Regulatory Effect of Guilu Bugu Prescription in Treating Th17/ Treg Cell Factors of Patients with Postmenopausal Osteoporosis Based on Syndrome Differentiation

Jin-yong LIU; He-ming WANG; Jian LIN; Xiu-ming CHEN; Yue-long FANG; Xiao-wen LIAN; Shu-he CAI

doi:10.13422/j.cnki.syfjx.20200933

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Regulatory Effect of Guilu Bugu Prescription in Treating Th17/ Treg Cell Factors of Patients with Postmenopausal Osteoporosis Based on Syndrome Differentiation

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- Regulatory Effect of Guilu Bugu Prescription in Treating Th17/ Treg Cell Factors of Patients with Postmenopausal Osteoporosis Based on Syndrome Differentiation
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 24, Pages: 116-121(2020)
- 作者机构：
  
  1.福建中医药大学附属康复医院，福州 350003
  2.福建省康复技术重点实验室，福州 350003
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20200933
  CLC： R289;R271;R271.9
- Received：04 June 2020，
  
  Published Online：18 June 2020，
  
  Published：20 December 2020
- 稿件说明：
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刘金勇,王和鸣,林坚等.龟鹿补骨方辨治绝经后骨质疏松症患者Th17/ Treg细胞因子的调节作用[J].中国实验方剂学杂志,2020,26(24):116-121.

LIU Jin-yong,WANG He-ming,LIN Jian,et al.Regulatory Effect of Guilu Bugu Prescription in Treating Th17/ Treg Cell Factors of Patients with Postmenopausal Osteoporosis Based on Syndrome Differentiation[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(24):116-121.
刘金勇,王和鸣,林坚等.龟鹿补骨方辨治绝经后骨质疏松症患者Th17/ Treg细胞因子的调节作用[J].中国实验方剂学杂志,2020,26(24):116-121. DOI： 10.13422/j.cnki.syfjx.20200933.

LIU Jin-yong,WANG He-ming,LIN Jian,et al.Regulatory Effect of Guilu Bugu Prescription in Treating Th17/ Treg Cell Factors of Patients with Postmenopausal Osteoporosis Based on Syndrome Differentiation[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(24):116-121. DOI： 10.13422/j.cnki.syfjx.20200933.

摘要

目的

观察龟鹿补骨方辨治绝经后骨质疏松症（PMO）肝肾阴虚证的临床疗效，及对Th17/Treg细胞因子的影响。

方法

将140例患者按随机数字表法分为对照组和观察组各70例。两组均给予西医治疗。对照组口服金天格胶囊，3粒/次，3次/d；观察组采用龟鹿补骨方辨证治疗，1剂/d；连续治疗6个月，并随访6个月。治疗前、治疗6个月和随访6个月采用双能X射线吸收检测法（DXA）测量腰椎L

2-4

骨密度和采用定量CT（QCT）测量腰椎骨密度；治疗前、治疗3个月和6个月进行肝肾阴虚证和中国人骨质疏松症生存质量简明量表（COQOL）评分；检测治疗前后雌二醇（E

），Ⅰ型原胶原氨基端前肽（PINP），骨保护素（OPG），Ⅰ型胶原交联 C 末端肽（S-CTX），抗酒石酸酸性磷酸酶（TRACP）水平；检测治疗前后CD4

细胞，计算Th17 细胞和Treg 细胞；检测治疗前后白细胞介素-17（IL-17），IL-22，IL-10和转化生长因子-

（TGF-

）水平；进行安全性评价。

结果

治疗6个月和随访6个月，两组DXA测量结果（腰椎L

2-4

骨密度和T-值）和QCT骨密度均持续升高（

0.01），且观察组腰椎L

2-4

骨密度，T-值和QCT骨密度均高于同期对照组（

0.01）；治疗3和6个月，观察组肝肾阴虚证积分和生活质量评分均低于同期对照组（

0.01）；观察组PINP，S-CTX和TRACP均低于对照组（

0.01），OPG，E

水平均高于对照组（

0.01）；观察组Th17细胞和Th17/Treg均低于对照组，Treg细胞高于对照组（

0.01）；观察组IL-17，IL-22水平均低于对照组（

0.01），IL-10和TGF-

水平均高于对照组（

0.01）。未发现龟鹿补骨方相关不良反应。

结论

在补充钙剂、维生素D等治疗基础上，龟鹿补骨方治疗PMO肝肾阴虚证患者，能进一步提高骨密度，升高雌激素水平，调节骨代谢标志物，Th17，Treg及相关因子的表达，逆转Th17/Treg失衡状况，减轻了临床症状，提高了生活质量，临床疗效优于金天格胶囊，且安全。

Abstract

Objective

To observe the clinical efficacy Guilu Bugu prescription in treating postmenopausal osteoporosis （PMO） with deficiency of liver and kidney Yin based on syndrome differentiation and the effect on Th17/Treg cell factors.

Method

One hundred and forty patients were randomly divided into observation group （70 cases） and control group （70 cases） by random number table. Both groups' patients got basic treatment of western medicine. Patients in control group got Jintiange capsules， 3 grains/time， 3 times/day. Patients in observation group got Guilu Bugu prescription， 1 dose/day. The treatment lasted for 6 months. And the 6-month follow-up was recorded. Before treatment， at the 6

month after treatment and at the 6

month of follow-up， bone density of lumbar vertebra L

2-4

were detected by DXA， and Lumbar BMD were detected by QCT. Before treatment， at the 3

and 6

month after treatment， deficiency of liver and kidney Yin and Chinese Osteoporosis-targeted quality of life questionnaire （COQOL） were scored. Before and after treatment， Estradiol （E

）， procollagen I amino terminal pro peptide （PINP）， osteoprotegerin （OPG）， collagen I cross linked C-terminal peptide （S-CTX）， tartrate resistant acid phosphatase （TRACP）， interleukin-17 （IL-17）， IL-22， IL-10， transforming growth factor-

（TGF-

） were detected， and CD4

cells， Th17 cells and Treg cells were calculated. And the safety was evaluated.

Result

At the 6

month after treatment and the 6

month of follow-up， DXA （bone mineral density and T-value of lumbar L

2-4

） and QCT bone mineral density increased （

0.01）， and the figures in observation group were all higher than those in control group （

0.01）. At the 3

and 6

month after treatment， scores of deficiency of liver and kidney Yin and quality of life were all lower than those in control group （

0.01）. Levels of PINP， S-CTX， TRACP， Th17 cells， ratio of Th17 and Treg， IL-17 and IL-22 were all lower than those in control group （

0.01）， and levels of OPG， E

， Treg， IL-10 and TGF-

were all higher than those in control group （

0.01）.There was no adverse reaction related to Guilu Bugu prescription.

Conclusion

Based on the supplementation of calcium and vitamin D， Guilu Bugu prescription can further improve the bone mineral density， raise the estrogen level， regulate the expressions of bone metabolism markers， Th17， Treg and relevant factors， reverse the imbalance of Th17/Treg， relieve the clinical symptoms and improve the quality of life， with a better efficacy than that of Jintange capsule and a high safety.

关键词

Keywords

references

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