坚骨胶囊联合阿仑膦酸钠对老年骨质疏松患者骨密度及血清酪氨酸3-单加氧酶/色氨酸5-单加氧酶激活蛋白eta、炎症指标的影响
doi: 10.12122/j.issn.1674-4500.2023.01.19
Effect of Jiangu capsule combined with alendronate sodium on bone mineral density and serum YWHAH and inflammation indexes in elderly patients with osteoporosis
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摘要:
目的 探讨坚骨胶囊联合阿仑膦酸钠对老年骨质疏松患者骨密度及血清酪氨酸3-单加氧酶/色氨酸5-单加氧酶激活蛋白eta（YWHAΗ）、炎症指标的影响。 方法 选取98例老年骨质疏松患者，以随机数字表法将其分为对照组（n=49）与观察组（n=49），对照组口服阿仑膦酸钠治疗，观察组在对照组的基础上加服坚骨胶囊。6月后比较两组骨密度、中医证候积分、疼痛程度及血清YWHAH、骨钙素、碱性磷酸酶、肿瘤坏死因子-α、白细胞介素-6水平。 结果 治疗后，两组腰椎、股骨颈骨密度高于治疗前、观察组高于对照组（P < 0.05）；两组中医证候积分低于治疗前、观察组低于对照组（P < 0.05）；两组静息及活动视觉模拟评分低于治疗前、观察组低于对照组（P < 0.05）；两组血清YWHAH水平低于治疗前、观察组低于及对照组（P < 0.05）；两组血清骨钙素水平高于治疗前、观察组高于对照组（P < 0.05），两组血清碱性磷酸酶水平低于治疗前、观察组低于对照组（P < 0.05）；两组肿瘤坏死因子-α及白细胞介素-6低于治疗前、观察组低于对照组（P < 0.05）。 结论 阿仑膦酸钠的基础上联合坚骨胶囊可有效提升老年骨质疏松患者骨密度、缓解疼痛，其机制可能与下调血清YWHAΗ水平、改善骨代谢指标、减轻炎症反应相关。 Abstract:Objective To investigate the effects of Jiangu capsule combined with alendronate sodium on bone mineral density, serum tyrosine YWHAH and inflammatory indexes in elderly patients with osteoporosis. Methods Ninety-eight elderly patients with osteoporosis were selected, and they were divided into control group (n=49) and observation group (n=49) by random number table method. The control group was treated with alendronate sodium, and the observation group was given Jiangu capsule on the basis of the control group. After 6 months, bone mineral density, TCM syndrome score, pain intensity and serum levels of YWHAH, osteocalcin, alkaline phosphatase, TNF-α and IL-6 were compared between the two groups. Results After treatment, the bone mineral density of lumbar vertebra and femoral neck in two groups were higher than that before treatment (P < 0.05). After treatment, the TCM syndrome score of the observation group was lower than that before treatment. After treatment, the resting and activity VAS scores of the observation group was lower than that before treatment (P < 0.05). After treatment, the level of serum YWHAH in the observation group was lower than that before treatment (P < 0.05). After treatment, the serum osteocalcin level in the observation group was higher than that before treatment(P < 0.05), and the serum alkaline phosphatase level in the observation group was lower than that before treatment(P < 0.05). After treatment, TNF-α and IL-6 in the observation group was lower than that before treatment (P < 0.05). Conclusion On the basis of alendronate sodium, combined with Jiangu capsule can effectively improve bone mineral density and relieve pain in elderly patients with osteoporosis. The mechanism may be related to down-regulating serum YWHAH level, improving bone metabolism indexes and alleviating inflammatory response. -
Key words:
- Jiangu capsule /
- alendronate sodium /
- osteoporosis /
- elderly /
- bone mineral density /
- YWHAΗ /
- inflammation
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图 1 患者治疗前后骨密度图像
A~C：依次为治疗前腰椎、右股骨、左股骨骨密度图像; D~F：依次为治疗后腰椎、右股骨、左股骨骨密度图像.
Figure 1. Bone mineral density image of patients before and after treatment.
