中药复方治疗绝经后骨质疏松症的临床研究概况
|
摘要
绝经后骨质疏松症为骨吸收大于骨形成的高转化型代谢性骨病,其并发症严重影响患者的生活水平及质量。中医认为本病与肝、脾、肾脏腑亏虚及血瘀等关系密切。近年来临床研究发现,中药复方治疗绝经后骨质疏松症效果明显,能够有效地改善患者的骨代谢水平,增加患者的骨密度,同时改善患者的临床症状。笔者就中药复方治疗绝经后骨质疏松的作用机制及临床疗效进行综述,旨在为中药复方治疗绝经后骨质疏松症提供数据支持及指导,为今后中药复方开发及靶向治疗绝经后骨质疏松症提供思路。以期指导临床辩证用方,提高对绝经后骨质疏松症的防治率。
Postmenopausal osteoporosis is a metabolic bone disease with greater bone resorption than bone formation, and its complications seriously affect the quality of life and everyday living of patients. Chinese medicine believes that this disease is closely related to liver, spleen and kidney deficiency and blood stasis. In recent years, clinical studies have found that traditional Chinese medicine has evident effects on the treatment of postmenopausal osteoporosis, and can effectively improve the level of bone metabolism, increase bone density, and at the same time improve the clinical symptoms of patients. This article summarizes the mechanism of action and clinical curative effect of traditional Chinese medicine compound on the treatment postmenopausal osteoporosis. The aim is to provide data to support and guide the use of Chinese herbal compound for the treatment of postmenopausal osteoporosis, and to provide ideas for the development of traditional Chinese medicine compound and the targeted treatment of postmenopausal osteoporosis. It is expected to guide clinical dialectical prescriptions and improve the prevention and treatment of postmenopausal osteoporosis.
Postmenopausal osteoporosis is a metabolic bone disease with greater bone resorption than bone formation, and its complications seriously affect the quality of life and everyday living of patients. Chinese medicine believes that this disease is closely related to liver, spleen and kidney deficiency and blood stasis. In recent years, clinical studies have found that traditional Chinese medicine has evident effects on the treatment of postmenopausal osteoporosis, and can effectively improve the level of bone metabolism, increase bone density, and at the same time improve the clinical symptoms of patients. This article summarizes the mechanism of action and clinical curative effect of traditional Chinese medicine compound on the treatment postmenopausal osteoporosis. The aim is to provide data to support and guide the use of Chinese herbal compound for the treatment of postmenopausal osteoporosis, and to provide ideas for the development of traditional Chinese medicine compound and the targeted treatment of postmenopausal osteoporosis. It is expected to guide clinical dialectical prescriptions and improve the prevention and treatment of postmenopausal osteoporosis.
引文
[1] 李建国,谢兴文,李鼎鹏,等.中药淫羊藿治疗骨质疏松症的研究进展[J].中国骨质疏松杂志,2018,24(3):389-393.
[2] 刘敏燕,李春霖.老年骨质疏松症的防治策略及进展[J].中华老年多器官疾病杂志,2013,12(5):397-400.
[3] 谷铭勇,曹学成,苏君,等.中药筋骨方对老年骨质疏松症患者血清抗酒石酸酸性磷酸酶的影响[J].长春中医药大学学报,2015,31(2):372-374.
[4] 招文华,任辉,沈耿杨,等.基于肾脑相关理论探讨海马-HPOA对绝经后骨质疏松症的调控作用[J].中国骨质疏松杂志,2018,24(2):264-269.
[5] 孙伟明,刘爽.雌激素影响绝经后骨质疏松分子机制研究进展[J].中国老年学杂志,2017,37(2):500-502.
[6] 赵巍,唐晶,刘悦,等.基于现代文献揭示“脾主运化、统血”等脾脏象理论科学内涵[J].中华中医药学刊,2014,32(6):1270-1275.
