可明显提高老年性骨质疏松症患者的骨矿含量。
4.治疗1年后,治疗组和对照组血中BGP水平较治疗前均升高,而BALP水平较治疗前均下降,组内比较治疗组均有显著性差异(P＜0.01):对照组均无显著性差异(P＞0.05);组间比较均有显著性差异(P＜0.01)。表明活血通络法可明显改善老年性骨质疏松症的骨代谢,促进骨形成。
5.治疗组总有效率93.33%,对照组总有效率73.33%,组间疗效比较有显著性差异(P＜0.05)。表明活血通络法可改善老年性骨质疏松症患者以腰背疼痛为主的临床表现,提高生活质量。
结论:
1.老年性骨质疏松症患者不仅存在明显的血瘀临床表现和微循环障碍,而且血液存在着“粘、浓、凝、聚”等血瘀证的客观病理变化。其发病与血瘀密切相关,血瘀是其发病的重要原因之一。
2.活血通络法可明显改善老年性骨质疏松症患者的血液流变性,改善其血瘀临床症状及微循环障碍,进而改善其以腰背疼痛为主的临床表现,提高生活质量。
3.活血通络法治疗老年性骨质疏松症,能够提高骨代谢水平,促进骨矿化,提高骨矿含量和骨密度,从而提高骨矿化药物的疗效。
Objective:
From the clinical angulation, to observe the effects of bone mineralization to the patients with Senile Osteoposis treated with Stasis-Eliminating Vein Dredging therapy, and to approach the pathogeny of Senile Osteoposis and the mechanism of the treatment to SOP with Stasis-Eliminating Vein Dredging therapy,to supply scientific theory basis for clinical application..
Methods:
60 Patients with Blood-Stasis type Senile Osteoporosis, were divided into two groups randomly, 30 patients per group: the treat group (treated with the Huoxuetongmai capsule and Caltrate D 600 chew tablet);the control group(treated with Caltrate D 600 chew tablet).Appraised the clinical stituation integrative scores ,Nail fold Microcirculation scores and Hemorheology, and determined anterior-posterior position lumbar2～4 vertebra body BMD, BGP, BALP, before and after treated 1 year, then contrast intragroup and selfgroup. Depending on the standard of curative effect, contrast the difference of curative effect between two groups.
Results:
1. Two groups clinical appearance integrative scores and Nail fold Microcirculation scores were lower than pretreatment after 1 year, with significant difference(P < 0.01), the change of the control group is also lower, but no significant significance(P > 0.05). There is a significant difference between the two groups (P<0.01). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can amend the clinical symptoms of Blood-Stasis and the microcirculation disturbance.
2. The hemorheology level of the treat group was lower than the pretreatment after 1 year, with significant difference(P < 0.01). the change of the control group has no significant difference (P > 0.05). There is a significant difference between the two groups (P < 0.01). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can amend the hemorheology.
3. The post-treatment Lumbar vertebra BMD were increased both in the treat group and the control group, with significant difference in the treat group (P < 0.01), but there is not significant difference in the control group (P > 0.05).There is a significant difference between the two groups (P < 0.01). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can improve the bone mineral contents(BMC) and BMD.
4. The BGP level in the blood of the treat group were improved than pretreatment and the BALP level in the blood of the treat group were lowered than pretreatment after 1 year, with significant difference(P < 0.01), the change of the control group has no significant significance(P > 0.05). There is a significant difference between the two groups (P < 0.01). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can improve the level of bone metabolism,promote bone formation.
5. The total availability rate is 93.33% in the treat group, and is 73.33% in the control group, which has a significant difference between the two groups (P < 0.05). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can amend the lumbodynia that is main clinical situation,improve the quality of life.
Conclusions:
1. The patients of Senile Osteoposis not only exist evident Blood-Stasis clinical situation, but also exist objective pathological change of Blood-Stasis.Its morbidity is intimate correlate to the Blood-Stasis and the Blood-Stasis is one of the important pathogenetic factors.
2. Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP, can amend the clinical symptoms of Blood-Stasis and the microcirculation disturbance,thereby amend the lumbodynia that is main clinical situation,improve the quality of life.
3. Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can improve the level of bone metabolism,promote the bone mineralization,improve the bone mineral contents(BMC) and BMD,thereby improve the curative effect of bone mineralization drugs.
观察活血通络法对老年性骨质疏松症骨矿化的影响,并从临床角度探讨老年性骨质疏松症的发病机理与从瘀论治老年性骨质疏松症的机制,为临床应用提供科学理论依据。
方法:
选取60例老年性骨质疏松症患者,中医证型符合血瘀型诊断标准,随机分为两组,每组30例:治疗组(予中成药“活血通脉胶囊”+钙尔奇D 600咀嚼片);对照组(予钙尔奇D 600咀嚼片)。各组治疗前及治疗1年后分别对血瘀临床表现综合评分、甲襞微循环评分,血液流变学指标(全血高切粘度、全血低切粘度、血浆粘度、红细胞压积、红细胞聚集指数、红细胞变形指数、血沉、纤维蛋白原、红细胞电泳时间),腰_(2-4)椎体前后位骨矿物密度(BMD)、血中骨钙素(BGP)及骨源性碱性磷酸酶(BALP)进行评价。治疗前及治疗1年后,组间及各组治疗前后进行对比,观察活血通络法对老年性骨质疏松症骨矿化的影响并评价活血通络法治疗老年性骨质疏松症的临床效果。
结果:
1.治疗1年后,治疗组血瘀临床表现综合评分及甲襞微循环评分均较治疗前降低,并有显著性差异(P＜0.01);对照组血瘀临床表现综合评分及甲襞微循环评分均较治疗前降低,但无统计学意义(P＞0.05);组间比较均有显著性差异(P＜0.01)。表明活血通络法可明显改善老年性骨质疏松症患者的血瘀临床症状及微循环障碍。
2.治疗1年后,治疗组血液流变学各项指标较治疗前均降低,有显著性差异(P＜0.01);对照组较治疗前无显著性差异(P＞0.05);组间比较有显著性差异(P＜0.01)。表明活血通络法可明显改善老年性骨质疏松症患者的血液流变性。
3.治疗1年后,治疗组和对照组腰椎BMD较治疗前均增高,组内比较治疗组有显著性差异(P＜0.01);对照组无显著性差异(P＞0.05);组间比较有显著性差异(P＜0.01)。表明活血通络法可明显提高老年性骨质疏松症患者的骨矿含量。
4.治疗1年后,治疗组和对照组血中BGP水平较治疗前均升高,而BALP水平较治疗前均下降,组内比较治疗组均有显著性差异(P＜0.01):对照组均无显著性差异(P＞0.05);组间比较均有显著性差异(P＜0.01)。表明活血通络法可明显改善老年性骨质疏松症的骨代谢,促进骨形成。
5.治疗组总有效率93.33%,对照组总有效率73.33%,组间疗效比较有显著性差异(P＜0.05)。表明活血通络法可改善老年性骨质疏松症患者以腰背疼痛为主的临床表现,提高生活质量。
结论:
1.老年性骨质疏松症患者不仅存在明显的血瘀临床表现和微循环障碍,而且血液存在着“粘、浓、凝、聚”等血瘀证的客观病理变化。其发病与血瘀密切相关,血瘀是其发病的重要原因之一。
2.活血通络法可明显改善老年性骨质疏松症患者的血液流变性,改善其血瘀临床症状及微循环障碍,进而改善其以腰背疼痛为主的临床表现,提高生活质量。
3.活血通络法治疗老年性骨质疏松症,能够提高骨代谢水平,促进骨矿化,提高骨矿含量和骨密度,从而提高骨矿化药物的疗效。
Objective:
From the clinical angulation, to observe the effects of bone mineralization to the patients with Senile Osteoposis treated with Stasis-Eliminating Vein Dredging therapy, and to approach the pathogeny of Senile Osteoposis and the mechanism of the treatment to SOP with Stasis-Eliminating Vein Dredging therapy,to supply scientific theory basis for clinical application..
