滋肾青芪颗粒对系统性红斑狼疮糖皮质激素导致骨代谢异常的调节作用
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上海市浦东新区中医药事业发展专项(编号:PDYNZJ2014-29);上海市卫计委中医药项目(编号:2014S20)


Zishenqingqi Granule on Bone Metabolic Abnormalities Induced by Systemic Lupus Erythematosus Glucocorticoids
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    摘要:

    目的:观察滋肾青芪颗粒对系统性红斑狼疮(SLE)应用糖皮质激素后骨转化指标及钙磷代谢的影响,探讨其对糖皮质激素导致骨代谢异常的调节作用。方法:将72例SLE活动度在5~14分间且应用糖皮质激素的患者随机分成治疗组和对照组各36例,疗程12周。观察治疗前后碱性磷酸酶(ALP)、骨钙素(OST)、和I型胶原羧基端肽B特殊序列(-CTX)及血清钙(BCa)、血清磷(BP)和中医症候的变化。结果:治疗12周后,-CTX对照组治疗后较治疗前有升高(P<0.05),但治疗后2组间差异无统计学意义(P>0.05);治疗组治疗前后OST升高(P<0.05),且治疗前后OST比较,治疗组(22.26±15.96)显著高于对照组(15.45±9.97),(P<0.01),ALP水平治疗组高于对照组(P<0.05)。对照组治疗前后血钙水平明显降低(P<0.05),治疗组治疗后血钙(2.22±1.24)高于对照组,对照组治疗后血磷(1.31±0.64)高于治疗组(P<0.05)。中医症候方面,治疗组在腰背酸痛、面部潮红方面改善显著优于对照组,五心烦热、失眠多梦症候方面亦有明显改善。讨论:滋肾青芪颗粒对骨吸收的影响不明显,但可以控制糖皮质激素对骨形成的抑制作用,并通过调节血钙磷的吸收增高血清钙磷水平。且可改善服用糖皮质激素后的面部潮红和腰背酸痛等症状的程度。

    Abstract:

    To observe Zishenqingqi Granule’s influence on bone transformation indexes and calcium phosphorus induced by metabolism systemic lupus erythematosus (SLE) after using glucocorticoid and to discuss its effect on bone metabolic abnormalities induced by glucocorticoids.Methods:72 cases of SLE-DAI between 5-14 points with application of glucocorticoids were randomly divided into the treatment group and the control group (n=36) for 12-week treatment. Alkaline phosphatase (ALP), osteocalcin (OG), type I collagen peptide (b-CTX) C-end and serum calcium (BCa), serum phosphorus (BP) and the changes of TCM symptoms were observed before and after treatment.Results:after 12-week treatment, type I collagen peptide C-end of the control group after treatment was higher than that before the treatment but with no significant difference. Osteocalcin level of the treatment group was obviously higher after the treatment and increased obviously compared with control group. Alkaline phosphatase level in the treatment group has obvious difference compared with the control group. Blood calcium of the control group significantly lower after the treatment, and blood calcium and blood phosphorus levels of the treatment group after treatment were significantly higher than those of the control group. TCM symptoms in the treatment group significantly improved and symptoms, like lower back pain and facial blushing released better compared with those of the control group. symptoms, like five-center heat, insomnia and much dream also have improved significantly.Conclusion:There is no obvious effects of Zishenqingqi Granule on bone resorption, but may control the inhibition function of glucocorticoid on bone formation and increase serum calcium phosphate levels by adjusting the blood calcium phosphorus absorption.

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陈晓云,顾军花,戴清漪,茅建春,陈湘君.滋肾青芪颗粒对系统性红斑狼疮糖皮质激素导致骨代谢异常的调节作用[J].世界中医药,2016,(04).

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  • 收稿日期:2016-01-12
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  • 在线发布日期: 2016-05-03
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