| Ankylosing spondylitis (AS)is a chronic inflammatory rheumatic disease whichmainly impinge on sacroiliac joint and vertebral column,the peripheral arthritisis also be involved.Osteoporosis(OP)is a common complication in AS,even in theearly stages.OP can lead to spine's deformities,osteoporotic fractures,and affectsprognosis of disease.The pathogenesis of OP in AS remains unclear.It might be dueto imbalancing of hormones,immune inflammatory,restricted movement,and soon.However,the etiology of that still remains controversial,and the treatmentof OP in AS has not received much attention.Therefore,it is a significative taskthat determine the pathogenesis of OP in AS,investigate the bone mass and bonemetabolism,treating AS OP so that decrease the harm of complication and improveprognosis of disease. In Traditional Chinese Medicine ( TCM ), basing on the pathogeny andmanifestation of AS,a lot of physicians think that AS is belonged to"Gubi","Wanbi","Wangbi" , mostofthemthinkthatthepathogenesisofASisrelatedtoasthenia etc andof kidney and Du meridian,evils intrusion,infirmity of inside and evils ofoutside ' combination. s According to Professor Jiao shude and basing earlier worthiesmy teather Professor Yan xiaoping namede AS the "DALU",and binding decades ofclinical experiece,teather think that the pathogenesis of AS(DALU) mainly related isto the asthenia of kidney and Du meridian,wind,cold,wet and heat evils(especiallycold and wet evils)deeply intrude kidney and Du meridian,and divide AS(DALU)into six symptoms:kidney-asthenia and Du-cold,evils intrude extrarthron,evilsintrude liver and lung,evils luxuriate and turn into heat,kidney injuried by wetand heat evils,remissive and stable.My teather treating AS(DALU)mainly with strongkidney - Du Fa. This paper has a report for treatment of OP in AS with strong kidney-Du Fa,basing AS flaring up due to asthenia of kidey and Du meridian,determined the bonemineral density (BMD),biochemical markers of bone metabolism,and spinal movementof AS patients,in order to test curative effect,explore pathogenesis of OP in AS,definite the treatment of strong kidney-Du Fa.Our study show:the total frequencyof osteoporosis and osreopenia in AS patient was 42.27% and 37.11%. We found 25.77%and 28.87%osteoporosis in the lumbar and in the total proximal femur ,23.71% and29.90% osteopenia in the lumbar and in the total proximal femur.The frequency ofosteoporosis fracture in the lumbar was 3.09%.OP in AS is related with releasedbone formation and increased bone resorption. Increased levels of PTH and immuneinflammatory take a role in increasing bone resorption.Moreover,immobilizationcaused by joit pain,stiffness can not be neglected in the pathogenese of AS OP.For英文摘要 5this reason,OP could result from AS by multifactor include imbalances of hormones,immune inflammation,restricted movement and so on.Total proximal femur is the betterplace than lumbar to evaluate the OP in AS,especially in advanced AS.Bone mineraldensities of the five symptoms in TCM were all reduced at different levels.Amongthem kidney-asthenia and Du-cold's BMD reduced most strikingly.The reduced BMDmaybe represent "the asthenia of kidney and Du meridian".Treatment based on strongkidney-Du Fa could regulated the balance between bone formation and bone resporption,increased bone formation,could also decreased immune inflammation and PTH levelconsequently reduced the influence to bone resporption,and the treatment was alsobeneficial for bone formation through reducing joit pain and increasing spinemobility.Our data shows that treatment with strong kidney-Du Fa could significantlyincreasing both lumbar and total proximal BMD particularly in the total proximal.Weassume that Strong kidney-Du Fa treatment is effective to OP in AS.The incre... |
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