[7] 贾小玥,郑黎薇,袁泉,等.肠道菌群:绝经后骨质疏松防治新靶点[J].中国骨质疏松杂志,2017,23(3):392-401.
[8] 宋献文,计佩芳,郭颂铭.加味左归丸治疗肾阴虚型绝经后骨质疏松症的临床研究[J].上海中医药杂志,2016,50(5):55-57.
[9] 张宝荣,谭颖颖.左归丸加味对绝经后骨质疏松症患者骨转换标志物和骨密度的影响[J].陕西中医药大学学报,2017,40(4):48-50.
[10] 谢宝华,鞠红梅,王丽,等.左归丸逆转TH1/TH2亚群偏移减轻雌激素缺乏骨丢失[J].济宁医学院学报,2013,36(6):174-178.
[11] 红梅.肝肾阴虚证绝经后骨质疏松症应用六味地黄丸加味治疗临床3组对照研究[J].双足与保健,2017,26(8):168-170.
[12] 周君权.六味地黄汤加味治疗绝经后骨质疏松症临床研究[J].新中医,2015,47(4):133-135.
[13] 卢严方,林贯川,刘倩倩,等.六味地黄丸对绝经期肾阴虚骨质疏松症的基因表达调控数据分析[J].中国骨质疏松杂志,2017,23(3):350-356.
[14] 陈娟,谢丽华,李生强,等.JAK/STAT通路介导的六味地黄丸对绝经后骨质疏松症肾阴虚证的免疫调节作用[J].中华中医药杂志,2017,32(4):1747-1750.
[15] 汤立军,张小琴.独活寄生汤对肝肾亏虚型绝经后骨质疏松症患者骨密度的影响及疗效观察[J].中国社区医师,2017,33(25):97-98.
[16] 王少锋,戴浩军.独活寄生汤辅助治疗绝经后骨质疏松症疗效分析[J].贵州医药,2017,41(1):65-66.
[17] 杨阳,张允富,李旭.独活寄生汤加减对绝经后骨质疏松症患者(肝肾阴虚)骨密度及骨代谢指标的影响[J].中国医学创新,2017,14(33):61-64.
[18] 吴晨,姜凤依,李欣,等.独活寄生汤联合钙尔奇对绝经后骨质疏松症患者骨代谢标志物的影响[J].中医药信息,2017,34(1):77-80.
[19] 张鹏贵,杜耿.独活寄生汤联合唑来膦酸治疗绝经后骨质疏松肝肾亏虚证70例[J].河南中医,2017,37(8):1446-1448.
[20] 宋小梅.仙灵骨葆胶囊治疗绝经期骨质疏松症临床研究[J].河南中医,2017,37(4):686-688.
[21] 陈鑫,朱雄白,林文军,等.仙灵骨葆胶囊治疗绝经后骨质疏松的疗效及其机制研究[J].中国临床药理学杂志,2015,31(10):827-829,854.
[22] 杜倩,王哲,运乃茹,等.仙灵骨葆胶囊安全性系统评价[J].中国药业,2017,26(19):37-43.
[23] 章轶立,廖星,刘福梅,等.仙灵骨葆胶囊上市后用药安全性系统评价[J].中国中药杂志,2017,42(15):2845-2856.
[24] 刘泽有,杨金玲,王在红,等.金天格胶囊联合利塞膦酸钠治疗绝经后骨质疏松的临床研究[J].现代药物与临床,2018,33(1):139-142.
[25] 黄广平,陈民,刘向前,等.金天格胶囊治疗绝经后骨质疏松症的临床观察[J].中药材,2017,40(4):970-972.
[26] 徐荣敏,陈国军,洪明飞,等.金天格胶囊联合雌激素治疗对绝经后骨质疏松患者骨密度和骨代谢的影响[J].中国妇幼保健,2017,32(9):1940-1943.
[27] 卞庆来,邹小娟,沈霖.青娥丸治疗绝经后骨质疏松症肾虚血瘀证的疗效观察[J].中华中医药杂志,2018,33(1):308-312.
