左归丸对甲强龙脉冲治疗Graves眼病骨代谢水平的影响

胡咏新; 孙利; 褚晓秋; 谢绍锋; 刘超

左归丸对甲强龙脉冲治疗Graves眼病骨代谢水平的影响

南京中医药大学附属中西医结合医院，江苏南京 210028

计量
- 文章访问数: 1536
- HTML全文浏览量: 2
- PDF下载量: 1265
- 被引次数: 0
出版历程
- 收稿日期: 2016-10-02
- 修回日期: 2016-12-10
- 刊出日期: 2017-03-10

Influence of Zuogui Pill on Bone Metabolism in Grave's Ophthalmopathy After Methylprednisolone Pulse Therapy

摘要

摘要: 目的探讨经方左归丸对甲强龙脉冲治疗Graves眼病(GO)骨代谢指标:1型前胶原N-端前肽（P1NP）、β-1型胶原羧基端肽（β-CTX）、25羟维生素D(25OHD)和碱性磷酸酶(ALP)的影响。方法选取符合条件的GO肾阴亏虚患者60例，其中治疗组32例，对照组28例，治疗组给予脉冲治疗联合左归丸，对照组给予脉冲治疗联合安慰剂，观察治疗前后2组证候积分、骨生化标记物的变化。结果治疗组治疗后证候评分较前明显好转（P<0.05），其中腰膝酸软、潮热盗汗改善明显优于对照组（P<0.05），疗效优于对照组（P<0.01）。血β-CTX、ALP水平明显降低，其中β-CTX水平与对照组比有显著性差异（P<0.05）。2组治疗后CAS积分、充血、水肿、疼痛症状都有明显改善(P<0.01)，但组间比，P>0.05。结论中药左归丸可以改善肾阴虚证候，抑制破骨细胞活性，纠正高骨转换，对预防糖皮质激素导致的骨质疏松有一定疗效。
- Graves眼病 /
- 左归丸 /
- 脉冲治疗 /
- 骨标记物
Abstract: OBJECTIVE To explore the influences of Zuogui Pill on such bone metabolism indexes as P1NP， β-CTX， 25OHD and ALP in patients with Grave's ophthalmopathy(GO) after methylprednisolone pulse therapy. METHODS 60 cases with GO due to kidney yin deficiency catering for the condition were selected and into the treatment group(32 cases) and the control group(28 cases). Patients in the treatment group were given methylprednisolone pulse therapy and Zuogui Pill， while those in the control group were treated with methylprednisolone pulse therapy and placebo. The syndrome integral scores and bone biochemical markers of both groups were observed before and after treatment. RESULTS The syndrome integral scores of the treatment group experienced an evident improvement than before(P<0.05). The treatment group is more superior to the control group in improving soreness and weakness of waist and knees， tidal fever and night sweating(P<0.05)， with better therapeutic effects(P<0.01). Both β-CTX and ALP levels in the blood serum went down， with significant differences being noticed in the β-CTX level of both treatment groups(P<0.05). CONCLUSION Chinese medicine Zuogui Pill is able to improve the symptoms caused by kidney yin deficiency， inhibit the osteoclast activity， rectify the high-bone turnover， which is conductive to preventing osteoporosis due to glucocorticoid.
- Grave's ophthalmopathy /
- Zuogui Pill /
- methylprednisolone pulse therapy /
- bone biomarker

HTML全文

参考文献(17)

[1]	BAHN R.High-dose intravenous glucocorticoid therapy for Graves' ophthalmopathy: where are we now?[J]. Thyroid， 2012， 22(1): 1-2.
[2]	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，2002：240．
[3]	Guiding Principle of Clinical Use on New Drugs of Traditional Chinese Medicine(Trial)[M]. Beijing: China medical science and technology press， 2002: 240.
[4]	郭玲玲，杨国庆，谷伟军，等．中重度甲状腺相关眼病单纯激素冲击及激素冲击联合放疗远期疗效观察[J]．中华内分泌代谢杂志，2015， 31（6）：506-509．
[5]	GUO LL， YANG GQ， GU WJ， et al. Long-term clinical outcomes of pulsed corticosteroids with or without orbital irradiation for moderate to severe Graves' ophthalmopathy[J]. Chin J Endocrinol Metab， 2015， 31(6): 506-509.
[6]	GASINSKA T， BOROWSKA A， WICHARY H， et al. Effect of methylprednisolone pulse therapy with and without alendronate on biochemical markers of bone turnover in patients with Graves' ophthalmopathy[J]. Pol Arch Med Wewn， 2012， 122(7/8): 341-346.
[7]	ZANG S， PONTO KA， KAHALY GJ. Intravenous glucocorticoids for graves' orbitopathy: efficacy and morbidity[J]. J Clin Endocrin Metabol， 2011， 96(2): 320-332.
[8]	PEARCE G，TABANSKY DA， DELMAS PD， et al.Corticosteroid-induced bone lose in men[J].J Clin Endocrinol Metab，1998， 83:801-806.
[9]	ALLAIN JJ， MCGREGOR A.Thyroid hormones and bone[J]. J Endocrinol， 1993，139:9-18.
[10]	鞠大宏，赵宏艳，刘梅洁，等．左归丸含药血清对成骨细胞IL-1、IL-6和COX-2表达的影响[J]．中国实验动物学报，2006， 14（2）：96-99．
[11]	JU DH， ZHAO HY， LIU MJ， et al. Effects of serum containing Zuogui Pill substances on the expression of IL-1， IL-6 and COX-2 in osteoblasts in vitro[J]. Acta Lab Anim Sci Sin， 2006， 14(2): 96-99.
[12]	林日阳，吴锋，何立群．熟地鳖甲与系膜细胞协同上调成骨细胞骨钙素基因及蛋白表达[J]．中国组织工程研究，2012， 16（20）：3725-3729．
[13]	LIN RY， WU F， HE LQ. Shudi Biejia and mesangial cells cooperatively up-regulate the gene and protein expression of osteocalcin in osteoblasts[J]. J Clin Rehabil Tis Eng Res， 2012， 16 (20): 3725-3729.
[14]	刘梅洁，潘静华，李艳，等．左归丸对糖皮质激素所致骨质疏松大鼠血清中BGP，IGF-I含量的影响[J]．中国实验方剂学杂志，2011， 17（16）：133-136．
[15]	LIU MJ， PAN JH， LI Y， et al. Effects of Zuogui Wan on BGP and IGF-I in Serum of Glucocorticoid-induced Osteoporosis Rats[J]. Chin J Exp Med Formul， 2011， 17 (16): 133-136.
[16]	胡咏新，孙利.“补肾健骨方”对2型糖尿病患者骨生化标记物的影响[J].江苏中医药，2012，44（1）：20-21.
[17]	HU YX， SUN L. The effects of BushenJiangu Fang on biochemical markers of bone in patients with type 2 diabetes[J]. Jiangsu J Tradit Chin Med， 2012，44(1):20-21.