表 1 两组治疗前、后骨密度
Table 1. Bone mineral density of two groups before and after treatment (n=49, g/cm2, Mean±SD)
组别 腰椎 股骨颈 治疗前 6月后 t P 治疗前 6月后 t P 对照组 0.982±0.112 1.037±0.122 2.325 0.022 0.844±0.030 0.869±0.027 4.336 < 0.001 观察组 0.979±0.118 1.125±0.116 6.176 < 0.001 0.850±0.033 0.899±0.020 8.889 < 0.001 t 0.129 3.659 0.942 6.2550 P 0.898 < 0.001 0.349 < 0.001 
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表 2 两组治疗前、后中医证候积分
Table 2. TCM syndrome score before and after treatment in both groups (n=49, score, Mean±SD)
组别 治疗前 6月后 t P 对照组 10.98±3.12 5.84±2.15 9.496 < 0.001 观察组 11.14±3.20 3.17±1.96 14.867 < 0.001 t 0.251 6.242 P 0.803 ＜0.001
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表 3 两组治疗前、后腰背疼痛VAS评分
Table 3. VAS score of back pain before and after treatment in both groups (n=49, score, Mean±SD)
组别 静息VAS评分 活动VAS评分 治疗前 6月后 t P 治疗前 6月后 t P 对照组 2.98±0.46 1.65±0.37 15.771 < 0.001 3.67±0.62 2.30±0.48 12.231 < 0.001 观察组 3.02±0.50 1.17±0.22 23.707 < 0.001 3.55±0.64 1.89±0.40 15.396 < 0.001 t 0.412 7.806 0.943 4.593 P 0.681 ＜0.001 0.348 < 0.001 VAS: 视觉模拟评分.
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表 4 两组治疗前、后血清YWHAH水平
Table 4. Serum YWHAH level before and after treatment in both groups (n=49, ng/mL, Mean±SD)
组别 治疗前 6月后 t P 对照组 2.89±0.45 1.87±0.31 13.066 < 0.001 观察组 2.82±0.39 1.32±0.26 22.401 < 0.001 t 0.823 9.516
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表 5 两组治疗前、后骨代谢指标水平
Table 5. Levels of bone metabolism indexes before and after treatment in the two groups (n=49, Mean±SD)
组别 BGP（μg/L） ALP（U/L） 治疗前 6月后 t P 治疗前 6月后 t P 对照组 3.27±0.36 3.80±0.44 6.526 < 0.001 115.44±12.38 95.73±10.82 8.391 < 0.001 观察组 3.31±0.41 4.43±0.49 12.271 < 0.001 117.82±13.59 84.60±10.13 13.719 < 0.001 t 0.513 6.696 0.906 5.256 P 0.609 < 0.001 0.367 < 0.001 BGP: 骨钙素; ALP: 碱性磷酸酶.
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表 6 两组治疗前、后炎性因子水平
Table 6. Levels of inflammatory factors before and after treatment in the two groups (n=49, pg/mL, Mean±SD)
组别 TNF-α IL-6 治疗前 6月后 t P 治疗前 6月后 t P 对照组 238.17±25.61 182.71±18.92 12.193 < 0.001 329.80±44.17 282.33±34.19 5.949 < 0.001 观察组 242.80±22.30 165.46±16.15 19.662 < 0.001 323.67±45.20 221.47±29.80 13.214 < 0.001 t 0.954 4.854 0.679 9.393 P 0.342 < 0.001 0.499 < 0.001 TNF-α: 肿瘤坏死因子-α; IL-6: 白细胞介素-6.
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[1] 周飞, 富晓旭, 高鸿. 老年骨质疏松症合并肌少症患者营养状态及血清生物化学指标的变化[J]. 中南医学科学杂志, 2021, 49(6): 683-6. doi: 10.15972/j.cnki.43-1509/r.2021.06.016 [2] 吴秀芳, 秦飞, 亓强, 等. TEAS联合腰痛宁胶囊治疗原发性骨质疏松症疼痛的效果观察[J]. 川北医学院学报, 2022, 37(9): 1157-60. doi: 10.3969/j.issn.1005-3697.2022.09.014 [3] Johnston CB, Dagar M. Osteoporosis in older adults[J]. Med Clin North Am, 2020, 104(5): 873-84. doi: 10.1016/j.mcna.2020.06.004 [4] Kaufman JM. Management of osteoporosis in older men[J]. Aging Clin Exp Res, 2021, 33(6): 1439-52. doi: 10.1007/s40520-021-01845-8 [5] Baniahmad F, Yousefi S, Rabiee M, et al. Alendronate sodium intercalation in layered double hydroxide/poly (ε-caprolactone): application in osteoporosis treatment[J]. Iran J Biotechnol, 2021, 19 (1): e2490. [6] Jia Y, Sun JG, Zhao Y, et al. Chinese patent medicine for osteoporosis: a systematic review and meta-analysis[J]. Bioengineered, 2022, 13(3): 5581-97. doi: 10.1080/21655979.2022.2038941 [7] 乔小万, 邓强, 李中锋, 等. 