補腎健脾活血中藥治療骨質疏鬆症的臨床研究

Clinical Research of the Treatment of Osteoporosis with Herbs that Supplement the Kidney, Fortify the Spleen and Vitalize Blood

林文彬(Wen-Bing Lin)

《中國中醫臨床醫學雜誌》 10卷4期 (2004/12) Pp. 272-282

https://doi.org/10.6968/TJCCTM.200412.0272

摘要

為了探討骨質疏鬆症的有效治療機制，通過中醫文獻綜合分析，採用補腎健脾活血為治療骨質疏鬆症的法則並根據此法則，選用中藥，對絕經後骨質疏鬆症婦女進行研究，以證實此法則的合理性與實用性。方法：臨床研究對門診就診的絕經後骨質疏鬆症婦女61病例，採用單盲隨機對照法，分為2組，即骨康治療組36例及鈣劑對照組25例，所選病人在治療前半年內均未使用治療骨質疏鬆症及影響骨代謝的藥物。經單光子骨密度儀測定治療前後橈尺骨骨密度及骨礦含量，腎虛症狀積分的前後對比，從而瞭解補腎健脾活血法的代表方骨康復方的治療效果，並與陽性照對組進行相關性分析。並分別於治療前及治療6個月後採取受試者禁食12小時後早晨空腹血和清晨空腹尿，檢測E2、IL-6和BGP等，比較治療前後2組差異。結論：補腎健脾活血中藥方（淫羊蕾、熟地、肉徒蓉、菟絲子、補骨脂、等），經過臨床觀察及動物試驗，證明其能提高骨礦含量，改善骨生物力學，降低骨轉化率，對骨骼有雙向作用。改善患者的腎虛症狀，減輕骨質疏鬆症引起的疼痛，提高骨礦含量及骨密度。本方對由於骨質疏鬆引起的腰背疼痛、肌肉痛有明顯的療效。

關鍵字

補腎 ； 健脾 ； 活血 ； 骨質疏鬆症臨床研究

並列摘要

Objective: To investigate the effect mechanisms in treatment of osteoporosis.
After analyzing various Chinese medical literatures, the principles of supplementing the kidneys, fortifying the spleen and vitalizing blood were chosen as the principles by which to treat osteoporosis. In order to ascertain the validity and clinical significance of these principles an herbal formula called Gukang, based on these methods, was used to treat women suffering from postmenopausal osteoporosis (PMOP).
Method: 61 women with outpatient PMOP were selected and divided into two groups according to single blind randomized control method, 36 cases in the Gukang group and 25 cases in a control group given calcium supplement. None of the subjects had received any medications that treat or affect osteoporosis 6 months prior to the study.
The efficacy of treatment was evaluated by analyzing and comparing the bone mineral content (BMC) and bone mineral density (BMD) of the radius and ulna bones of the two groups, as well as kidney vacuity symptoms scores prior to and after treatment. The levels of E2, IL-6 and BGP were also measured six months prior to and after treatment using fasting blood and urine samples.
Conclusion: The formula Gukang supplements the kidneys, fortifies the spleen and vitalizes blood. It is comprised of yin yang huo (Epimedii Herba), shu di huang (Rehmannia Radix Conquita), rou cong rong (Cistanche Caulis), tu si Zi (Cuscutae Semen), bu gu zhi (Psoraleae Semen), da zao (Ziziphi Fructus), dang gui (Angelica Sinensis Radix), dan shen (Salvia Miltiorrhizae Radix), huang qi (Astragali Radix), and bai shao (Peoniae Radix Alba). Through clinical observation and controlled experiments Gukang has been proven to have a twofold effect on bone growth. Gukang can increase BMC and BMD while reducing bone turnover, thus strengthening bones. Gukang also improves kidney vacuity symptoms and relieves pain caused by osteoporosis, including lumbar pain, back pain as well as muscular pain.
In Gukang bu gu zhi acts as sovereign to supplement the kidney and strengthen bone. Yin yang huo, shu di huang, rou cong rong, tu si Z1 and bai shao act as ministers by supplementing the kidney nourishing yin and enriching essence. Huang qi acts as assistant to help reinforce the middle burner and replenish qi, while dang gui and dan shen also act as assistants by vitalizing the blood and freeing the channels. Da zao acts to harmonize the spleen and stomach.
Based on the summation of evidence from clinical observation and experimental study the treatment of osteoporosis with Chinese medicine should follow the principles of supplementing the kidneys and strengthening bone while fortifying the spleen, vitalizing blood and freeing the channels. In ancient times physicians emphasized treating kidney vacuity but overlooked supplementation of the spleen, vitalizing blood and transforming stasis as important factors of therapy.

並列關鍵字

supplementing kidney ； fortifying spleen ； vitalizing blood ； clinical research of osteoporosis