The Basic Research Of Bu-shen-huo-xue Decoction On Treatment Of Postmenopausal Osteoporosis

Objective:To study the therapeutic effect of invigorating the kidney and promoting blood circulation method and Bu-shen-huo-xue decoction on treatment of postmenopausal osteoporosis, and explore its mechanism.Method:To investigate the therapeutic effect of invigorating the kidney and promoting blood circulation method on treatment of postmenopausal osteoporosis through a systematic literature review and meta-analysis. To investigate the therapeutic effect of Bu-shen-huo-xue decoction on treatment of postmenopausal osteoporosis and explore its mechanism through animals experiment and cells experiment.1.Systematic literature review and meta-analysis:multi-Keyword literature retrieval (invigorating the kidney, tonifying liver and kidney, promoting blood circulation method, nourishing spleen and activating blood, osteoporosis, Randomized controlled trials, clinical research). By consulting CNKI database, the Vip database and WanFang database from 2000.01-2016.09, all the related RCTs were included in the study. Review Manager 5.3 software was used, for Meta analysis. Outcome assessment indexes included the subjective satisfaction, bone mass density (BMD) and Visual Analogue Scale (VAS) Pain Score.Then methodological quality of the internalized literatures were valuated by Jadad method in 5 aspects, Random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data and selective reporting. 2.Animals experiment:The experimental model of posemenopausal osteoporosis was produced in the ovariectomized rats,100 rats were divided into blank group, model group, treatment group and sham treatment group. Treatment group and sham treatment group were treated with Bu-shen-huo-xue decoction and placebo saline solution respectively. The expression of bone metabolic index(TRACP, BALP, PINP, PICP, CTX and NTX) in serum at 4,8,12W post-surgery were detected by ELISA. BMD at 12W of the L2-6 were detected by dual-energy X-ray absorptiometry.3.Cells experiment:Cancellous bone specimens from the femoral head were obtained from patients with femoral neck fracture merger osteoporosis, osteoblast cells were seeded and cultured in vitro. SD rats were divided into three groups (high, middle and low doses) to prepare drug serum. MTT, ALP activity assay and alizarin red staining were used to observe the proliferation, activity of ALP and the number of mineral node of cultured osteoblasts in vitro.Results:1.Systematic literature review and meta-analysis:invigorating the kidney and promoting blood circulation method has its unique advantage in treating osteoporosis, it can obviously improve the clinical therapeutic effectiveness, relieve the pain and enhance BMD. The relative low quality of evaluated articles suggests that there exist some methodology problems in the clinic RCTs of TCM on treating osteoporosis.2.Animals experiment:The serum levels of BALP, TRACP-5b, CTX and NTX increased in model control and sham-treatment groups compared with the blank control group, and the serum levels of PINP and PICP decreased from 4W to 12W post-surgery. Bu-shen-huo-xue decoction inhibited the increase in serum levels of BALP, TRACP-5b, CTX, NTX, and increased the serum levels of PINP and PICP compared with model and sham treatment groups.3.Cells experiment:Osteoblast proliferation in high and middle groups were obviously added and showed a some dose dependence 48h after drug intervention. The activity of alkaline phosphatase(ALP) in the high, moderate and low dose groups were obviously increased 72h after drug intervention. The depositing of calcium salt crystal was obviously increased in high dose group 72h after drug intervention.Conclusion:Invigorating the kidney and promoting blood circulation method has its unique advantage in treating osteoporosis, especially in symptom improvement aspect. The mechanism of Bu-shen-huo-xue decoction treating the Postmenopausal osteoporosis may be related with its adjusting effect on bone metabolism and the effects promote proliferation, differentiation, maturation and mineralization of the osteoblasts in vitro.