摘要
目的:中药治疗绝经后骨质疏松症已收到越来越多的关注,探寻中药复方制剂补骨脂治疗绝经后骨质疏松症机制及其前景展望。资料来源:应用计算机检索CNKI1994-11/2004-12的与补骨脂和骨质疏松症相关文献,检索词“补骨脂,骨质疏松症”,限定文献语种为中文。资料选择:对资料进行初审,纳入标准:①补骨脂复方制剂对绝经后骨质疏松症作用机制。②单味补骨脂对绝经后骨质疏松症可能机制研究。排除标准:文献中重复研究、综述类文章、骨质疏松症中非绝经后骨质疏松症。未排除文章资料是否应用了随机、对照、盲法。资料提炼:共收集到172篇相关文献,12篇符合纳入标准,排除160篇,其中非绝经后骨质疏松症、药物组成中无补骨脂的临床或实验报道145篇,综述12篇,3篇为重复报道。资料综合:①补骨脂复方制剂对绝经后骨质疏松症的防治作用:临床研究表明,绝经后骨质疏松症患者应用补骨脂复方制剂治疗后尿钙、尿羟脯氨酸排出量减少,血清白细胞介素6及肿瘤坏死因子α水平均降低;腰脊酸痛、胫酸膝软或足跟痛、耳鸣或耳聋、脱发或齿摇等肾虚症状明显缓解,患者血清雌、孕激素水平提高;肝肾不足型绝经后骨质疏松症患者的骨密度值显著提高,患者T淋巴细胞亚群CD3,CD4水平、CD4/CD8比值以及血清免疫学IgG,IgM水平明显提高。基础研究表明:补肾密骨液(杜仲、胡桃肉、补骨脂、淫羊藿、干地黄、淮牛膝等量)可增加大鼠后肢胫骨中的Ca,Mg,Mn,Cu的含量;骨康方提取液(由补骨脂、淫羊藿、黄芪、肉苁蓉、丹参等药物组成)能有效提高去势大鼠体内雌二醇含量,降低体内白细胞介素6含量,而且能够提高骨钙素含量。②单味补骨脂的防治作用:补骨脂对新生大鼠成骨细胞的增殖有显著促进作用。表明补骨脂抗骨质疏松的作用与其增加成骨细胞的数量和促进成骨细胞的增殖能力有关。结论:①补骨脂治疗绝经后骨质疏松症有一定的临床和实验效果。②可能的作用机制:类性激素样作用;间接促进成骨细胞增殖;对破骨细胞有明显抑制作用;补骨脂中含有较丰富的锰、锌,调节体内内环境微量元素的平衡,促进骨生成;改善骨基质的分子结构,使骨机构力学特性得以加强。
OBJECTIVE： More and more attention was drawn to the treatment of postmenopausal osteoporosis （PMO） by traditional Chinese medicine. To probe into the mechanism in treatment of PMO by Chinese compound preparation of fructus psoraleae and its prospect. DATA SOURCES： A computer-based search was conducted in CNKI for articles related to fructus psoraleae and PMO published between November 1994 and December 2004 with the key words of ＂fructus psoraleae, postmenopausal osteoporosis＂, and the language was limited to Chinese. STUDY SELECTION： Data were checked in the first trial. Inclusion criteria： ① The mechanism of fructus psoraleae in the treatment of PMO.② Research on the possible mechanism of fructus psoraleae in the treatment of PMO. Exclusion criteria： Repetitive studies, reviews and papers related to osteoporosis but not PMO. Papers were included without considering they were randomised, control or blind. DATA EXTRACTION： Of 172 relevant literatures, 12 ones were in accordance with the inclusion criteria, and 160 papers were excluded, including 145 clinical or experiment reports about non-PMO and medicine without the component of fructus psoraleae, 12 reviews as well as 3 repetitive studies. DATA SYNTHESIS： ① Fructus psoraleae compound preparation could prevent and treat PMO： clinical researches showed that, the output of urinary calcium and hydroxyproline in patients with PMO decreased, and the serum interleukin-6 as well as the tumor necrosis factor-α were reduced after treated by fructus psoraleae compound preparation. Symptoms of renal deficiency such as pain in lumbar vertebrae, sour tibia and powerless knee, talagia, tinnitus, deafness, lapsus pilorum and luxated tooth etc. The levels of serum estrogenic hormone and pregnancy hormone in patients were enhanced. The bone density in patients with PMO of liver and kidney deficiency was significantly increased, and the levels of T leukomonocyte subgroup CD3, CD4, the ratio of CD4/CD8 and levels of serum immune IgG, IgM were greatly enhanced in patients. Basic research suggested that： Bushen migu liquid （composed of equal amount of eucommia bark, walnut meat, fructus psoraleae, aceranthus sagittatus, adhesive rehmannia dried root and radix achyranthis bidentatae） could increase the contents of Ca, Mg, Mn, Cu in tibia of posterior limb in rats. Gukangfang extraction （composed of fructus psoraleae, aceranthus sagittatus, astragali radix, caulis cistanchis and danshen root etc.） could effectively enhance the in vivo content of dihydroxyestrin in demasculinized rats as well as enhance the bone gla protein content.② The prevention and treatment effect of single fructus psoraleae： The fructus psoraleae could significantly promote the osteoblastic proliferation of new born rats, which indicated that the anti-effect of fructus psoraleae on osteoporosis was related to the osteoblastic number and its promotion effect on the reproductive activity of osteoporosis. CONCLUSION： ① Fructus psoraleae has certain clinical and experimental effect on PMO. ② Possible mechanism of action： hormonelike effect, can indirectly promote the proliferation of osteoblast and has significant inhibition effect on osteoclast. There are abundant manganese and zinc in fructus psoraleae, which can maintain the balance of microelements in the internal environment in vivo, promote the bone formation, ameliorate the molecular structure of bone matrix and reinforce the features in mechanics of bone organization.
出处
《中国临床康复》
CSCD
北大核心
2006年第35期145-147,共3页
Chinese Journal of Clinical Rehabilitation
基金
江苏省农机基金资助(GXZ05031)~~
作者简介
王全权，男，1972年生，江苏省涟水县人，汉族，南京中医药大学临床中药学在读硕士，主治医师，主要从事针灸及中药治疗痛症的研究。
