Study On The Correlation Between TCM Syndrome Type And Bone Metabolism Index Of Senile Primary Osteoporosis

ObjectiveBy collecting the biochemical indexes of bone metabolism,bone mineral density and TCM syndrome types of elderly patients with primary osteoporosis,the correlation between biochemical indexes of bone metabolism and TCM syndrome types of senile POP was analyzed.MethodFrom January 2021 to December 2021,207patients with senile POP were diagnosed in the Department of Orthopaedics,Xiamen Hospital of traditional Chinese Medicine affiliated to Fujian University of traditional Chinese Medicine.All the patients were examined by serum bone metabolism index and bone mineral density imaging examination,and the subjects were investigated on the spot with self-made questionnaire.The information of the four TCM diagnoses of the patients was collected and TCM syndrome differentiation was carried out.The correlation between TCM syndrome type and bone metabolism index in elderly patients with primary osteoporosis was compared by statistical method.Results1.A total of 207 cases were collected,including 62 cases of yin deficiency of liver and kidney,59 cases of yang deficiency of spleen and kidney,43 cases of deficiency of kidney yang and 43cases of blood stasis and qi stagnation.2.There was no significant difference in sex and age among the four syndrome types.The average age was 70.93±7.73years old,and the ratio of male to female was 1:13.3.The results of Kruskal-Wallis H test showed that there was no significant difference in the distribution of Bone mineral density（BMD）and parathyroid hormone（PTH）among different TCM syndrome types.There were significant differences in the distribution of N-terminal osteocalcin（N-MID）,25-hydroxyvitamin D（25-（OH）D₃）,β-collagen special series（β-Crosslaps）and total type I collagen N-terminal extension peptide（Total-PINP）in different TCM syndrome types.4.The results of Logistic regression analysis showed that PTH,N-MID,25-（OH）D₃,β-Crosslaps and Total-PINP all had different effects on TCM syndrome types.5.The results of Spearman rank correlation analysis showed that there was a negative correlation between PTH and TCM syndrome type,but there was no significant correlation between N-MID,25-（OH）D3,β-Crosslaps,Total-PINP and TCM syndrome type.Conclusions1.Among the four syndrome types of liver and kidney yin deficiency,spleen and kidney yang deficiency,kidney yang deficiency and blood stasis and qi stagnation,the incidence of liver and kidney yin deficiency is the highest,followed by spleen and kidney yang deficiency.2.There was no significant difference in the distribution of age,BMD and PTH in elderly patients with POP,but there was no significant difference in the distribution of N-MID,25-（OH）D3,β-Crosslaps and Total-PINP in elderly patients with POP.3.The syndrome of yin deficiency of liver and kidney and blood stasis and qi stagnation syndrome had a higher rate of bone transformation,while the osteogenic ability of blood stasis and qi stagnation syndrome increased;the activity of osteoblasts and osteoclasts decreased in spleen and kidney yang deficiency syndrome and kidney yang deficiency syndrome;vitamin D deficiency was easy to occur in patients with spleen and kidney yang deficiency syndrome.There is a negative correlation between4.PTH and TCM syndrome type.PTH,N-MID,25-（OH）D3,β-Crosslaps and Total-PINP all have different effects on TCM syndrome type.According to the results of this investigation,it can be concluded that there is a correlation between the biochemical indexes of bone metabolism and TCM syndrome types,and the biochemical indexes of bone metabolism play an auxiliary role in the determination and identification of TCM syndrome types of elderly POP.