| ObjectiveTo explore the change of the TCM syndromes during the development of Osteoporosis, To study the correlation between four TCM syndromes and Cytokines/Hormones/BGP/BMD in Osteoporosis, To study the best classification of TCM syndromes, To filter the best indexs of judgement methods of TCM syndromes, To explore The correlation between inter-Cytokines/Hormones/BGP/ BMD.Methods85 Cases of postmenopausal women of Osteoporosis were collected and divided into four groups according the judgement of four TCM syndromes respectively. There are 21examples in Kidney yang-deficiency;21examples in Liver and kidney yin-deficency;20examples in Spleen and kidney yang-deficency and 23examples in Qi-blood stasis. each case have their blood sampled in the morning before breakfast, Examine Estradiol (E2)/Testosterone (T) /IL-6/IGF-1/TNF-α/OPG and BGP in serum. And detect their BMD by normotopia of L2-L4 by DXA. The data analysises use one-way ANOVA/Hierarchical Cluster/Discriminant/Factor/Regression.Result①From kidney yang-deficiency/Spleen and kidney yang-deficency/Liver and kidney yin-deficency to qi-blood stasis, Index E2/T/IGF-1/OPG/BMD is decline and IL-6/TNF-α/BGP is ascend.②There is statistically significant differences between kidney yang-deficiency/Spleen-kidney yang-deficency/Liver-kidney yin-deficency and qi-blood stasis in E2/IL-6/BGP/BMD, There is statistically significant differences between kidney yang-deficiency/liver and kidney yin-deficiency and qi-blood stasis in IGF-1/TNF-α, There is no statistically significant differences between kidney yang-deficiency/Spleen and kidney yang-deficency /Liver and kidney yin-deficency in eight index;Mean of 95% believable space of E2/IL-6/TNF-α/IGF-1/OPG/BPG/BMD in deficiency syndrome is (68.01-80.75 ) (pmol/L)/(27.23-42.35) (ng/dl)/(19.91-30.07) (ng/ml)/(35.39-46.55) (μg/L)/(115.39-146.09) (pg/ml)/(2.82-3.26) (ug/L)/ (0.590-0.618) (g/cm2) range; Mean of 95% believable space of E2/IL-6/TNF-α/IGF-1/OPG/BPG/BMD in qi-blood stasis is (32.93-54.16)(pmol/L ),(69.09-112.57) (ng/dl)/(35.47-65.80) (ng/ml)/(17.08-32.03) (μg/L)/(82.59-117.81) (pg/ml)/(3.75-4.86) (μg/L)/(0.425-0.466 ) (g/cm2) range.③Discriminant of four TCM syndromes, The precision rate of judgement of Kidney yang-deficiency is 57.1%, Spleen and kidney yang-deficency is 50% and Liver and kidney yin-deficency is 23.8%, qi-blood stasis is 95.7%, But in Discriminant of tow TCM syndromes, the precision rate of judgement of deficiency syndrome (Kidney yang-deficiency/Spleen and kidney yang-deficency/Liver and kidney yin-deficency) is 93.5%, Qi-blood stasis is 95.7%.④Cluster analysises show that E2/IL-6/TNF-α/BGP/BMD in every syndrome can cluster into two syndromes of deficiency syndrome and blood stasis, The other indexs can not.⑤Factor analysises points out that each of four TCM syndromes can be divided into three main factors by defferent indexs. kidney yang-deficiency s main factorl in E2/IL-6/IGF-1, main factor2 in TNF-α/BGP, main factor3 in T/OPG have larger loads; Spleen and kidney yang-deficency's main factorl in E2/IL-6/IGF-1/OPG, main factor2 in TNF-α/BGP, main factor3 in T/IGF-1 have larger loads; Liver and kidney yin-deficency's main factorl in E2/OPG/BGP , main factor2 in IL-6/TNF-α/IGF-1, main factor3 in T have larger loads; qi-blood stasis's main factorl in TNF-α/IGF-1/BGP, main factor2 in E2/OPG , main factor3 in T/IL-6 have larger loads.