[28] 马陈,沈霖,杨艳萍,等.青娥丸对绝经后骨质疏松症患者血清癌胚抗原相关细胞黏附分子1,β-链蛋白水平及骨密度的影响[J].中国中医骨伤科杂志,2017,25(2):15-18.
[29] 余海,徐晓娟,沈霖,等.青娥丸对绝经后骨质疏松症患者骨密度、骨转换标志物及骨桥蛋白的影响[J].中国中医骨伤科杂志,2016,24(1):21-23.
[30] 周广文,向楠,沈霖,等.加味青娥丸对绝经后骨质疏松症患者的骨密度、骨代谢标志物及血清MGP水平的影响[J].中国中医骨伤科杂志,2016,24(3):4-8,13.
[31] 卢朝霞,王欣,周少怀.补肾健脾汤对绝经后骨质疏松症患者细胞因子及骨密度水平的影响[J].陕西中医,2017,38(4):438-439.
[32] 刘鸿雁,李剑,翟羽,等.健脾补肾活血方治疗女性绝经后骨质疏松效果及对血清1型原胶原氨基末端前肽、β-胶原特殊序列水平的影响[J].中国老年学杂志,2018,38(2):431-432.
[33] 唐保明.补肾调冲方治疗绝经后骨质疏松症62例[J].中国实验方剂学杂志,2015,21(6):191-194.
[2] 刘敏燕,李春霖.老年骨质疏松症的防治策略及进展[J].中华老年多器官疾病杂志,2013,12(5):397-400.
[3] 谷铭勇,曹学成,苏君,等.中药筋骨方对老年骨质疏松症患者血清抗酒石酸酸性磷酸酶的影响[J].长春中医药大学学报,2015,31(2):372-374.
[4] 招文华,任辉,沈耿杨,等.基于肾脑相关理论探讨海马-HPOA对绝经后骨质疏松症的调控作用[J].中国骨质疏松杂志,2018,24(2):264-269.
[5] 孙伟明,刘爽.雌激素影响绝经后骨质疏松分子机制研究进展[J].中国老年学杂志,2017,37(2):500-502.
[6] 赵巍,唐晶,刘悦,等.基于现代文献揭示“脾主运化、统血”等脾脏象理论科学内涵[J].中华中医药学刊,2014,32(6):1270-1275.
[7] 贾小玥,郑黎薇,袁泉,等.肠道菌群:绝经后骨质疏松防治新靶点[J].中国骨质疏松杂志,2017,23(3):392-401.
[8] 宋献文,计佩芳,郭颂铭.加味左归丸治疗肾阴虚型绝经后骨质疏松症的临床研究[J].上海中医药杂志,2016,50(5):55-57.
[9] 张宝荣,谭颖颖.左归丸加味对绝经后骨质疏松症患者骨转换标志物和骨密度的影响[J].陕西中医药大学学报,2017,40(4):48-50.
[10] 谢宝华,鞠红梅,王丽,等.左归丸逆转TH1/TH2亚群偏移减轻雌激素缺乏骨丢失[J].济宁医学院学报,2013,36(6):174-178.
[11] 红梅.肝肾阴虚证绝经后骨质疏松症应用六味地黄丸加味治疗临床3组对照研究[J].双足与保健,2017,26(8):168-170.
[12] 周君权.六味地黄汤加味治疗绝经后骨质疏松症临床研究[J].新中医,2015,47(4):133-135.
[13] 卢严方,林贯川,刘倩倩,等.六味地黄丸对绝经期肾阴虚骨质疏松症的基因表达调控数据分析[J].中国骨质疏松杂志,2017,23(3):350-356.
[14] 陈娟,谢丽华,李生强,等.JAK/STAT通路介导的六味地黄丸对绝经后骨质疏松症肾阴虚证的免疫调节作用[J].中华中医药杂志,2017,32(4):1747-1750.