Methods:
60 Patients with Blood-Stasis type Senile Osteoporosis, were divided into two groups randomly, 30 patients per group: the treat group (treated with the Huoxuetongmai capsule and Caltrate D 600 chew tablet);the control group(treated with Caltrate D 600 chew tablet).Appraised the clinical stituation integrative scores ,Nail fold Microcirculation scores and Hemorheology, and determined anterior-posterior position lumbar2～4 vertebra body BMD, BGP, BALP, before and after treated 1 year, then contrast intragroup and selfgroup. Depending on the standard of curative effect, contrast the difference of curative effect between two groups.
Results:
1. Two groups clinical appearance integrative scores and Nail fold Microcirculation scores were lower than pretreatment after 1 year, with significant difference(P < 0.01), the change of the control group is also lower, but no significant significance(P > 0.05). There is a significant difference between the two groups (P<0.01). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can amend the clinical symptoms of Blood-Stasis and the microcirculation disturbance.
2. The hemorheology level of the treat group was lower than the pretreatment after 1 year, with significant difference(P < 0.01). the change of the control group has no significant difference (P > 0.05). There is a significant difference between the two groups (P < 0.01). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can amend the hemorheology.
3. The post-treatment Lumbar vertebra BMD were increased both in the treat group and the control group, with significant difference in the treat group (P < 0.01), but there is not significant difference in the control group (P > 0.05).There is a significant difference between the two groups (P < 0.01). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can improve the bone mineral contents(BMC) and BMD.
4. The BGP level in the blood of the treat group were improved than pretreatment and the BALP level in the blood of the treat group were lowered than pretreatment after 1 year, with significant difference(P < 0.01), the change of the control group has no significant significance(P > 0.05). There is a significant difference between the two groups (P < 0.01). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can improve the level of bone metabolism,promote bone formation.
5. The total availability rate is 93.33% in the treat group, and is 73.33% in the control group, which has a significant difference between the two groups (P < 0.05). To illustrate that Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can amend the lumbodynia that is main clinical situation,improve the quality of life.
Conclusions:
1. The patients of Senile Osteoposis not only exist evident Blood-Stasis clinical situation, but also exist objective pathological change of Blood-Stasis.Its morbidity is intimate correlate to the Blood-Stasis and the Blood-Stasis is one of the important pathogenetic factors.
2. Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP, can amend the clinical symptoms of Blood-Stasis and the microcirculation disturbance,thereby amend the lumbodynia that is main clinical situation,improve the quality of life.
3. Stasis-Eliminating Vein Dredging principle to the patients with Blood-Stasis type SOP can improve the level of bone metabolism,promote the bone mineralization,improve the bone mineral contents(BMC) and BMD,thereby improve the curative effect of bone mineralization drugs.
引文
[1]刘忠厚,杨定焯.中国人骨质疏松症建议诊断标准(第二稿).中国骨质疏松杂志[J],2000,6(1):2.
[2]Torring O.Osteoporosis among the elderly is a "silent epidemics".Insufficient prophylaxis and underdiagnosing are big problems Lakartidningen[J],2001,14(28-29):32
[3]朴俊红,庞莲萍,刘忠厚,等.中国人口状况及原发性骨质疏松症诊断标准和发生率.中国骨质疏松杂志[J],2002,8(1):1-7.
[4]李彩艳,时利平,洪景福.老年性骨质疏松症的病因及治疗进展.中国临床医药[J],2003,4(15):93.
[5]王文健.补肾法对老年男性下丘脑-垂体-性腺轴作用的临床和实验研究.中医杂志[J],1986:27(4):32
[6]周文泉,于向东.骨质疏松症的中医及中西医结合研究评述.中国临床康复[J],2002,18(6):2768-2769.
[7]刘庆思.中西医结合诊治骨质疏松症[M].北京:中国中医药出版社,2001.3.
[8]颜德馨,胡泉林,王平平.气虚血瘀是人体衰老的主要机制.中国医药学报[J],1989,4(2):10-12.
