Theory And Clinical Research On Prevention And Treatment From Kidney On Glucocorticoid Induced Osteoporosis

Osteoporosis (OP) is a metabolic disease characterized by bone mass reducing and micro-structure of bone tissue destroying. It’s divided into two kinds according to the cause. One is primary and the other is secondary. Glucocorticoid induced osteoporosis(GIO) is the third one which is inferior to post menopausal and aged osteoporosis.Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease, manifesting damages in multiple systems, with multiple self-antibodies characterized by anti-nuclear antibodies in the serum. Glucocorticoid is still one of the common medicines used to cure systemic lupus erythematosus.In traditional chinese medicine, glucocorticoid is one kind of yang materials. A mass of glucocorticoid used for a long term will induce kidney yin defficiency. When glucocorticoid is reduced, kidney yang will be insufficient due to losing warm nourishment of the yang material. The cause of glucocorticoid is similar to "drug toxin". The pathogenesis is that "yang is always sufficient while yin is always insufficient."Clinically we adopt the ways of nourishing yin or warm yang to interfere and to prevent and treat glucocorticoid induced osteoporosis based on the amoumt of glucocorticoid.ObjectiveTo observe the clinical effect of the prevention and treatment of glucocorticoid induced osteoporosis through kidney. To evaluate the clinical effect and the safety of the prevention and treatment of glucocorticoid induced osteoporosis through kidney in systemic lupus erythematosus.Methods Based on the clinical test principled of random, control and open-label,80patients suffering from systemic lupus erythematosus were divided into two groups:the patients in the treatment group(n=40) were given the changed decoction of Jinkui Shenqi pills combined with the tablets of calcium carbonate and vitaraine D3and the soft capsule of calcitriol. The treatment lasted2months. After treatment, the metabolic indexes such as blood calcium, blood phosphor, urine calcium, urine phosphor were observed and tested. IPTH、ALP、 BGP、25-(OH) D3and BMD were also tested. Analyzed and statistically analyzed the test results.ResultsThere was no significant difference in blood calcium and urine phosphor between the treatment group and the control group(P>0.05). The level of blood phosphor,25-(OH)D3and ALP were higher in the treatment group than that in the control group(P<0.05). The level of urine calcium and IPTH in the treatment group were lower than that in the control group ((P<0.05). The treatment group had lower BGP and BMD than the control group((P<0.05). There was no patient falling off from the two groups and there was no any side effect in the two groups.ConclusionBased on the treatment through kidney, the decoction of Jingui Shenqi pills combined with western medicines had better therapeutic effects than the western medicine used only. Especially prevention and treatment through kidney had specific improvement in the bone turnover, bone metabolism, bone mineral density, and so on. The combination of the decoction with western medicines has better clinical effects and safety in preventing and treating GIO in SLE.