A Tentative Research On The Treating Mechanism Of BuShenQiangDuZhiLv Decoction On The Changes Of AS Patients' Bone Substances

ObjectiveAccording to the famous professor in Chinese Medicine, Jiao Shude's theories of ankylosing spondylitis (stagnation of asthenia kidney and cold syndrome in du-channel), this thesis studies the adoption of Bushenqiangduzhilv decoction in restoring ankylosing spondylitis (AS), evaluates the curative effects before and after 24 weeks treatment referring to the clinical and laboratory examination index sign, and explores the mechanism that Bushenqiangduzhilv decoction works on the changes of bone substances of AS from the perspective of molecular biology referring to OPG/RANKL/RANK signal transferring system.Method:30 cases with ankylosis spondylitis (stagnation of asthenia kidney and cold syndrome in du-channel)were collected and treated with BuShenQiangDuZhilv decoction. Therapeutic effect was evaluated according to the standard by Assessment on Ankylosing Spondylitis Response Criteria (ASAS), symptom effect of Chinese Medicine, Main index effect, Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), radiology changes, OPG/RANKL of AS patients were analyzed before and after 6 months treatment. The side effect was recorded as well.Result(1)There was obvious improvement according to the Assessment in Ankylosing Spondylitis (ASAS) criteria after treatment. The improvement rate of ASAS20, ASASSO and ASAS70 is 40.00%(12/30), 33.33%(10/30) and 6.67%(2/30) respectively after 12 weeks of treatment. And it is respectively 20.0%(6/30), 50.00%(15/30) and 13.33%(4/30) after 24 weeks. (2)The total effective rate of CM symptom effect in the AS patients was 36.67% (11/30), 83.33% (25/30) and 90.00% (27/30) respectively after 4,12 and 24 weeks of treatment.(3)There was significant difference in 10cm VAS for back pain, duration of back early morning stiffness(EMS), Bath Ankylosing Spondylitis Disease Activity Index(BADAI), global assessment of patients and doctors after 6 months of treatment。In the Schober's test, occiput to wall and finger to floor distance, there was significant difference after 24 weeks of treatment in contrast to pretreatment (P＜0.05). While the difference of chest expansion was not significant (P＞0.05).(4)There was significant difference in ESR, CRP, IgA, IgG and IgM after 24 weeks of treatment in contrast to pretreatment (P＜0.05). while the radiology changes before and after 24 weeks of treatment was insignificant(P＞0.05).(5 For OPG, RANKL in blood serum between the normal persons and the patients with AS before tested, there were significant difference (P＜0.05). and the difference in OPG,RANKL before andafter treatment for the AS patients was also significant (P＜0.05).Conclusion(1)BuShenQiangDuZhiLv dcoction had much better curative effect for the AS paients (stagnation of asthenia kidney and cold syndrome in du-channel), particularly for the improvement in clinical symptoms.(2) For the treated group, there was an obvious drop in their serum OPG and RANKL, and the difference of their chest expansion and radiology changes before and after treatment was not significant. This proved the improving function of this decoction in the bone substances changes of the patients.