[9]Meumie-HE.Predictions on future diagnosis and treatment of osteoporosis.Calcif-Tissue-Int[J].1995,57(2):83.
[10]井上哲郎.日本骨质疏松症研究进展.中国骨质疏松杂志[J],1995,1(1):47.
[11]眭承志,周军,等.绝经后骨质疏松症血瘀病机的客观初步论证.中医研究[J],2005,18(1):30-33.
[12]眭承志,刘志坤,等.绝经后骨质疏松症与血瘀.中国中西医结合杂志[J],2005,25(5):456-458.
[13]眭承志,王彦伟,等.血瘀证在绝经后骨质疏松症中的量化研究.中医药通报[J],2005,4(2):32-33.
[14]第二届全国活血化瘀研究学术会议修订.血瘀证诊断标准.中西医结合杂志[J],1987,7(3):129.
[15]王宁华.疼痛定量评定的进展.中国临床康复[J],2002,6(18):2738-2739.
[16]周丕琪,沈霖,杜靖远,等.PMOP与血清IL-6,TNF-α浓度关系的临床研究.中国骨质疏松杂志[J],2001,7(1):1-3,8.
[17]田牛.实用临床微循环学[M].第一版.北京:军事科学出版社,1989.28-31.
[18]中华人民共和国卫生部.中药新药临床研究指导原则[S].第3辑,1997:149.
[19]赵玉堂,刘凯军,李金花,等.骨矿含量与肾虚、肾主骨关系的研究.中国骨质疏松杂志[J],1996,2(3):19-21.
[20]李跃华,董元龙.老年人骨质疏松患病率与肾虚证型关系的调查.中国中西医结合杂志[J],1995,15(6):366-367.
[21]许志奇,韩素华,杨定焯,等.肾虚证骨矿物质含量的初步研究.中西医结合杂志[J].1991, 11(3):222.
[22]李边达.中药治疗无菌性股骨头坏死及骨质疏松症的主要药效学研究技本要求.中药新药与临床[J],1992,3(2):7.
[23]周丕琪,沈霖,杜靖远,等.补肾法对绝经后骨质疏松患者IL-6、TNF-a的影响.中国中医骨伤科杂志[J],2000,8(4):1-3.
[24]谢林,姚共和,郭振球.健脾养胃法治疗骨质疏松症初探.湖南中医学院学报[J],1996,16(4):7-9.
[25]刘忠厚.骨质疏松学.北京:科学出版社,1998.234-235.
[26]何华.老年气虚血瘀初探.新中医[J],1991,23(7):52.
[27]杨少锋.关于骨质疏松症与血瘀关系的探讨.湖南中医药学报[J],1996,2(4):25.
[28]韩英,聂英坤,姜礼红,等.128例老年骨质疏松症患者的红细胞流变性分析.中国微循环[J],2002,1(6):43-44.
[29]汪延华.钙、降钙素、维生素D与骨质疏松症[M].合肥:中国科学技术大学出版杜,2004.
[30]Schanne FA,Kane AB,Young EE,et al.Calcium dependence of toxiccell death:a final common pathway.Science[J],1979,206:700.
[31]陈利国,孙兆贵,王蕾,等.血瘀证与血管内皮细胞内游离钙浓度关系的实验研究.山东中医药大学学报[J],2001,25(1):55.
[32]Uchio Y,Ochi N,et al.Intraosseous hypertension and venous congestion in osteonecrosis of the knee.Clin Orthop[J],2001,384(3):217-223.
[33]马克昌,冯坤,朱太咏,等.骨生理学[M].郑州:河南医科大学出版社,2000.515-516.
[34]谢林,郭振球,姚共和.绝经后骨质疏松中医辨证分析.中国医药报[J],1999,14(3):35-39.
[35]蒋瑞峰.甲襞微循环障碍与中医血瘀证之关系探讨.新中医[J],1983,32(8):48-49.
[36]翁维良.临床常用血液流变学指标的含义与评价(一).微循环学杂志[J],1994,4(1):43.
[37]田牛.微循环的临床与基础[M].第一版.北京:原子能出版社,1996.3.
