Effect Of Calcium Combined With Calcitriol On Bone Mineral Density And Vascular Calcification In Senile Osteoporosis Patients With Kidney Deficiency And Blood Stasis

Objective:This study firstly collected literature related to senile osteoporosis in the field of traditional Chinese medicine and then used CiteSpace analysis to verify whether kidney deficiency and blood stasis type is the most common type of senile bone pine.Subsequently,a retrospective study was conducted to evaluate the effects of calcium supplements on bone mineral density and vascular calcification in elderly patients with this syndrome type of osteoporosis.It is hoped that this can provide some theoretical support for the rational use of calcium supplements in the clinic.Study 1: Metrology and visualization analysis of TCM literature related to senile osteoporosis based on CiteSpace Method:The Chinese Journal Full-text Database(CNKI)was used as the data source to retrieve the related literature on the syndrome types of senile osteoporosis in traditional Chinese medicine.After the manual screening,CiteSpace 6.1.R3 was used for measurement and visual analysis,and annually published papers,authors,research institutions and keywords were analyzed.Result:A total of 999 articles were included after screening,and the number of studies showed a fluctuating upward trend.2021 was the peak with 115 papers.The three authors with the most articles were Shi Xiaolin(13 articles),Yan Xiaoping(8 articles)and Fan Junming(8 articles).The institutions with the most articles were mainly traditional Chinese medicine universities or affiliated hospitals,and the top three institutions were Zhejiang University of Chinese Medicine(27 articles),Guangzhou University of Chinese Medicine(23 articles),and Gansu University of Chinese Medicine(22 articles).The degree of cooperation between different teams is generally loose.According to the results of co-occurrence and emergence of keywords,kidney deficiency and blood stasis were the most relevant keywords in TCM’s etiology,pathogenesis and syndrome types.It became a research hotspot from 2017 to 2018.The research trends mainly focused on acupuncture,medication rules,pathogenesis and data mining.Based on the research results and the analysis of etiology,pathogenesis and syndrome classification by doctors and modern scholars,it is believed that kidney deficiency and blood stasis type is the main syndrome type of senile osteoporosis patients.Conclusion: The type of kidney deficiency and blood stasis is the main syndrome type of senile osteoporosis patients.It is predicted that the research hotspot in recent years may focus on acupuncture,medication rules,pathogenesis and data mining,so as to provide scientific research or clinical ideas for scholars in related fields.Study2:Effect Of Calcium Combined With Calcitriol On Bone Mineral Density And Vascular Calcification In Senile Osteoporosis Patients With Kidney Deficiency And Blood StasisMethod: This retrospective study selected elderly patients with osteoporosis who met the inclusion and exclusion criteria in outpatients and inpatients of the 900 th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from January 1,2017 to January 1,2022(The patient lived in Fuzhou Army cadre convalesce,Fujian Province).After the questionnaire judged the syndrome type,the patients with kidney deficiency and blood stasis type were selected for the study.After 360 cases were included,SPSS 25.0 software was used.According to the use of calcium,144 cases were grouped by propensity score matching(PSM)and finally included.There were 46 males and 98 females with an average age of(80.7±6.50)years.The patients were divided into an experimental group(n=72)and a control group(n=72)according to whether they took experimental drugs(Caltrate combined with calcitriol).The patients were divided into three subgroups according to the duration of treatment: group A(6 months to 1 year),group B(1 year to 3 years),and group C(more than 3 years).The related indicators of patients were obtained,including height,weight,bone mineral density,thoracic aorta calcification score,creatinine,uric acid,alkaline phosphatase,total cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,calcium,phosphorus,and glycosylated hemoglobin.Body mass index(BMI)was calculated according to height and weight.The combined cardiovascular diseases such as coronary heart disease,hypertension,heart failure and type Ⅱ diabetes mellitus were recorded.SPSS25.0 software was used for statistical analysis of the above data to analyze the effect of calcium combined with calcitriol on bone mineral density and vascular calcification in patients with senility osteoporosis of kidney deficiency and blood stasis type.Result: 1.In the comparison of basic information,there was no significant difference in age,gender,BMI,Cr,UA,ALP,TC,TG,HDL-C,LDL-C,Ca,Mg,P,GHb between the experimental group and the control group(P > 0.05).2.2 There was a difference in BMD between the two groups(P < 0.01),but there was no difference in fragility fracture.3.Calcium combined with calcitriol treatment can promote the calcification of thoracic aorta.There was a significant difference in calcification score between groups(260.97±115.14 vs 301.58±113.32,P <0.05).The group had more high-risk calcifications.And there was statistical difference(P < 0.05).In the comparison of diseases,there were significant differences in coronary heart disease and hypertension(P < 0.05)but no difference in heart failure and diabetes(P > 0.05).The incidence was higher in the experimental group than in the control group.4.There were no significant differences among the three groups in bone mineral density,fracture,calcification score,calcification degree,cardiovascular disease,and type Ⅱ diabetes(P > 0.05).Partial correlation analysis showed that there was no correlation between the time of taking calcium and the incidence of coronary heart disease,hypertension and heart failure(P > 0.05).Conclusion: 1.Calcium combined with calcitriol can effectively improve bone mineral density and aggravate vascular calcification in patients with senile osteoporosis of kidney deficiency and blood stasis type.2.In patients with kidney deficiency and blood stasis type,bone mineral density was improved after 6 months of taking calcium.Long-term use could maintain bone mineral density,and no progressive aggravation of vascular calcification was observed.