补肾活血汤调节骨代谢改善骨质疏松疗效观察
Observation on the therapeutic effect of Bushen Huoxue decoction in regulating bone metabolism and improving osteoporosis
  
DOI:10.3969/j.issn.1006-7108.2025.07.009
中文关键词:  骨质疏松  补肾活血  骨代谢  肾虚血瘀  外泌体
英文关键词:tonifying kidney and promoting blood circulation  osteoporosis  Kidney deficiency and blood stasis  Bone metabolism  exosomes
基金项目:国家自然科学基金青年科学基金项目(82004387)
作者单位
黄永铨1* 欧爱华1 麦秀钧1 陈善创1 刘启宇1 刘子桃1 江涛1 刘军2 1.广州中医院大学第二附属医院广东 广州 511400 2.广东省第二中医院广东 广州 510000 
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中文摘要:
      目的 观察补肾活血汤治疗骨质疏松(osteoporosis,OP)的临床疗效,并对其安全性进行评价。方法 招募2021年9月至2023年9月于广东省中医院诊治的OP患者60例。患者自愿选择是否服用中药,其中对照组采用OP基础治疗及西医抗OP治疗方案,试验组在对照组基础治疗上联合补肾活血汤治疗,疗程均为6个月。治疗前后检测骨密度、骨代谢、外泌体,FRAX工具评估患者脆性骨折发生的概率,并进行中医证候评分和安全性评价。结果 治疗后,两组患者骨密度均明显改善(P<0.05),但试验组并未优于对照组(P>0.05);两组患者骨代谢指标较治疗前明显下降(P<0.05),但试验组并未优于对照组(P>0.05);两组患者血清25(OH)2D3水平较治疗前明显上升(P<0.05),且试验组高于对照组(P<0.05);治疗后FRAX评分两组均下降(P<0.05),且试验组优于对照组(P<0.05);治疗后,试验组总有效率(92.3 %)明显高于对照组(76.9 %)(P<0.05);随治疗时间进展两组患者中医证候评分呈下降趋势,试验组下降更显著(P<0.05);治疗期间,两组均无发生严重药物不良反应,患者肝、肾功能无明显变化。结论 补肾活血汤可有效降低OP患者的骨代谢水平,促进血清外泌体的分泌,改善中医证候,但期待进行扩大样本量,实施严格的、临床随机对照试验以进一步验证其临床效果。
英文摘要:
      Objective To observe the clinical efficacy of Bushen Huoxue decoction in treating osteoporosis (OP) and evaluate its safety. Methods Recruit 60 patients with osteoporosis who were treated at Guangdong Provincial Hospital of Traditional Chinese Medicine from September 2021 to September 2023. The patients voluntarily chose whether to take traditional Chinese medicine, with the control group receiving OP basic treatment and Western medicine anti OP treatment plan. The experimental group received a combination of BuShen HuoXue decoction treatment on the basis of the control group, with a treatment course of 6 months for both groups. Before and after treatment, bone density, bone metabolism, and extracellular vesicles were measured. FRAX tool was used to assess the probability of brittle fractures in patients, and traditional Chinese medicine syndrome scores and safety evaluations were conducted. Results After treatment, both groups of patients showed significant improvement in bone density (P<0.05), but the experimental group was not superior to the control group (P>0.05); Two groups of patients showed a significant decrease in bone metabolism indicators compared to before treatment (P<0.05), but the experimental group was not superior to the control group (P>0.05); The serum levels of 25(OH)2VitD3 in both groups of patients increased significantly compared to before treatment (P<0.05), and the experimental group was higher than the control group (P<0.05); After treatment, both groups showed a decrease in FRAX scores (P<0.05), and the experimental group was better than the control group (P<0.05); After treatment, the total effective rate of the experimental group (92.3%) was significantly higher than that of the control group (76.9%) (P<0.05); As the treatment time progressed, the TCM syndrome scores of both groups of patients showed a downward trend, with the experimental group showing a more significant decrease (P<0.05); During the treatment period, neither group experienced serious adverse drug reactions, and there were no significant changes in the patients' liver and kidney function. Conclusion: Bushen Huoxue decoction can effectively reduce the bone metabolism level of OP patients, promote the secretion of serum exosomes, and improve traditional Chinese medicine syndromes. However, it is expected to expand the sample size and implement strict clinical randomized controlled trials to further verify its clinical effects.
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