[38]Jarvinen M,Kannus P.Injury of an extremity as a risk factor for the development of osteoporosis[J].J Bone Jonit Surg,1997,79A,263-276.
[39]陈金标,秦林林.骨质疏松症与遗传[J].中国骨质疏松杂志,2000,6(2):89-91.
[40]王洪复.骨质疏松症的诊断[J].国际内分泌代谢杂志,2006,26(4):285-288.
[41]Rnsso R,Minisola S,Se arda A,et al.Temporal relationship between bone loss and increased bone turnover:a longitudinal study following natural menopause.Endnerinol Invest[J],1995,18:723.
[42]Delmas PD.Biochemical markers ofbone turnover.Bone Miner Res[J],1993,(Sup2):5549.
[43]Ebbesen EN,Thomsen JS,Beck-NielsenH,etal.Age and gender related differences in vertebral bone mass,density,and strength.Bone Miner Res[J],1999,14:1394-1403.
[44]Gonnlls Cepouaro.Pondrelli C,et al.The usefulness of bone turnover in predicting the response to rtansdemal estrogen therapy in postmenopausal osteoporosis.Bone Miner Res[J].1997,12(4):624-631
[45]Garnero P,Delmas PD.A model to monitor the efficacy of alendronate treatment in women with osteoporosis using a biochemical maker of bone turnover.Bone[J].1999,24:603-609
[46]徐兆山.水蛭的临床应用.中医药学报[J],1990,5(2):38.
[47]王怡,翁维良,刘剑刚.动物类活血化瘀药对血液流变性作用的研究.中药药理与临床[J]1997,13(3):1.
[48]赖宗礼.活血通脉胶囊治疗高脂血症40例.安徽中医学院学报[J],2000,19(1):21.
[49]廖林峰.活血通脉胶囊治疗冠心病心绞痛疗效观察.中国中医急诊[J],2003,12(4):298-299.
[50]赵新杰,夏华玲,冯勇.水蛭的药理作用及其在骨伤科临床中的应用.中医正骨[J],2001,13(9):51
[51]翁维良,王怡.止痛活血化瘀药实验研究。中国中医基础医学杂志[J],1997,3(5):42-44.
[52]郭世绂,罗先正,邱贵兴.骨质疏松基础与临床[M].天津:天津科学技术出版社,2001:188.
[53]金慰芳,朱文菁,等.补肾中药HU-ECS对培养成骨细胞的增殖、分化及矿化功能的影响.中国骨质疏松杂志[J],2001,7(1):9-11.
[1]刘忠厚.骨质疏松学[M].第一版.北京:科学出版社,1998.531.
[2]Torring O.Ostenporosis among the elderly is a "silent epidemics".Insufficient prophylaxis and underdiagnosing are big problems.Lakartidningen[J],2001,14(28-29):32
[3]刘庆思.中西医结合诊治骨质疏松症[M].北京:中国中医药出版社,2001.73.
[4]谢林,姚共和,郭振球.健脾养胃法治疗骨质疏松症初探.湖南中医学院学报[J],1996,16(4):7-9.
[5]陈中冀,史载祥.实用血瘀证学[M].北京:人民卫生出版杜,1999.2 8.
[6]颜德馨,胡泉林,王平平.气虚血瘀是人体衰老的主要机制.中国医药学报[J],1989,4(2):10-12.
[7]杨少锋.关于骨质疏松症与血瘀关系的探讨.湖南中医药学报[J],1996,2(4):25.
[8]眭承志,周军,刘志坤.绝经后骨质疏松症血瘀病机的客观初步论证.中医研究[J],2005,18(1):30-34.
[9]井上哲郎.日本骨质疏松症研究进展.中国骨质疏松杂志[J],1995,1(1):47.
[10]汪延华.钙、降钙素、维生素D与骨质疏松征[M].合肥:中国科学技术大学出版杜.2004.
[11]Schanne FA,KaneAB,Young EE.et al.Calcium dependence of toxiccell death:a final common pathway.Science[J],1979.206:700.
