| Objective:1 Explore the distribution characteristics of TCM syndromes in osteoporosis;2 Study the differences between osteoporosis syndrome of spleen and kidney yang deficiency and non-spleen and kidney yang deficiency in 25-OH-VD,IPTH,TP,ALB,ALP,Ca,P,BUN,Cr,UA and blood lipid,etc.To provide objective basis for TCM syndrome differentiation of osteoporosis.Methods: Collecting information of 363 cases of osteoporosis patients from our geriatric outpatient department and orthopedic such as Gender,age,height,weight,BMI,medical history,bone density and other four biochemical indicators and patient diagnosis information with a questionnaire survey.According to the TCM syndrome differentiation criteria,the patients were differentiated into four syndrome types: spleen-kidney yang deficiency syndrome,liver-kidney yin deficiency syndrome,qi stagnation and blood stasis syndrome,and qi and blood deficiency syndrome,Explore the distribution characteristics of TCM syndromes in 363 patients;158 patients with serum 25-OH-VD and IPTH were divided into the spleen-kidney yang deficiency group and the non-spleen-kidney yang deficiency group,To study the differences of serum 25-OH-VD,IPTH levels and the correlation between25-OH-VD,IPTH and bone mineral density in two groups of patients;189 patients with other biochemical indicators were also divided into the spleen and kidney yang deficiency group and the non-spleen and kidney yang deficiency group,Study the differences in these biochemical indicators between the two groups of patients,and the correlation between these biochemical indicators and bone mineral density.Result:Study 1:1 The distribution characteristics of TCM syndrome types of osteoporosis are spleen-kidney yang deficiency syndrome(39.70%)> liver-kidney yin deficiency syndrome(32.25%)>qi stagnation and blood stasis syndrome(15.44%)> qi deficiency syndrome(12.61%),and spleen and kidney yang deficiency are the most.2 The differences in the overall bone mineral density values of the four syndrome types were statistically significant(P <0.001),and the bone mineral density values of the patients with liver-kidney-yin deficiency syndrome and qi stagnation and blood stasis syndrome were significantly higher than the spleen-kidney yang deficiency In the syndrome group,the difference was statistically significant(P <0.01);there was no statistically significant difference in the overall bone mineral density values of the femoral neck and hip(P> 0.05).The osteoporosis patients with spleen and kidney yang deficiency had lower overall bone mineral density in the lumbar spine.3 In all age groups,except for patients in the age group of <40 years,the overall density of femoral neck bones and hips in patients under the age of 70 years are higher than those in patients over the age of 70 years(P < 0.05),the femoral neck and hips of patients over 70 years old have lower bone mineral density values.Patients over 70 years of age have lower bone mineral density values in the femoral neck and hips as a whole.4 According to Pearson correlation analysis,there was a significant negative correlation between the patient’s age and the overall BMD of the femoral neck and hip.The correlation coefficients were-0.325,(P <0.001),-0.336,(P <0.001),and had no correlation with the overall lumbar BMD.Correlation(P> 0.05);there was a significant positive correlation between BMI and femoral neck,hip,and lumbar BMD,with correlation coefficients of 0.297,(P <0.001),0.290,(P <0.001),0.179,(P = 0.001).The older the age,the lower the BMD value,and the higher the BMI,the higher the BMD value.Study 2:1 The total bone mineral density value of the osteoporosis spleen and kidney yang deficiency group was lower than that of the osteoporosis non-spleen and kidney yang deficiency group,and the difference was statistically significant(P <0.05),but there was no statistically significant difference in the bone mineral density values of the entire hip and femoral neck(P> 0.05).The osteoporosis patients with spleen and kidney yang deficiency had lower overall bone mineral density in the lumbar spine.2 The serum 25-hydroxyvitamin D in osteoporosis group was lower than that in the non-spleen-kidney-yang deficiency group of osteoporosis,the difference was statistically significant(P <0.01),and the serum IPTH value of the two groups is different,there was no statistical significance(P> 0.05),),patients with spleen and kidney Yang deficiency syndrome have lower blood 25 hydroxyqing vitamin D levels.3 Spearman correlation analysis showed that there was a significant positive and weak correlation between serum 25-OH-VD value and lumbar vertebra bone density,with a correlation coefficient of 0.296,P <0.001,and a significant negative and weak correlation with parathyroid hormone.Correlation coefficient It is-0.266,P <0.001,and has no correlation with femoral neck BMD value and hip total BMD value(P> 0.01);serum parathyroid hormone level and lumbar spine total BMD value,femoral neck BMD value There was no correlation between the total BMD of the hip(P> 0.01).The higher the serum25-hydroxyvitamin D level,the lower the patient’s serum IPTH level and the higher the bone mineral density value.4 There is no difference in serum total protein,albumin,alkaline phosphatase,calcium,phosphorus,blood lipid,urea,creatinine,uric acid and other biochemical indicators between the osteoporosis spleen and kidney Yang deficiency syndrome group and the non-spleen and kidney Yang deficiency syndrome group.There was a statistical difference(P> 0.05).5 By Pearson correlation analysis,there was a significant positive correlation between serum TP,ALB,and femoral neck bone density,and hip overall bone density.Among them,the correlation coefficient between TP and femoral neck bone density was 0.300,P <0.001,ALB and The correlation coefficient of femoral neck bone density is 0.301,P <0.001,the correlation coefficient of TP and total hip bone density is 0.210,P <0.01,the correlation coefficient of ALB and total hip bone density is 0.221,P <0.01;serum TC,LDL-c had a negative correlation with the overall lumbar spine bone mineral density value.The correlation coefficient between TC and lumbar spine bone mineral density was-0.152,P <0.05,and the correlation coefficient between LDL-c and lumbar spine bone mineral density was-0.146,P<0.05.Adequate protein intake and normal blood lipid levels help maintain a higher level of bone density.Conclusion:1 The distribution of TCM syndrome types of osteoporosis is mainly spleen-kidney yang deficiency syndrome and liver-kidney yin deficiency syndrome.2 Osteoporosis patients with spleen-kidney yang deficiency syndrome had lower lumbarvertebrae overall bone density than patients with liver-kidney yin deficiency syndrome and qi stagnation blood stasis syndrome.3 In patients over 70 years of age,the overall bone mineral density of the femoral neck and hip decreased significantly,and more attention should be paid to the prevention and treatment of osteoporosis.4 The older the patients with osteoporosis,the lower the bone density,and a certain high BMI value may have a positive significance for the prevention of osteoporosis.5 Adequate intake of vitamin D and protein has a positive significance for preventing osteoporosis,and hyperlipidemia may promote the occurrence of osteoporosis.6 Vitamin D deficiency is common in patients with osteoporosis.7 Low vitamin D levels may be one of the objective evidences for syndrome differentiation of spleen,kidney and yang deficiency in osteoporosis. |
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