[15] 汤立军,张小琴.独活寄生汤对肝肾亏虚型绝经后骨质疏松症患者骨密度的影响及疗效观察[J].中国社区医师,2017,33(25):97-98.
[16] 王少锋,戴浩军.独活寄生汤辅助治疗绝经后骨质疏松症疗效分析[J].贵州医药,2017,41(1):65-66.
[17] 杨阳,张允富,李旭.独活寄生汤加减对绝经后骨质疏松症患者(肝肾阴虚)骨密度及骨代谢指标的影响[J].中国医学创新,2017,14(33):61-64.
[18] 吴晨,姜凤依,李欣,等.独活寄生汤联合钙尔奇对绝经后骨质疏松症患者骨代谢标志物的影响[J].中医药信息,2017,34(1):77-80.
[19] 张鹏贵,杜耿.独活寄生汤联合唑来膦酸治疗绝经后骨质疏松肝肾亏虚证70例[J].河南中医,2017,37(8):1446-1448.
[20] 宋小梅.仙灵骨葆胶囊治疗绝经期骨质疏松症临床研究[J].河南中医,2017,37(4):686-688.
[21] 陈鑫,朱雄白,林文军,等.仙灵骨葆胶囊治疗绝经后骨质疏松的疗效及其机制研究[J].中国临床药理学杂志,2015,31(10):827-829,854.
[22] 杜倩,王哲,运乃茹,等.仙灵骨葆胶囊安全性系统评价[J].中国药业,2017,26(19):37-43.
[23] 章轶立,廖星,刘福梅,等.仙灵骨葆胶囊上市后用药安全性系统评价[J].中国中药杂志,2017,42(15):2845-2856.
[24] 刘泽有,杨金玲,王在红,等.金天格胶囊联合利塞膦酸钠治疗绝经后骨质疏松的临床研究[J].现代药物与临床,2018,33(1):139-142.
[25] 黄广平,陈民,刘向前,等.金天格胶囊治疗绝经后骨质疏松症的临床观察[J].中药材,2017,40(4):970-972.
[26] 徐荣敏,陈国军,洪明飞,等.金天格胶囊联合雌激素治疗对绝经后骨质疏松患者骨密度和骨代谢的影响[J].中国妇幼保健,2017,32(9):1940-1943.
[27] 卞庆来,邹小娟,沈霖.青娥丸治疗绝经后骨质疏松症肾虚血瘀证的疗效观察[J].中华中医药杂志,2018,33(1):308-312.
[28] 马陈,沈霖,杨艳萍,等.青娥丸对绝经后骨质疏松症患者血清癌胚抗原相关细胞黏附分子1,β-链蛋白水平及骨密度的影响[J].中国中医骨伤科杂志,2017,25(2):15-18.
[29] 余海,徐晓娟,沈霖,等.青娥丸对绝经后骨质疏松症患者骨密度、骨转换标志物及骨桥蛋白的影响[J].中国中医骨伤科杂志,2016,24(1):21-23.
[30] 周广文,向楠,沈霖,等.加味青娥丸对绝经后骨质疏松症患者的骨密度、骨代谢标志物及血清MGP水平的影响[J].中国中医骨伤科杂志,2016,24(3):4-8,13.
[31] 卢朝霞,王欣,周少怀.补肾健脾汤对绝经后骨质疏松症患者细胞因子及骨密度水平的影响[J].陕西中医,2017,38(4):438-439.
[32] 刘鸿雁,李剑,翟羽,等.健脾补肾活血方治疗女性绝经后骨质疏松效果及对血清1型原胶原氨基末端前肽、β-胶原特殊序列水平的影响[J].中国老年学杂志,2018,38(2):431-432.
[33] 唐保明.补肾调冲方治疗绝经后骨质疏松症62例[J].中国实验方剂学杂志,2015,21(6):191-194.