[12]陈利国,孙兆贵,王蕾,等.血瘀证与血管内皮细胞内游离钙浓度关系的实验研究.山东中医药大学学报[J],2001,25(1):55.
[13]Uchio Y,Ochi N,et al.Intraosseous hypertension and venous congestion in osteonecrosis of the knee.Clin Orthop[J],2001,384(3):217-223.
[14]马克昌,冯坤,朱太咏,等.骨生理学[M].郑州:河南医科大学出版社,2000.515-516.
[15]Meumie HE.Predictions on future diagnosis and treatment of osteoporosis.Calcif Tissue Int[J],1995,57(2):83.
[16]Kasperk C,Helmboldt A,Borcsok I,et al.Skeletal site-dependent expression of the androgen receptor in human osteoblastic cell population.Calcif Tissue Int[J],1997,61:464-433.
[17]Pederson L,Kremer M,Judd J,et al.Androgen regulate bone re-sorption activity of isolated osteoblasts in vitro.Proc Nat Acad Sci USA[J],1999,96:505-510.
[18]Sasano H,Uzuki M,Sawai T,et al.Aromatase in human bone tissue.Bone Miner Res[J],1997,12:1416-1423.
[19]王静,张兰,张家庆,等.雌激素对血浆内皮素水平的影响.中华内分泌代谢杂志[J],1997,55(4):50-52.
[20]郭世绂,罗先正,邱贵兴.骨质疏松基础与临床[M].天津:天津科学技术出版,2001.188.
[2]Torring O.Osteoporosis among the elderly is a "silent epidemics".Insufficient prophylaxis and underdiagnosing are big problems Lakartidningen[J],2001,14(28-29):32
[3]朴俊红,庞莲萍,刘忠厚,等.中国人口状况及原发性骨质疏松症诊断标准和发生率.中国骨质疏松杂志[J],2002,8(1):1-7.
[4]李彩艳,时利平,洪景福.老年性骨质疏松症的病因及治疗进展.中国临床医药[J],2003,4(15):93.
[5]王文健.补肾法对老年男性下丘脑-垂体-性腺轴作用的临床和实验研究.中医杂志[J],1986:27(4):32
[6]周文泉,于向东.骨质疏松症的中医及中西医结合研究评述.中国临床康复[J],2002,18(6):2768-2769.
[7]刘庆思.中西医结合诊治骨质疏松症[M].北京:中国中医药出版社,2001.3.
[8]颜德馨,胡泉林,王平平.气虚血瘀是人体衰老的主要机制.中国医药学报[J],1989,4(2):10-12.
[9]Meumie-HE.Predictions on future diagnosis and treatment of osteoporosis.Calcif-Tissue-Int[J].1995,57(2):83.
[10]井上哲郎.日本骨质疏松症研究进展.中国骨质疏松杂志[J],1995,1(1):47.
[11]眭承志,周军,等.绝经后骨质疏松症血瘀病机的客观初步论证.中医研究[J],2005,18(1):30-33.
[12]眭承志,刘志坤,等.绝经后骨质疏松症与血瘀.中国中西医结合杂志[J],2005,25(5):456-458.
[13]眭承志,王彦伟,等.血瘀证在绝经后骨质疏松症中的量化研究.中医药通报[J],2005,4(2):32-33.
[14]第二届全国活血化瘀研究学术会议修订.血瘀证诊断标准.中西医结合杂志[J],1987,7(3):129.
[15]王宁华.疼痛定量评定的进展.中国临床康复[J],2002,6(18):2738-2739.
[16]周丕琪,沈霖,杜靖远,等.PMOP与血清IL-6,TNF-α浓度关系的临床研究.中国骨质疏松杂志[J],2001,7(1):1-3,8.
[17]田牛.实用临床微循环学[M].第一版.北京:军事科学出版社,1989.28-31.
[18]中华人民共和国卫生部.中药新药临床研究指导原则[S].第3辑,1997:149.
[19]赵玉堂,刘凯军,李金花,等.骨矿含量与肾虚、肾主骨关系的研究.中国骨质疏松杂志[J],1996,2(3):19-21.
