Investigation And Study On Distribution Of TCM Syndromes And Related Factors Of Senile Osteoporosis

Objective: To explore the distribution rules of different TCM syndromes and related influencing factors of senile osteoporosis,and provide important reference and guidance for the diagnosis and prevention of this disease.Methods: A total of 323 elderly patients with osteoporosis who met the inclusion criteria were selected.According to the expert consensus on prevention and treatment of primary osteoporosis by traditional Chinese medicine(2015),such syndromes as kidney deficiency and blood stasis,liver and kidney Yin deficiency,qi stagnation and blood stasis,spleen and kidney Yang deficiency,and spleen and stomach weakness were classified.Stratified according to age,respectively in different syndrome types of general data and serum calcium(Ca),serum phosphorus(P),serum magnesium(Mg),alkaline phosphatase(ALP),uric acid(UA),triglycerides(TG),total cholesterol(TC),low density lipoprotein(LDL),high-density lipoprotein(HDL),hemoglobin(HB),bone mineral density(BMD)and bone joint markers for the statistical analysis of test results.Results: 1.Comparison of general information of patients: gender,weight and body mass index between the five groups have statistical significance(P< 0.05);2.Comparison of previous medical history: fracture history,diabetes history and hypertension history were statistically significant(P<0.05);3.Biochemical indicators: there were statistically significant differences in the levels of P,ALP and Hb among the five groups(P<0.05).4.The results of bone mineral density(BMD)and bone conversion markers under the five syndromes showed statistically significant differences in the lowest BMD,mean BMD and 25-hydroxyvitamin D(P<0.05).5.The proportion analysis of five syndromes at different age stratification: significant differences were found among TCM syndromes at different ages: > kidney deficiency and blood stasis syndrome,> liver and kidney Yin deficiency,> spleen and kidney Yang deficiency,> spleen and stomach weakness;In patients aged 75 ≤ 80 years old,> syndrome of qi stagnation and blood stasis,> syndrome of kidney deficiency and blood stasis,> syndrome of liver and kidney Yin deficiency,spleen and stomach weakness,> syndrome of spleen and kidney Yang deficiency;> qi stagnation and blood stasis syndrome > liver and kidney Yin deficiency > spleen and stomach weakness,spleen and kidney Yang deficiency;> kidney deficiency and blood stasis > liver and kidney Yin deficiency > spleen kidney Yang deficiency > spleen and stomach weakness;6.The results of bone mineral density(BMD)and bone conversion markers at different age groups were compared: the difference of calcitonin in different age groups was statistically significant(P<0.05).7.Comparison of bone mineral density values and bone conversion markers at different age levels under various syndromes: there were statistically significant differences in 25-hydroxyvitamin D indicators among patients with kidney deficiency and blood stasis at different age levels(P<0.05).Arrival of calcitonin in different age groups in patients with Yin deficiency of liver and kidney has statistical difference(P<0.05).Patients with qi stagnation and blood stasis were stratified at different ages,and there was no statistical difference in each indicator(P<0.05).The minimum bone mineral density of patients with spleen-kidney Yang deficiency in different age groups has statistical difference(P<0.05).There were statistically significant differences in the stratification of calcitonin and osteocalcin in patients with weak spleen and stomach at different ages(P<0.05).Conclusion: 1.Qi stagnation and blood stasis syndrome accounted for the largest proportion in elderly patients with osteoporosis.2.Among the elderly patients with osteoporosis,the proportion of qi stagnation and blood stasis type in females is larger than that of other syndromes,and that of kidney deficiency and blood stasis type in males is larger than that of other syndromes.3.Low or high body weight is a possible factor affecting bone metabolism.4.Elderly patients with osteoporosis are often associated with common chronic diseases.5.Bone mineral density and 25-hydroxyvitamin D can be used as the objective basis of TCM syndrome differentiation,and phosphorus and alkaline phosphatase can be used as auxiliary indexes of TCM syndrome differentiation.6.Blood stasis syndrome is the main syndrome of osteoporosis in the elderly.