| Ankylosing Spondylitis(AS) is a chronic inflammatory rheumatic disease which mainly impinge on sacroiliac joint and vertebral column, the peripheral arthritis is also be involved. Osteoporosis (OP) is a common complication in AS,even in the early stages.OP can lean to spine' s deformities, osteoporotic fractures, and affects prognosis of disease. The pathogenesis of OP in AS remains unclear. It might be due to imbalancing of hormones restricted movement,and so on. However ,the etiology of that still remains controversial,and the treatment of OP in AS has not received much attention .Therefore, it is a significative task that determine the pathogenes of OP in AS, investigate the bone mass and bone metabolism, treating AS OP so that decrease the harm of complication and improve prognosis of disease.In Tradtional Chinese Medicine (TCM), basing on the pathogeny and manifestation of AS,a lot of physicians think that AS is belonged to "Gubi' "Wangbi' "Wanbi"ect, and most of them think that the pathogenesis of AS is related to asthenis of kidney and Du meridian, evils intrusion infirmity of inside and evils of outside's combination. According to Professor Jiao shude and basing earlier worthies my teather Professor Yan xiaoping named AS the "DALU", and binding decades of clinical experiece,teather think that the pathogenesis of AS (DALU) is mainly related to the asthenia of kidney and Du meridian ,wind cold wet and heat evils (especially cold and wet evils) deeply intrude kidney and Du meridian , and divide AS (DALU) into six symptoms: kidney-asthenia and Du-cold, evils intrude extrarthron,evils intrude liver and lung, evils luxuriate and turn into heat, kidney injuried by wet and haet evils, remissive and stable. My treater treating AS (DALU) mainly with strong kindey - 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 kidney and Du meridian ,determined the bone mineral density (BMD), biochemical markers of bone metabolism, and spinal movement of AS patients, in order to test curative effect, explore pathogenesis of OP in AS , definite the treatment of strong kindey -Du Fa . Our study show : the total frequency of osteooporosis and osteoporosis and osreopenia in AS patient was 15.87% and 45.50%. We found 33.33% and 3.33% osteoporosis in the total proximal,23.71% and 29.90% osteopnia in the lumbar and in the total proximal femur. OP in AS is related with released bone formation and increased bone resorption . Increased levels of PTH and immune inflammatory take a role in increasing bone resorption . Moreover , immobilization caused by joit pain, stiffnesscan not be neglected in the pathogenese of AS OP. For this reason ,OP could result from AS by multifactor include imbalances of hormones ,immune inflammation , restricted movement and so on . Total proximal femur is the better ulace than lumbar to evaluate the OP in AS,especially in advanced AS . Bone mineral densities of the five symptoms in TCM were all reduced at different levels. Among them kidney-asthenia and Du-cold' s BMD reduced most strikingly. The reduced BMD maybe represent "the asthebia of kindey and Du meridian". Treament based on strong kidney-Du Fa could regulated the balance between bone formation and bone resporption, increased bone formation, could also decreased immune inflammation and PTH level consequently reduced the influence to bone resporption, and the treatment was also beneficial for bone formation through reducing joit pain and increasing spine mobility. Our data shows that treatment with strong kidney-Du Fa could significantly increasing both lumbar and total proximal BMD particularly in the total proximal. We assume that Strong kidney-Du Fa treatment is effective to OP in AS .The increasing of BMDin AS patient reflect the decreasing of asthenia of kidney and Du meridian. |
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