[20]李跃华,董元龙.老年人骨质疏松患病率与肾虚证型关系的调查.中国中西医结合杂志[J],1995,15(6):366-367.
[21]许志奇,韩素华,杨定焯,等.肾虚证骨矿物质含量的初步研究.中西医结合杂志[J].1991, 11(3):222.
[22]李边达.中药治疗无菌性股骨头坏死及骨质疏松症的主要药效学研究技本要求.中药新药与临床[J],1992,3(2):7.
[23]周丕琪,沈霖,杜靖远,等.补肾法对绝经后骨质疏松患者IL-6、TNF-a的影响.中国中医骨伤科杂志[J],2000,8(4):1-3.
[24]谢林,姚共和,郭振球.健脾养胃法治疗骨质疏松症初探.湖南中医学院学报[J],1996,16(4):7-9.
[25]刘忠厚.骨质疏松学.北京:科学出版社,1998.234-235.
[26]何华.老年气虚血瘀初探.新中医[J],1991,23(7):52.
[27]杨少锋.关于骨质疏松症与血瘀关系的探讨.湖南中医药学报[J],1996,2(4):25.
[28]韩英,聂英坤,姜礼红,等.128例老年骨质疏松症患者的红细胞流变性分析.中国微循环[J],2002,1(6):43-44.
[29]汪延华.钙、降钙素、维生素D与骨质疏松症[M].合肥:中国科学技术大学出版杜,2004.
[30]Schanne FA,Kane AB,Young EE,et al.Calcium dependence of toxiccell death:a final common pathway.Science[J],1979,206:700.
[31]陈利国,孙兆贵,王蕾,等.血瘀证与血管内皮细胞内游离钙浓度关系的实验研究.山东中医药大学学报[J],2001,25(1):55.
[32]Uchio Y,Ochi N,et al.Intraosseous hypertension and venous congestion in osteonecrosis of the knee.Clin Orthop[J],2001,384(3):217-223.
[33]马克昌,冯坤,朱太咏,等.骨生理学[M].郑州:河南医科大学出版社,2000.515-516.
[34]谢林,郭振球,姚共和.绝经后骨质疏松中医辨证分析.中国医药报[J],1999,14(3):35-39.
[35]蒋瑞峰.甲襞微循环障碍与中医血瘀证之关系探讨.新中医[J],1983,32(8):48-49.
[36]翁维良.临床常用血液流变学指标的含义与评价(一).微循环学杂志[J],1994,4(1):43.
[37]田牛.微循环的临床与基础[M].第一版.北京:原子能出版社,1996.3.
[38]Jarvinen M,Kannus P.Injury of an extremity as a risk factor for the development of osteoporosis[J].J Bone Jonit Surg,1997,79A,263-276.
[39]陈金标,秦林林.骨质疏松症与遗传[J].中国骨质疏松杂志,2000,6(2):89-91.
[40]王洪复.骨质疏松症的诊断[J].国际内分泌代谢杂志,2006,26(4):285-288.
[41]Rnsso R,Minisola S,Se arda A,et al.Temporal relationship between bone loss and increased bone turnover:a longitudinal study following natural menopause.Endnerinol Invest[J],1995,18:723.
[42]Delmas PD.Biochemical markers ofbone turnover.Bone Miner Res[J],1993,(Sup2):5549.
[43]Ebbesen EN,Thomsen JS,Beck-NielsenH,etal.Age and gender related differences in vertebral bone mass,density,and strength.Bone Miner Res[J],1999,14:1394-1403.
[44]Gonnlls Cepouaro.Pondrelli C,et al.The usefulness of bone turnover in predicting the response to rtansdemal estrogen therapy in postmenopausal osteoporosis.Bone Miner Res[J].1997,12(4):624-631
[45]Garnero P,Delmas PD.A model to monitor the efficacy of alendronate treatment in women with osteoporosis using a biochemical maker of bone turnover.Bone[J].1999,24:603-609
[46]徐兆山.水蛭的临床应用.中医药学报[J],1990,5(2):38.
