Study On The Mechanism Of Preventing And Treating PMOP With Zuogui Pill Based On Theory Of Supplement The Kidney And Tiangui

Objective:To explore the basic connotation of the theory of Tiangui in Chinese medicine,analyze the theoretical basis of treatment of postmenopausal osteoporosis with Bushen Yigui and observe the effects of Zuogui Pill on bone mineral density,bone metabolism and related protein expression in postmenopausal osteoporosis model rats.The mechanism of influence and pharmacodynamics provides theoretical and experimental evidence for the clinical application of Zuogui Pill for postmenopausal osteoporosis.Methods:Systematic combing of the records of "Tiangui" in the ancient and modern medical literature,exploring the origin of Tiangui theory and its material properties and functional characteristics,analyzing the significance of Shen deficiency depletion and Tiangui depletion in the pathogenesis of PMOP,exploring the treatment of PMOP in traditional Chinese medicine,explaining the Zuogui Pill prevent and treat PMOP in the theoretical basis of traditional Chinese medicine.Forty-six Sprague-Dawley rats aged six months were selected and randomly divided into model group(40)and sham group(6).The model group was treated with ovariectomy,and the sham group only removed the same amount of adipose tissue around the ovary.One month later,the rats in the model group were randomly divided into five groups(model group,Zuogui Pills high,middle and low dose groups,positive control group).The Zuogui Pill low-,medium-,and high-dose groups were given once daily oral gavage powder suspensions 2.3 g/kg/d,4.6 g/kg/d,and 6.9 g/kg/d,and the positive control group was given 17?-estradiol was intragastrically administered once a day at 25 ?g/kg/day,and the model group and sham operation group were given intragastric administration once a day.Three months later,rats in each group were anesthetized with intraperitoneal injection of pentobarbital and were sacrificed after abdominal aorta blood was collected.Serum samples were collected to detect the bone turnover marker(N-terminal propeptide of type I procollagen,PINP),type I collagen carboxy terminal peptide beta specific sequence(beta-C-terminal telopeptide of type I collagen,?-CTX),osteocalcin(osteocalcin,OCN),take the femur bone density test,take the tibial cancellous bone.The changes of osteoprotegerin(OPG)and receptor activator for nuclear factor-?B ligand(RANKL)proteins were detected.Result:The theory of Tiangui originated from Huangdi Neijing,and the successive generations of doctors continued to supplement it.Tiangui is a special substance that is metabolized by kidney essence and plays an important role in promoting reproductive function and strong bones.Kidney essence deficiency,Tiangui dried up,and bone loss are the basic pathogenesis of PMOP.Zuogui Pill is a representative formula for the prevention and treatment of PMOP with BuShen Yigui.The close correlation between Tiangui and bone in physiology and pathology deserves to be studied.Experimental studies showed that:(1)Bone mineral density:Zuogui Pills High-dose group and estradiol group were significantly higher than the model group(P<0.05).(2)Serum bone metabolism:PINP and OCN in Zuogui Pills and estradiol groups were significantly lower than those in the model group(P<0.05),and ?-CTX in Zuogui Pills high-dose group and estradiol group also It is significantly lower than the model group.(3)Expression of bone tissue protein:The expression level of OPG protein was significantly higher in Zuogui Pill high dose group and estradiol group than in model group(P<0.05).The relative expression of RANKL protein in Zuogui Pills high-dose group and estradiol group was significantly lower than that in the model group(P<0.05).Conclusion:Tiangui is an important substance that promotes reproductive function and strong bones by the kidney essence.Kidney Yin deficiency,tiangui is dry form the basic pathogenesis of PMOP.Bushenyigui is the basic method for prevention and treatment of PMOP.Zuogui Pill is a representative of it.Increasing the bone density,regulating bone metabolism,up-regulating OPG,down-regulating RANKL are part of the pharmacodynamic mechanisms of Zuogui Pill replenishing Tiangui strong bones.