| ObjectiveVia comprehensively analyzing the current research works of Chinese and Western medicine on chronic obstructive pulmonary disease (COPD) and osteoporosis, we design the experimental protocols for research of clinical investigation, and explore the correlation between the severity of nephrasthenia syndrome of patients who suffer from COPD and are in stable phase, and bone mineral density, providing the reference for clarifying the scientificalness of "kidney governing bones" theory in traditional Chinese medical science. Meanwhile, it also provides instructive significance for developing the character and superiority of traditional chinese medicine and using these Chinese medicine which help for kidney reinforcing for prevention and treatment of osteoporosis in clinical.MethodologyAccording to cases included and excluded criterion, we collect 118 patients, who go to department of respiration or outpatient clinic in First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine for stable stage of COPD and are discriminated to suffer from nephrasthenia syndrome from September 2015 to March 2016. There are 93 males and 25 females among the 118 patients. We record the general information for each patient, including the following. First, we bleed venous blood to analyze the contents of calcium, phosphorus, alkaline phosphatase in serum, respectively, and determine the lung function indices. Second, we utilize the Dual Energy X-ray Absorptiometry to detect the BMD and T values on the second, third and forth Lateral lumbar spine of each patient, and further count detection rate of osteopenia and osteoporosis of COPD in stable phase. According to "Operation standard for grade evaluation of kidney deficiency syndrome factor" published by Shi et al. [1], we score kidney deficiency symptom for each patient. We also explore the effect of age, gender, and degree of airflow limitation on bone mineral density, and utilize Pearson to investigate the correlation between score of nephrasthenia syndrome and bone mineral density of patients.ResultsThe research results show that the total detection rate of osteoporosis for patients with chronic obstructive is 25.4%, and that of males is 26.9% while that of females is 20.0%. The average age of patients is descending from the patients with COPD complicated (COPD) with osteoporosis, to those with COPD and low bone mass, and to those with COPD and normal bone mass. It is not statistically significant for body weights differences of patients with different changes of bone mass (P=0.644>0.05), and no correlation is found between body weight and bone mineral density (r=-0.047, P=0.613>0.05) and between body weight and score of nephrasthenia syndrome (r=-0.050, P=0.591>0.05). In contrast, it has strong correlation between bone mineral density and degree of airflow limitation (FEV1%pred) (r=0.376, P=0.000<0.01). Along with the increase of degree of airflow limitation, the bone mineral density shows trend of gradual decline. There is also no correlation between degree of airflow limitation and score of nephrasthenia syndrome (r=-1.01, P=0.278>0.05). As for the bone metabolism, the changes of calcium and phosphorus in serum among groups with different changes of bone mass are not satistically significant (P>0.05). The alkaline phosphatase of normal bone mass group is lower than that of decreased bone mass group, and that of decreased bone mass group is lower than that of osteopenia group (K0.05). It is not statistically significant of nephrasthenia syndrome score between normal bone mass and decreased bone mass groups, and between decreased bone mass and osteopenia group (P>0.05). But the nephrasthenia syndrome score of normal bone mass group is lower than that of osteopenia group (P<0.05). Bone mineral density T value is strongly correlated with nephrasthenia syndrome score (r=-0.254,P=0.005<0.01).ConclusionThe research results show that nephrasthenia syndrome of patients with COPD in stable phase has obvious correlation with bone mineral density. The osteoporosis is more serious of, the nephrasthenia syndrome score is higher. The detection rate of osteoporosis patients with COPD is much higher than common persons. Along with the increase of degree of airflow limitation, the bone mineral density gradually decline. It indicates we can should pay more attention to the degreed of osteoporosis for patients with COPD. We can conduct early intervention and "kidney reinforcing" treatment for those with serious osteoporosis. It can help to avoid the situation of cataclasis caused by osteoporosis, which may lead to progress of case and influence the quality of life. |
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