| Objective:To observe the effect of overall adjustment acupuncture on bone metabolism BALP and TRACP-5b in PMOP patients,and to explore its mechanism from the perspective of bone metabolism.Methods: 72 patients who met the PMOP diagnostic criteria were randomly divided into a control group of 36 cases and a treatment group of 36 cases.The control group was treated with alendronate sodium(70mg po qw),and the treatment group was treated with overall adjustment acupuncture on the basis of the control group,with acupuncture at the main points of "Dazhu,Zusanli,and Shenshu" combined with cupping,Seven-star needle tapping,treatment 2 times a week.The treatment course of the two groups was 3 months.After the treatment,the changes of BALP,TRACP-5b,E2,FSH,LH,VAS score,TCM syndrome score and BMD were observed.The data obtained was analyzed statistically using SPSS26.0 software.Results:(1)Baseline analysis: before treatment,the age(P=0.642),course of disease(P=0.641),body mass index(P=0.690),VAS score(P=0.567),TCM syndrome score(P=0.836),BMD(P=0.799),E2(P=0.637),FSH(P=0.694),LH(P=0.670),BALP(P=0.850),TRACP-5b(P=0.399),statistics Analysis showed that there was no significant difference(P>0.05),and it was comparable.(2)VAS score: The comparison within the group showed that the pain of the two groups of patients was improved to a certain extent after treatment.The VAS score(2.47±1.03)after treatment in the treatment group was significantly different from that before treatment(4.85±1.81)(t=12.362,P=0.000<0.05),the control group after treatment(3.95±2.03)compared with before treatment(4.60±1.75),there is a significant difference(t=2.709,P=0.010<0.05).The comparison between groups showed that the VAS score of the treatment group was significantly lower than that of the control group(t=-3.804,P=0.000<0.05).(3)TCM syndrome score: Comparison within the group shows that the TCM syndrome scores of the two groups after treatment are reduced to varying degrees.After treatment(4.39±1.66)compared with before treatment(8.15±2.41),there is Significant difference(t=-5.048,P=0.000<0.05),the control group after treatment(6.29±2.16)compared with before treatment(7.89±2.06),there is a significant difference(t=-5.030,P=0.000< 0.05);comparison between groups showed that the TCM syndrome score of the treatment group was significantly lower than that of the control group(t=-3.629,P=0.000<0.05).(4)Bone mineral density: Comparison within the two groups showed that the BMD of the two groups increased.After treatment(0.755±0.075)compared with before treatment(0.698±0.043),there was a significant difference(t=-4.466,P=0.000<0.05)),the control group after treatment(0.711±0.034)compared with before treatment(0.701±0.037),there was no statistical difference(t=-1.463,P=0.144>0.05).The comparison between groups showed that the BMD of the treatment group was significantly higher than that of the control group(t=-4.372,P=0.000<0.05).(5)Sex hormones: Comparison within the group showed that(1)E2: E2 levels increased in the two groups after treatment,and there was a statistical difference between the treatment group(58.74±3.39)and before treatment(50.89±3.45)(t=-16.928),P=0.000< 0.05),the control group after treatment(54.22±2.22)was significantly different from before treatment(50.53±2.83)(t=-13.130,P=0.000 < 0.05);(2)FSH: two groups after treatment The FSH level decreased.After treatment(75.13±10.48),there was a statistical difference between the treatment group(75.13±10.48)and the pretreatment FSH(91.64±3.62)(t=9.210,P=0.000<0.05),and the control group after treatment(82.21±6.14)Compared with before treatment(91.97±3.17),there was a statistical difference(t=11.299,P=0.000 < 0.05);(3)LH: LH levels decreased in the two groups after treatment,after treatment(40.71±9.85)and before treatment(55.77±2.88)compared with statistical difference(t=9.439,P=0.000<0.05),the control group after treatment(45.29±6.95)compared with before treatment(55.48±2.76)there was a statistical difference(t=9.789,P=0.000<0.05).The comparison between groups showed that the E2 level of the treatment group was significantly higher than that of the control group(t=6.462,P=0.000<0.05),and the FSH level of the treatment group was significantly lower than that of the control group(t=-3.374,P=0.001<0.05).The level of LH was also significantly lower than that of the control group(t=-2.227,P=0.029<0.05).(6)Bone metabolism: Comparison within the group showed that :(1)BALP:BALP decreased in both groups after treatment.After treatment(14.36±2.73)and before treatment(19.46±1.42),there was a significant difference in treatment group(t=13.091,P=0.000<0.05),the control group after treatment(16.32±2.22)was significantly different from before treatment(19.52±1.06)(t=10.223,P=0.000<0.05);(2)TRACP-5b: TRACP in the two groups after treatment-5b were all decreased,the treatment group after treatment(2.85±0.32)was significantly different from before treatment(3.41±0.19)(t=9.945,P=0.000<0.05),and the control group(3.07±0.27)after treatment was compared with that before treatment(3.41±0.19).Before treatment(3.45±0.18),there was a significant difference(t=9.538,P=0.000<0.05).The comparison between groups showed that the BALP level of the treatment group was significantly lower than that of the control group(t=-3.259,P=0.002 < 0.05);the TRACP-5b level of the treatment group was significantly lower than that of the control group(t=-3.044,P=0.003<0.05).(7)Comprehensive efficacy: After treatment,the total effective rate in the treatment group was 87.88%,and the total effective rate in the control group was 57.14%,the therapeutic effect of the treatment group was significantly better than that of the control group(z=2.385,P=0.017<0.05).(8)Safety observation: During the treatment of this study,the safety indicators of the two groups of patients such as ECG,liver function,and kidney function were normal,and there were no adverse reactions during the treatment.Conclusion: 1.The overall adjustment acupuncture method has a significant synergistic effect on PMOP.The overall adjustment acupuncture method combined with alendronate sodium is superior to PMOP patients in alleviating the pain of PMOP patients,improving the TCM syndrome score,and increasing the bone density of PMOP patients Just use alendronate sodium.2.The overall adjustment acupuncture method combined with alendronate sodium can reduce BALP,promote bone formation,reduce TRACP-5b,and inhibit bone resorption.At the same time,it can also increase the E2 level of PMOP patients and reduce the FSH and LH levels.3.The mechanism of the overall adjustment acupuncture on PMOP may be related to the regulation of the HPG axis.By improving the level of sex hormones in patients with PMOP,inhibiting the function of osteoclasts,accelerating the speed of bone formation,adjusting bone metabolism and restoring balance,so as to achieve the purpose of treating PMOP. |
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