Ankylosing Spondylitis Patients With Osteoporosis And Tcm Syndrome Type Of Relationship Research

Ankylosing spondylitis (AS)is a chronic inflammatory rheumatic disease characteried by a predominantly axial skeleton.With a series of changs in bone metabolism ,Osteoporosis (OP)is a common complication in AS,and could lead to the increase in spinal fracture risk.The pathogenesis is unknown of which AS lead to OP,and there are many controversies in bone transform types,immune inflammation,restricted movement,and otherwise.Therefore,it is a significative task that determine the pathogenesis of OP in AS ,investigate the bone mass and bone metabolism ,so that provide the foundation for preventing and treating OP in AS.In Traditional Chinese Medicine(TCM),basing on the pathogeny and manifestation in AS,a lot of physicions think that AS is belonged to "Gubi"and "Wangbi"etc,and the identifying classifications in AS is complexed.Professor Jiao shude and professor Yan xiaoping consider that AS attributs to the "DALU".According to professor Jiao and binding decades of clinical experiece ,my teather divides it into six symptoms；kidney-asthenia and Du-cold,evils intrude extrathron,evils intrude liver and lung,evils luxurite and turn into heat,kidney injuried by wet and heat evils,remissive and stable.This paper determined the bone mineral density (BMD),biochemical markers of bone metabolism ,and spinal movement in patients with AS,in order to explore the relationship between OP in AS and identifying classifications in TCM.The results show:the total prevalance ratio of oseteoporosis and low bone mass in patiens with AS are 41.79%,35.82%, respectively;the one at lumbar and femoral neck are 26.87%,11.94%,32.84%,29.85%,respectively；the ratio in lumbar fracture risk is 1.49%.The inflammatory reaction results in the bone mass lose which is characteried by reduced bone formation at least.It could be presumed that bone formation in patiens with AS maybe low and bone resporption maybe high,moreover,the alteration of balance between bone formation and resporption may lead to the rapid lose in spine bone mass,and may be accompanied by the severity obstacle on spinal function.So OP could result from AS by multifactor include immune inflammation,restricted movement and so on.Dual Energy X-ray Absorption (DEXA) is able to evaluate the bone mineral density in early AS patients,and in severity AS at hipbone.Among five symptoms in TCM, kidney-asthenia and Du-cold is the most common; evils luxurite and turn into heat,kidney injuried by wet and heat evils, evils intrude extrathronare fewer than the forenamed symptom;evils intrude liver and lung is the most seldem.The low bone mass maybe represent "kidney-Du asthenia",and ESR/CRP "evils intrusion".BMD at lumbar in "kidney-asthenia and Du-cold"and "evils luxurite and turn into heat",BMD at lumbar in "kidney-asthenia and Du-cold"and "evils luxurite and turn into heat"and "kidney injuried by wet and heat evils",BMD at thighbone neck and Ward′s in "evils intrude liver and lung" are reduce statistically,respectively.Compared with control cohorts,BMD in "evils intrude extrathron"is not reduce statistically.The asthenia of kidney-Du in "kidney-asthenia and Du-cold"and "evils luxurite and turn into heat"and "kidney injuried by wet and heat evils"is severity,both the "evils intrusion".meanwhile, The asthenia of kidney-Du in "evils intrude extrathron"and "evils intrude liver and lung"are severity,but the "evils intrusion"not. In"kidney-asthenia and Du-cold"and "evils luxurite and turn into heat"and "kidney injuried by wet and heat evils",we could take the therapy which complementing kidney-Du and remove evils(cold,heat,wet and heat)are equally important,whereas in "evils intrude extrathron"and "evils intrude liver and lung",we should emphasize complementing kidney-Du.