| Objective1. To sum up and conclude the main Traditional Chinese Medicine (TCM) syndrome type of Osteoporosis.2. To study the Curative effect of Bushen Huoxue Recipe (BHR) in senile osteoporosis. To analysize the characteristic and advantage of treatment of Bushen Huoxue Recipe for senile osteoporosis.3. To observe the effects of Bushen Huoxue Recipe(BHR) medicated serum on cell proliferation and Hypoxia inducible factor-1a in osteoblasts of rats cultured in vitro. Discuss the therapeutic mechanism of BHR treating osteoporosis.Method1. Literature research:According to record and understanding of osteoporosis in Ancient Book. Analyzed and overviewed the syndrome type of osteoporosis in Domestic literature. Summed up the main TCM syndrome type of osteoporosis is kidney deficiency and blood stasis.Then Then discussed the relationship between osteoporosis and syndrome of kidney deficiency and blood stasis usin the theory of Chinese traditional medicine, the current situation of diagnosis and treatment, and therapeutic mechanism2. Clinical research:(1) Object:80cases of elderly patients were selected in out-patient treatment between June2010and August2011. The patients were randomly divided into two groups of40patients each, two groups of gender, age, the condition of no significant difference, with comparable.(2) Treatment method:①basis treatment of Calcium Carbonate Chewable D3(0.5g/tablet,1tablets each time, Twics daily)+Ossification of three alcohol capsule oral(0.25ug/Particle,1capsules each time,1times daily);②Treatment group was treating with based treatment plus Bushenhuoxue Decoction:Rehmannia24g, the dogwood12g, tree peony bark9g, Chinese yam12g, Poria9g, the Alisma9g, the eucommia12g, the epimedium18g, Astragalus15g, Salvia12g, safflower9, thirty-seven3g, Decoction, an agent each day.③The control group was treating with basic treatment plus alendronate sodium tablets (10mg/tablet,1tablets each time,1times daily) oral.3months for1courses of treatment, continuously taking2courses.(3) Outcome measures:VAS pain score, bone mineral density(BMD), efficacy evaluation, TCM syndrome score,bone metabolic markers (osteocalcin, bone alkaline phosphatase, tartrate resistant acid phosphatase),SF-36quality of life score.3. Experimental study:The rat calvaria primary osteoblast-like cells were separated, amplified, establishment of in vitro culture system, with low, medium, high three different concentrations of Bushenhuoxue decoction containing serum and blank control group intervention, using the MTT method for the detection of osteoblast proliferation, PNPP assay for the detection of alkaline phosphatase (ALP) content, Alizarin red staining for detection of the number of mineralized nodules of bone cells. Western blot analysis and observe the HIF-1α protein expression.Result1. Literature study:Kidney deficiency and blood stasis is the main syndrome type of traditional Chinese medicine in the primary osteoporosis2. Clinical study:The treatment group and control group were followed up for35people each.(1) VAS score:Two groups of VAS scores decreased gradually with the increase of treatment time (P＜0.05), two week and one month after treatment there was significantly difference between two groups (P＜0.05), while three month and six month, there was no significant difference two groups (P>0.05); (2) Bone mineral density:After treatment, there was no significant change in the both groups (P>0.05); before treatment there was no significant difference between the two groups (P>0.05) after treatment there was also no significant differences between the two groups (P>0.05);(3) Efficacy evaluation:After treatment, the markedly effective rate was57.1%, the total effective rate was88.6%in treatment group, while the markedly effective rate was45.7%and the total effective rate was85.6%in the control group, the markedly effective rate and total efficiency between the two groups have no significant difference(P>0.05);(4) The TCM syndrome score:Scorses decreased significantly after treatment in both groups (P＜0.05), but scorse of the treatment group decreased more significantly than the control group, and there was significantly different between the two groups in each time of the observation point (P＜0.05);(5) Bone metabolism markers:after treatment,bone formation markers including osteocalcin, bone alkaline phosphatase in two groups increased, and the Bone resorption markers tartrate resistant acid phosphatase decreased significantly (P＜0.05), there had no significant difference between two groups before treatment(P>0.05), there had no significant difference between two groups after treatment(P>0.05);(6) The SF-36scale quality of life scores:All dimensions of quality of life score increased significantly in both groups after treatment (P<0.05). four dimensions including the physiological function, vitality, physiological function, social function in treatment group were Improved obviously than the control group (P＜0.05), while four dimensions including somatic pain, mental health, emotional functioning, general health had no significant difference comparison with the control group(P>0.05).3. Experimental study:(1) Bushen Huoxue Recipe containing serum could increase the osteoblast proliferation in vitro, except the low concentration in the24h group compared with the control group without significant difference (P>0.05), each concentration group at each time point can promote osteoblast proliferation greatly compared with the control group with significant difference (P<.0.01), in a concentration-dependent manner;(2) After cultured48,72,96h with Each concentration treatment group, ALP secretion was increased to varying degrees, compared with the control group with significant difference (P＜0.01);(3) The osteogenic induction after staining with alizarin red traditional Chinese medicine groups calcified nodule number significantly increased compared with the control group with significant difference (P<0.01);(4) The traditional Chinese medicines groups reduced the expression of HIF-1α. Compared with the control group, the medium and high concentration groups showed very significant difference (P＜0.01), also low concentration group showed significant differences (P＜0.05).Conclusion1. Kidney deficiency and blood stasis is an important etiology and pathogenesis of senile osteoporosis.2. Bushen Huoxue Recipe in treating deficiency of kidney and blood stasis type of senile osteoporosis can effectively relieve pain, improve the kidney deficiency and blood stasis syndrome score, increase bone formation, reduce bone resorption, improve the quality of life, the clinical effect is satisfactory, which fully demonstrates the advantages and characteristics of Chinese medicine in dialectical theory of governance and focus on regulating the whole.3. Bushen Huoxue Recipe can promote proliferation of osteoblasts in vitro, increased ALP activity and increase of mineralized nodules, and reduce the osteoblast HIF-1α expression in a concentration-dependent manner, to a certain extent it can partly reflects the mechanism of the recipe in promoting osteogenesis and improving local microcirculation. |
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