⑥Eight indicators cluster five kinds:The first kind is E2/OPG/IGF-1 that is to promote the osteoblast and inhibit osteoclast,The sencond kind is androgen (T), The third kind is cytokines IL-6/TNF-αthat is to promote osteoclast activity, The fourth kind is BGP that is produced by osteoblast and represent bone metabolism, The fifth is BMD that is reflect bone mineral content .Regression analysises show that The correlation between E2 and T/IGF-1/OPG is significant positive, The correlation between E2 and IL-6 is significant part negative, the correlation between E2 and TNF-α/BGP is significant negative, The correlation between T and IGF-1 is significant positive, T and BGP is significant negative, the correlation between IL-6 and TNF-α/BGP is significant part positive,the correlation between IL-6 and IGF-1/OPG is significant part negative, the correlation between TNF-αand IGF-1 is part negative, the correlation between TNF-a and BGP is significant part positive, the correlation between IGF-1 and OPG is significant part positive, the correlation between IGF-1 and BGP is part significant negative, the correlation between OPG and BGP is part significant negative, the correlation between BMD and E2/IGF-1 is part significant positive, the correlation between BMD and IL-6/TNF-α/BGP is part significant negative.Conclusion①With the Osteoprosis become more serious,The order of TCM syndrome is from kidney yang-deficiency to Spleen and kidney yang-deficency to Liver and kidney yin-deficency to qi-blood stasis.②In eight indexs, E2/IL-6/TNF-α/IGF-1/BPG can distinguish deficiency syndrome from qi-blood stasis,It can be thinked deficiency syndrome as E2 in 2 68.01-80.75 (pmol/L), IL-6 in 27.23-42.35 (ng/dl), TNF-αin 19.91-30.07 (ng/ml), IGF-1 in 35.39-46.55 (μg/L), OPG in 115.39-146.09 ( pg/ml), BPG in 2.82-3.26 (μg/L), BMD in 0.590-0.618 (g/cm2) range, It can be thinked qi-blood stasis as E2 in 32.93-54.16 (pmol/L), IL-6 in 69.09-112.57 (ng/dl), TNF-αin 35.47-65.80 (ng/ml), IGF-1 in 17.08-32.03 (μg/L), OPG in 82.59-117.81) (pg/ml), BPG in 3.75-4.86 (μg /L), BMD in 0.425-0.466 (g/cm2) range.③The best types of TCM syndromes in Osteoporosis is deficiency and qi-blood stasis, If the deficiency syndrome type Continually, It is easier to produce wrong result.④E2/IL-6/TNF-α/BGP is the best indexs to distinguish deficiency syndrome from qi-blood stasis.⑤Factor analysises make more methods of treatments of Osteoporosis. kidney yang-deficiency treatment have three kinds, The first kind aim at E2/IL-6/IGF-1, The second aim at TNF-α/BGP, The third aim at T/OPG; Spleen and kidney yang-deficency treatment have three kinds, The first kind aim at E2/IL-6/IGF-1/OPG, The second aim at TNF-α/BGP, The third aim at T/IGF-1; Liver and kidney yin-deficency treatment have three kinds, The first kind aim at E2/OPG/BGP, The second aim at IL-6/TNF-α/IGF-1, The third aim at T; Qi-blood stasis treatment have three kinds, The first kind aim at TNF-α/IGF-1/BGP, The second aim at E2/OPG, The third aim at T/IL-6.⑥Eight indexs cluster four kinds:The first kind is E2/OPG/IGF-1 that is to promote the osteoblast and inhibit osteoclast, The sencond kind is androgen (T), The third kind is cytokines IL-6/TNF-αthat is to promote osteoclast activity, The fourth kind is BGP that is produced by osteoblast and represent bone metabolism. Regression analysises show that The correlation between E2 and T/IGF-1/OPG is significant positive, The correlation between E2 and IL-6 is significant part negative, the correlation between E2 and TNF-α/BGP is significant negative, The correlation between T and IGF-1 is significant positive,T and BGP is significant negative, the correlation between IL-6 and TNF-α/BGP is part significant positive, the correlation between IL-6 and IGF-1/OPG is part significant negative, the correlation between TNF-αand IGF-1 is part significant negative, the correlation between TNF-αand BGP is part significant positive, the correlation between IGF-1 and OPG is part significant positive, the correlation between IGF-1 and BGP is part significant negative, the correlation between OPG and BGP is part significant negative. the correlation between BMD and E2/IGF-1 is part significant positive, the correlation between BMD and IL-6/TNF-α/BGP is part significant negative. |
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