The Preliminary Clinical Observation Of Xianlinggubao Capsule Combined With Gold Caltrate In The Prevention Of Osteoporosis Secondary To Rheumatoid Arthritis

ObjectiveTo preliminarily discuss the effects and possible mechanisms of Xianlinggubao Capsule combined with Gold Caltrate in the prevention of osteoporosis(OP) secondary to rheumatoid arthritis(RA). Methods64 patients with RA who accepted the diagnosis and treatment in our hospital were randomly divided into control group and observation group, 32 cases in each group. There were 13 males and 19 females in control group, mean age(50.8 ± 6.9) years, mean disease duration(68.8 ± 13.5) months; there were 11 males and 21 females in observation group, mean age(51.1 ± 6.8) years, mean disease duration(67.4 ± 15.2) months. The general conditions of the two groups were comparable(P>0.05). On the basis of conventional RA treatment, patients in the control group orally took gold Caltrate and patients in the observation group orally took Gold Caltrate and Xianlinggubao Capsules.The observation courses in the two groups were both 3 months. The duration of morning stiffness, joint swelling index, joint tenderness index, joint function index, platelet count(PLT), erythrocyte sedimentation rate(ESR), rheumatoid factor(RF), C reactive protein(CRP), anti-cyclic citrullinated peptide(anti-CCP), calcium, phosphorus, alkaline phosphatase(ALP), osteocalcin(OC), procollagen type I amino-terminal propeptide(PINP). tartrate-resistant acid phosphatase-5b(TRACP-5b), C-terminal telopeptides of type I collagen(CTX), osteoprotegerin(OPG), receptor activator of nuclear factor-κB ligand(RANKL) and the bone densities of umbar spine, femoral neck, Ward triangle and trochanter in the two groups were recorded before observation and after observation. Results1 There was no significant difference between the duration of morning stiffness, joint tenderness index, joint swelling index and joint function index of two groups before drug intervention(P>0.05); the duration of morning stiffness obviously shorted, the joint tenderness index, joint swelling index and joint function index obviously decreased in the two groups after drug intervention(P<0.05); the duration of morning stiffness in the observation group was obviously shorter than it in the control group(P<0.05), and the joint tenderness index, joint swelling index and joint function index were all lower than these in the control group after drug intervention.2 There was no significant difference between the PLT, ESR, RF, CRP, anti-CCP, calcium and phosphorus of two groups before drug intervention(P>0.05); the PLT, ESR, RF, CRP, anti-CCP obviously decreased(P<0.05), calcium and phosphorus increased in the two groups after drug intervention; the PLT, ESR, RF, CRP, anti-CCP in the observation group were lower than these in the control group, and the calcium and phosphorus were higher than these in the control group after drug intervention.3 There was no significant difference between the ALP, OC, PINP, TRACP-5b and CTX of two groups before drug intervention(P>0.05); the ALP, TRACP-5b, CTX decreased, OC and PINP increased in the two groups after drug intervention; the ALP, TRACP-5b, CTX in the observation group were lower than these in the control group, and OC and PINP were higher than these in the control group after drug intervention.4 There was no significant difference between the OPG and RANKL levels of two groups before drug intervention(P>0.05); the OPG increased, RANKL decreased in the two groups after drug intervention; the OPG in the observation group was obviously higher than it in the control group, and RANKL was obviously lower than it in the control group after drug intervention(P<0.05).5 There was no significant difference between the bone densities of umbar spine, femoral neck, Ward triangle and trochanter of two groups before drug intervention(P>0.05); the bone densities obviously decreased in the control group(P<0.05), the bone densities were without obvious change in the observation group, and the bone densities were obviously higher than these in the control group after drug intervention(P<0.05). ConclusionOn the basis of Gold Caltrate, the joint application of Xianlinggubao Capsule can effectively alleviate RA condition, improve the clinical symptoms, bone metabolism, inhibit the decrease of bone density, prevent the development of OP secondary to RA, which may be related to it regulating OPG and RANKL levels.