Clinical Efficacy And Mechanism Research On The Treatment Of Postmenopausal Osteoporosis By Bushen Tongluo Decoction

Objective:To observe the effects of Bushentongluo recipe on indicators such as bone mineral density and bone metabolism and the regulatory effects on both Wnt/?-catenin and OPG/RANKL/RANK signaling pathways in patients with postmenopausal osteoporosis through clinical study,so as to explore the treatment effect and molecular mechanism of Bushentongluo recipe on osteoporosis.Methods:Sixty patients with postmenopausal osteoporosis who were treated in the outpatient department of Nantong Third People's Hospital from December 1,2016 to March 30,2017 were selected,and the patients were randomly divided into the alendronate sodium group and Bushentongluo recipe(BSTL)group,with 30 patients in each group.All patients took Caltrate D orally(600mg,1 tablet per day)at the same time,and the course of treatment was 3 months.During the observation,no other Chinese-western drugs for treatment of osteoporosis were used.The general data,lumbar vertebra 1-4 bone mineral density(L1-4 BMD),T value,serum Ca,serum P,alkaline phosphatase,osteocalcin,serum p-catenin,RANKL and OPG levels of all patients were measured and recorded before and after treatment.Results:in patients of the BSTL group after 3 months of treatment,the reexamination showed that the levels of L1-4 BMD and T value,serum Ca and P were significantly increased(P<0.05).The levels of alkaline phosphatase,osteocalcin,procollagen I N terminal peptide(PINP)and carboxyterminal cross-linked telopeptides of type ? collagen(CTX-1)were significantly decreased(P<0.05),while the levels of estradiol,calcium/creatinine(urine)were not significantly different from those before treatment(P>0.05).In patients of the control group(alendronate sodium group)after 3 months of treatment,the reexamination showed that both L1-4 BMD and T value were significantly increased(P<0.05),the levels of serum P and CTX-1 were significantly decreased(P<0.05);there were no significant differences in the levels of estradiol,serum Ca,alkaline phosphatase,osteocalcin,PINP and calcium/creatinine(urine)compared with those before treatment(P>0.05).After 3 months of treatment,the levels of L1-4 BMD and T value,serum Ca and serum P in the BSTL group were significantly increased(P<0.05)and the levels of alkaline phosphatase,osteocalcin and PINP were significantly decreased(P<0.05)compared with those in the alendronate sodium group.There were no significant differences in the levels of estradiol,calcium/creatinine(urine)and CTX-1 between the two groups(P>0.05).The levels of ?-catenin and OPG were significantly increased(P<0.05)and the levels of RANKL and RANKL/OPG were significantly decreased in patients of the BSTL group after 3 months of treatment.Conclusion:Bushentongluo Recipe has a significant effect on postmenopausal osteoporosis,and can increase the bone density,reduce the serum calcium and phosphorus losses and improve the bone metabolism,so as to achieve good results.Bushentongluo recipe can up-regulate the gene expressions of ?-catenin and OPG to promote the formation and differentiation of osteoblasts,inhibit the gene expression of RANKL,inhibit the activity of osteoclasts,and finally realize the balance of bone reconstruction.