Effect Of Bufei Yishen Huoxue Recipe On Bone Turnover Markers In Patients With Chronic Obstructive Pulmonary Disease

Purpose and significanceThe purpose of this project is to further confirm the clinical efficacy of Bufei Yishen Huoxue Prescription,and to verify its safety,to provide evidence for exploring TCM comprehensive treatment plan for patients with COPD and OP,it has positive significance in reducing the disability rate and improving the prognosis of this disease.Method60patients with COPD(GOLD level 2/3,comprehensive evaluation B/C group)were randomly divided into observation group and control group with 30 cases in each group.Patients of the control group was treated with COPD conventional Western medicine.On the basis,patients of the observation group was treated with Chinese medicine of Bufei Yishen Huoxue Prescription once daily,both groups were treated for 12 weeks.The score of TCM symptoms,levels of PINP and P-CTX,bone mineral density in both groups were under monitoring before and after treatment.The results will be statistically analyzed using statistical software SPSS22.0.Results(1)The baseline data of sex,age,course of COPD,percentage of forced expiratory volume in the first second of pulmonary function(FEV1%)between the observation group and the control group had no significant difference(P>0.05),which was comparable(2)After treatment,the total scores of TCM symptom scores in the observation group and the scores of wheezing,expectoration,chest tightness,weakness of waist and knees,and frequent night urination were significantly decreased(P<0.05).After treatment,the total score of observation group was significantly lower than that in the control group(P<0.05).After treatment,The scores of total scores and wheezing,chest tightness,fatigue,weakness of waist and knees were compared,the observation group was significantly better than the control group(P<0.05).It indicated that Bufei Yishen Huoxue Prescription can significantly improve the TCM symptom scores of patients with COPD,especially for the improvement of wheezing,sputum,chest tightness,fatigue,weak waist and knee,and frequent night urination.(3)After treatment,the P1NP of the observation group showed an upward trend,while the control group showed a downward trend,however,there was no significant difference with the two groups after treatment(P>0.05).The increase of P1NP in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the β-CTX showed a downward trend in the observation group,and the control group showed an upward trend,however,there was no statistically significant difference in △β-CTX neither between the two groups or within groups(P>0.05).It indicated that the effect of Bufei Yishen Huoxue Prescription on the increase of bone formation marker P1NP in COPD patients was significantly better than that of the control group,and showed a trend of lowering the bone resorption marker β-CTX.(4)After treatment,the bone mineral density of the observation group and the control group showed a slight decrease trend,there was no significant difference in mean BMD and the average BMD decrease(ABMD)between the two groups after treatment(P>0.05).Early monitoring of bone mineral density changes is of limited value in predicting anti-bone resorption drug therapy response.BMD meaningful changes need to be detected by DXA bone densitometer for at least half a year.The 12-week study did not reflect changes in bone density,it is necessary to extend the course of study for further observation.(5)Dry mouth occurred in 1 case in each group after treatment.One case of anorexia occurred in the observation group,and the symptoms improved after 1 week without intervention.After treatment,there were no abnormal blood routine,urine routine,liver function and kidney function in both groups.The results showed that the prescription was safe,without obvious toxic and side effects,and easy to accept by patients.Conclusion and significanceBufei Yishen Huoxue Prescription can effectively relieve the clinical symptoms of patients with COPD,restore the functional state of osteoblast,improve bone metabolism,and play a role in preventing the occurrence of osteoporosis in COPD.