| ObjectiveThis research mainly chooses patients with postmenopausal osteoporosis (PMOP) as research objects to observe the influence of high-frequency and low amplitude vibration on some index (Bone metabolic markers[BMMs], bone mineral density [BMD], body fat content as well as the rating of symptom questionnaire) The whole study is divided into three parts:1. To observe the early changes of BMMs affected by mechanical vibration therapy and to explore the detection value of its initial diagnosis and treatment by BMMs.2. To note the changes of bone mineral density and body fat content or other criterions brought by mechanical vibration so as to probe into the functional mechanism of altering bone mineral density and body fat content.3. To discuss the clinical value of the living quality of patients with postmenopausal osteoporosis under the treatment of mechanical vibration based on the rating of Chinese Osteoporosis-targeted Quality of Life questionnaire (COQOL) and to provide preliminary clinical basis for the treatment of mechanical vibration associated with drugs or sequential therapy.MethodsA clinical research will be conducted on 60 patients with postmenopausal osteoporosis (Aged 49-70) who conform to the standard and are randomly divided into Whole Body Vibratiom group (WBV) and Alendronate group (ALN) (both given based treatment at the same time). Serum biochemical index changes in bone metabolism of the two groups will be studied after 20 days and 3 months later respectively;bone mineral density, body fat content and life rating scale will be analyzed after a 6-month treatment.Results1. There is no significant difference between repeated measurement on the time of PINP as well as β-crosslaps and treatment interaction effect. While the time of PINP, β-crosslaps decreases as time increases, there is no remarkable variation in therapy effect. After the treatment, PINP of both groups shows a declining tendency, with WBV group decreasing more dramatically than its ALN counterpart after 20 days, but was outcompeted after 3 months. With regard to β-crosslaps, both two groups show a downward trend after the treatment, more remarkably in ALN group than in WBV group after 20-day treatment and then leveled off earlier, but figures in WBV group maintained steady downward trend.2. Analysis shows no significant difference between repeated measurement N-terminal osteocalcin (BGP), parathyroid hormone (PTH) interaction time and the therapy effect. There is no obvious difference in the time effect of both BGP and PTH, with BGP increasing as time grows; the therapy effect of both BGP and PTH are almost the same. The figure of BGP of the two groups are on the decline, with that of ALN group outnumbering that of WBV group after 20-day or 3-month treatment, but the latter basically maintain a steady downward tendency; in regard to the change of PTH after the treatment, the figure of WBV group fall after an increase both in 20 days and 3 months while figure of the other group appears a slight rising trend after a drop during the same period.3. There was no noticeable difference between repeated measurement of blood calcium and blood phosphorus time and treatment interaction effect. Blood calcium of both group are declining after the treatment of 20 days and 3 months, with that of WBV stronger than that of ALN. As for blood phosphorus change trend, both group reveal a trend of descending after ascending, with more obvious in WBV group.4. Striking difference can be seen between repeated measurement of blood magnesium time and treatment interaction effect. Comparing single effect, the means of both groups show notable difference with varying baseline; Under the ALN treatment, there are striking differences in the comparison of repeated measurements for 3 times. Under the WBV treatment, there are no significant differences. The blood magnesium time effect depicts marked difference while zero can be seen in the treatment effect. The figure of WBV experiences a growing trend after the treatment of 20 days and 3 months while there is a firs falling and then rising trend in that of ALN.5. There is no significant difference between repeated measurement blood ALP time and treatment interaction effect. The time effect of blood ALP in both groups reveal no difference but treatment effect shows great divergence. Observing the changes of blood ALP of two groups after the treatment:figures in WBV experience a trend of rise first then fall after 20-day and 3-month treatments while that of ALN depict a steady decline.6. After a 6-month treatment, indexes such as L1-L4, left femoral neck, upper left femur, Ward’s triangle, and left femoral big tuberosity BMD increase greatly compared with the situations before the treatment. There is a remarkable statistical sense in comparing the differences before and after the treatment:the highest changing rate can be seen in the Ward’s triangle BMD (8.37%); the indexes listed above in ALN group increase significantly compared with those before the treatment after 6 months, which also have great statistical sense; L1-4 BMD has the biggest changing rate (3.17%), and although the Ward’s triangle BMD increases, there is little statistical value in comparison of the treatment before and after. The left femur (neck, upper, big tuberosity), Ward’s triangle rate of WBV group are higher than those of ALN group after a 6-month treatment while the reverse is true in comparison of changing rate of lumbar BMD. The difference of BMD in two groups is not statistically significant.7. The body fat content (including the left femur and normal spine) of WBV group decreases after the treatment, and the comparison between treatment before and after has statistical sense; there is no obvious statistical value in the difference before and after the treatment in ALN group. The difference is of statistical significance in changes of body fat content, left femur fat content and fat content of normal spine of after a treatment of 6 months in both groups.8. The total score of pain symptoms, physical function, social adaptation in WBV group decreases significantly and the differences in improved living quality before and after the treatment is statistically significant; the rising score of mental functions show great statistical value. In comparison, there is a marked falling trend in the total score of pain symptoms, body function. It is of statistical value in the comparison of the improved living quality under the treatment, the comparison of rising score of physical function as well as the pain symptoms, physical function, social adaptation, and mental psychological function in WBV group after a 6-month treatment. However, there is no statistical value in the comparison of increasing score of social adaptability before and after the treatment. Conclusion1. Postmenopausal osteoporosis does not show high transformation of serum index. Both mechanical vibration and Allen phosphonic acid sodium can cause short-term changes in serum bone metabolic markers, and serum bone metabolic markers curative effect can be predicted based on changing trends and judge the risk of fractures;2. Mechanical vibration may save more bone reconstruction unit to maintain bone mass by reducing bone turnover; in order to improve the lumbar spine and femoral bone mineral content and bone mineral density, sequential or combination therapy with anti-OP drugs can be considered.3. Alendronate can obviously increase lumber vertebra density; mechanical vibration can increase femur and hip bone mineral density significantly and the Ward’s triangle can be used as a mechanical vibration treatment indications and outcome indicators;Mechanical vibration is especially suitable for postmenopausal osteoporosis treatment;.4. Mechanical vibration can reduce body fat content and improve musculoskeletal function, which embodies the traditional Chinese medical connotation of "Treatment for flaccidity aims at yangming meridian", "Of the same to flesh and blood ".which is of great therapeutic value especially for patients with obesity and dyslipidemia;5. Mechanical vibration can improve quality of life in patients with postmenopausal OP comprehensively, which can be used as the OP exercise rehabilitation training method;6. Mechanical vibration embodies the Chinese medicine treatment of "qi" (function), "blood " (bone metabolism) pathogenesis treatment principle.7. The nursing treatment and health education of osteoporosis patients should be strengthened and a comprehensive system of diagnosis and treatment should be constructed. |
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