Clinical Study On The Effect Of Midd Moxlbustion On The Back-shu Acupoints For Bone Metabolism In PMOP Patients With Deficiency Of Spleen And Kidney

Objective:This study is based on "Bushen Jianpi" as the basic method.The changes of bone mineral density,visual analogue scale(VAS)of clinical pain and TCM symptom scale were analyzed before and after treatment.To determine the clinical efficacy of PMOP patients with spleen and kidney deficiency in the treatment of mild moxibustion.At the same time,in order to seek a safe,convenient and effective method for the treatment of patients with PMOP.We observe the changes of bone metabolism indexes before and after the treatment,study the effect and mechanism of mild moxibustion on bone metabolism in PMOP patients with spleen and kidney deficiency.Methods:1.Clinical efficacy study of mild moxibustion:Randomly,60 cases(diagnosed as PMOP patients with spleen and kidney deficiency)were divided into treatment group(withmild moxibustion)30 cases and control group(with Caltrate D)30 cases.The changes of bone mineral density,visual analogue scale of clinical pain and TCM symptom scale in postmenopausal osteoporosis women were observed before and after treatment.2.Study of bone metabolic markers in PMOP patients with spleen and kidney deficiency:After bone mineral density test,60 cases(diagnosed as PMOP patients with spleen and kidney deficiency)were divided into osteopenia,osteoporosis and severe osteoporosis group according to the Diagnostic criteria for osteoporosis.All patients in the morning fasting blood was determined by ELISA of BALP and TRACP-5b content;suspension array to detect the BGP,OPG,DKK-1,RANKL and other 20 kinds of bone metabolic markers.3.Study on Mechanism of mild moxibustion:Randomly,60 cases(diagnosed as PMOP patients with spleen and kidney deficiency)were divided into treatment group(with mild moxibustion)30 cases and control group(with Caltrate D)30 cases.The content of BALP and TRACP5b in plasma before and after treatment were detected by ELISA.The content of BGP,OPG,DKK-1 and RANKL in plasma before and after treatment were detected by suspension array;The difference of mRNA expression of DKK-1,OPG and RANKL in plasma before and after treatment by Real-time PCR.Resμlts:1.Compared with before treatment,after mild moxibustion Piyu and Shenyu three months.No significant change in bone mineral density,with no significant difference(P>0.05);In the control group(with Caltrate D),Bone mineral density with no significant difference(P>0.05)too.According to visual analogue scale(VAS)of clinical pain,Two groups of patients with bone pain were improved.The VAS score was decreased and there were significant difference(P<0.01),and the effect of the treatment group(with mild moxibustion)than control group(with Caltrate D).According to TCM symptom scale,control group(with Caltrate D)(P>0.05)TCM syndrome total score before treatment showed no significant difference(P>0.05),the treatment group(with mild moxibustion)TCM syndrome total score decreased and there was significant difference(P<0.01).2.Bone metabolic markers:ACTH,IL-1β,PTH,SOST,TNF-a,MIP-1α,FGF-2,IL-10,MCP-1,IFN-γ and TGF-β levels showed no significant linear correlation with bone mineral density(P>0.05)in patients.BALP,TRACP-5b,DKK-1,RANKL,IL-6,OPN,BGP levels were negatively correlated with bone mineral density,OPG,Leptin,FGF-23,InsμLin levels were positively correlated with bone mineral density,and the correlation was statistically significant(P<0.05).3.Compared with before treatment,after mild moxibustion of Piyu and Shenyu three months.BGP.BALP.OPG levels increased compared with before treatment,with significant difference(P<0.01).The levels of TRACP-5b,DKK-1 and RANKL were significantly lower than those before treatment(P<0.01).Conclusions:1.According to the resμLts of the bone mineral density,visual analogue scale of clinical pain and TCM symptom scale,it can be considered that the mild moxibustion of Piyu and Shenyu can improve the clinical symptoms of the patients and play an important role in the prevention and treatment of PMOP.2.In the plasma of patients with BALP,TRACP5b,BGP,DKK-1,RANKL,OPG,IL-6,Leptin,OPN,FGF-23 and InspLin can be used as an index to evaluate the severity of osteoporosis in postmenopausal women,and the correlation was statistically significant(P<0.01).3.mild moxibustion of Piyu and Shenyu can up-regμLate the expression of BGP,BALP,OPG and down-regμLate the expression of TRACP-5b,DKK-1 and RANKL.To promote the proliferation and differentiation of osteoblasts,increase bone formation,inhibit the differentiation of osteoclasts,and reduce the level of bone resorption,so as to achieve the purpose of prevention and treatment of osteoporosis.