基于"肾虚髓枯"理论探讨骨质疏松症的病机及中药治疗[J]. 中国骨质疏松杂志, 2022, 28(5): 760-5, 780. doi: 10.3969/j.issn.1006-7108.2022.05.026 [8] 彭斯伟, 宋敏, 范凯, 等. 单味中药治疗肾虚型骨质疏松症机制研究状况[J]. 中国临床药理学杂志, 2022, 38(1): 76-80. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYZ202201018.htm [9] 《中国老年骨质疏松症诊疗指南》工作组, 中国老年学和老年医学学会骨质疏松分会, 马远征, 等. 中国老年骨质疏松症诊疗指南(2018) [J]. 中国骨质疏松杂志, 2018, 24(12): 1541-65. doi: 10.3969/j.issn.1006-7108.2018.12.001 [10] 郑筱萸. 中药新药临床研究指导原则试行[M]. 北京: 中国医药科技出版社, 2002: 1-392. [11] 陈赛楠, 李生强, 谢丽华, 等. 续苓健骨方联合阿仑膦酸钠调控EphB4/EphrinB2双向通路对去卵巢骨质疏松大鼠的研究[J]. 中国骨质疏松杂志, 2022, 28(5): 637-42. doi: 10.3969/j.issn.1006-7108.2022.05.003 [12] 杜丽坤, 李佳睿. 骨质疏松症的中医认识及防治[J]. 中国骨质疏松杂志, 2022, 28(2): 296-9. doi: 10.3969/j.issn.1006-7108.2022.02.025 [13] 张润云, 倪青, 张新菊, 等. 骨质疏松症中医药防治研究浅析[J]. 中国临床保健杂志, 2022, 25(1): 34-6. https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ202201004.htm [14] Nathan KG, Lal SK. The multifarious role of 14-3-3 family of proteins in viral replication[J]. Viruses, 2020, 12(4): 436. doi: 10.3390/v12040436 [15] Aghazadeh Y, et al. The role of the 14-3-3 protein family in health, disease, and drug development[J]. Drug Discov Today, 2016, 21 (2): 278-87. doi: 10.1016/j.drudis.2015.09.012 [16] Dalrymple A, Tuttle P, Feller L, et al. 14-3-3η protein as a potential biomarker in juvenile idiopathic arthritis[J]. Pediatr Rep, 2021, 13 (1): 65-71. doi: 10.3390/pediatric13010008 [17] Hussin DAAH, Shaat RM, Metwally SS, et al. The significance of serum 14-3-3η level in rheumatoid arthritis patients[J]. Clin Rheumatol, 2021, 40(6): 2193-202. doi: 10.1007/s10067-020-05524-3 [18] 曹启辉, 曾进海, 吉杰, 等. 仙灵骨葆胶囊对骨质疏松症患者骨密度和血清Ⅰ型胶原羧基末端交联肽、N端中段骨钙素、骨钙素的影响[J]. 中国医院用药评价与分析, 2017, 17(1): 22-4. https://www.cnki.com.cn/Article/CJFDTOTAL-YYPF201701007.htm [19] 高屹, 侯晓晨, 唐娟. 双能X线骨密度仪与血清B-ALP、BGP、TRACP5b在骨质疏松症中的应用价值[J]. 中国医学创新, 2022, 19 (1): 158-61. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYCX202201040.htm [20] 邓艳玲, 翁文玉, 招泽豪, 等. 黄芪三仙汤抗绝经后骨质疏松作用机制的研究[J]. 广州中医药大学学报, 2022, 39(4): 898-907. https://www.cnki.com.cn/Article/CJFDTOTAL-REST202204027.htm [21] 孙胜奎, 廖建红, 范银燕, 等. 丹参川芎联合骨瓜或骨肽对糖尿病骨质疏松患者糖代谢和骨代谢的影响[J]. 世界中医药, 2019, 14(6): 1493-7. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZA201906031.htm [22] 任树军, 刘俊桐, 于长江, 等. 生髓健骨胶囊对酒精性骨质疏松大鼠TNF-α、TGF-β1和空骨陷窝的影响[J]. 海南医学院学报, 2022, 28 (3): 187-91. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYY202203005.htm [23] 龙雨. 依降钙素注射液对老年骨质疏松患者血清中IL-6、性激素水平的影响及其临床价值[J]. 中国老年学杂志, 2022, 42(8): 1912-4. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ202208038.htm [24] 庞江娜, 武永富, 梁芳, 等. 黄芪注射液联合摩擦步训练对绝经期骨质疏松症患者雌激素水平及骨密度影响研究[J]. 辽宁中医药大学学报, 2017, 19(12): 139-42. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB201712044.htm [25] 支美汝, 韩舒, 刘凯洋, 等. 生草乌和诃子制草乌细胞毒性及抗炎作用的比较研究[J]. 中国药房, 2020, 31(22): 2701-5. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYA202022003.htm -
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