[47]王怡,翁维良,刘剑刚.动物类活血化瘀药对血液流变性作用的研究.中药药理与临床[J]1997,13(3):1.
[48]赖宗礼.活血通脉胶囊治疗高脂血症40例.安徽中医学院学报[J],2000,19(1):21.
[49]廖林峰.活血通脉胶囊治疗冠心病心绞痛疗效观察.中国中医急诊[J],2003,12(4):298-299.
[50]赵新杰,夏华玲,冯勇.水蛭的药理作用及其在骨伤科临床中的应用.中医正骨[J],2001,13(9):51
[51]翁维良,王怡.止痛活血化瘀药实验研究。中国中医基础医学杂志[J],1997,3(5):42-44.
[52]郭世绂,罗先正,邱贵兴.骨质疏松基础与临床[M].天津:天津科学技术出版社,2001:188.
[53]金慰芳,朱文菁,等.补肾中药HU-ECS对培养成骨细胞的增殖、分化及矿化功能的影响.中国骨质疏松杂志[J],2001,7(1):9-11.
[1]刘忠厚.骨质疏松学[M].第一版.北京:科学出版社,1998.531.
[2]Torring O.Ostenporosis among the elderly is a "silent epidemics".Insufficient prophylaxis and underdiagnosing are big problems.Lakartidningen[J],2001,14(28-29):32
[3]刘庆思.中西医结合诊治骨质疏松症[M].北京:中国中医药出版社,2001.73.
[4]谢林,姚共和,郭振球.健脾养胃法治疗骨质疏松症初探.湖南中医学院学报[J],1996,16(4):7-9.
[5]陈中冀,史载祥.实用血瘀证学[M].北京:人民卫生出版杜,1999.2 8.
[6]颜德馨,胡泉林,王平平.气虚血瘀是人体衰老的主要机制.中国医药学报[J],1989,4(2):10-12.
[7]杨少锋.关于骨质疏松症与血瘀关系的探讨.湖南中医药学报[J],1996,2(4):25.
[8]眭承志,周军,刘志坤.绝经后骨质疏松症血瘀病机的客观初步论证.中医研究[J],2005,18(1):30-34.
[9]井上哲郎.日本骨质疏松症研究进展.中国骨质疏松杂志[J],1995,1(1):47.
[10]汪延华.钙、降钙素、维生素D与骨质疏松征[M].合肥:中国科学技术大学出版杜.2004.
[11]Schanne FA,KaneAB,Young EE.et al.Calcium dependence of toxiccell death:a final common pathway.Science[J],1979.206:700.
[12]陈利国,孙兆贵,王蕾,等.血瘀证与血管内皮细胞内游离钙浓度关系的实验研究.山东中医药大学学报[J],2001,25(1):55.
[13]Uchio Y,Ochi N,et al.Intraosseous hypertension and venous congestion in osteonecrosis of the knee.Clin Orthop[J],2001,384(3):217-223.
[14]马克昌,冯坤,朱太咏,等.骨生理学[M].郑州:河南医科大学出版社,2000.515-516.
[15]Meumie HE.Predictions on future diagnosis and treatment of osteoporosis.Calcif Tissue Int[J],1995,57(2):83.
[16]Kasperk C,Helmboldt A,Borcsok I,et al.Skeletal site-dependent expression of the androgen receptor in human osteoblastic cell population.Calcif Tissue Int[J],1997,61:464-433.
[17]Pederson L,Kremer M,Judd J,et al.Androgen regulate bone re-sorption activity of isolated osteoblasts in vitro.Proc Nat Acad Sci USA[J],1999,96:505-510.
[18]Sasano H,Uzuki M,Sawai T,et al.Aromatase in human bone tissue.Bone Miner Res[J],1997,12:1416-1423.
[19]王静,张兰,张家庆,等.雌激素对血浆内皮素水平的影响.中华内分泌代谢杂志[J],1997,55(4):50-52.
[20]郭世绂,罗先正,邱贵兴.骨质疏松基础与临床[M].天津:天津科学技术出版,2001.188.