本文選題：原發(fā)性骨質(zhì)疏松癥 + 腎虛量化評(píng)分��； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:分析女性絕經(jīng)后骨質(zhì)疏松癥腎虛量化評(píng)分、患者雌二醇(E2)與骨密度(BMD)的相關(guān)性,將腎虛量化評(píng)分與E2兩者結(jié)合起來(lái)分析,揭示腎虛證候輕重程度與E2、骨密度水平的相關(guān)性;通過(guò)E2、腎虛量化評(píng)分與骨代謝標(biāo)志物相相關(guān)性的分析,從骨代謝角度上探討腎虛造成骨質(zhì)疏松癥的可能作用機(jī)制,從而更加客觀的把握腎虛對(duì)骨代謝的影響,為臨床補(bǔ)腎中藥、腎虛量化評(píng)分的恰當(dāng)使用提供較好的依據(jù)。方法:將41例符合本次研究要求的患者納入研究中,每間隔10歲分為一組,共3組(A組:54-63y;B組:64-73y;C組:74-83y),統(tǒng)計(jì)整理納入患者的年齡、身高、體重情況。檢測(cè)所有納入患者的E2、BMD(腰椎)、兩種骨代謝標(biāo)志物:PINP與β-CTx,分別為代表骨形成標(biāo)志的Ⅰ型前膠原氨基端延長(zhǎng)肽與骨破壞標(biāo)志的Ⅰ型膠原羧基端肽β特殊序列,對(duì)每個(gè)患者進(jìn)行腎虛量化評(píng)分,并且運(yùn)用直線相關(guān)分析法對(duì)各個(gè)項(xiàng)目指標(biāo)數(shù)值進(jìn)行相應(yīng)的統(tǒng)計(jì)和分析。結(jié)果:1、在三個(gè)組的患者基線特征(身體質(zhì)量指數(shù)(Body Mass Index,BMI)、身高、體重)統(tǒng)計(jì)學(xué)比較結(jié)果中,任意兩組間P值均大于0.05,無(wú)統(tǒng)計(jì)學(xué)差異,說(shuō)明各組之間存在可比性。2、各組之間腎虛量化評(píng)分、骨代謝標(biāo)志物、BMD、E2相比較:腎虛量化評(píng)分:A組和C組相比較,P0.01;A組和B組相比較,P0.01;B組和C組相比較,P0.01β-CTx和PINP:A組和C組相比較,P0.01;A組和B組相比較,P0.01;B組和C組相比較,P0.01;BMD:A組和B組相比較,P0.05;A組和組C相比較,P0.01;B組和組C相比較,P0.05;E2:A組和B組相比較,P0.05;A組和組C相比較,P0.01;B組和組C相比較,P0.05;3、腎虛量化評(píng)分與年齡、BMD、E2、β-CTx、PINP的相關(guān)性(r):腎虛量化評(píng)分與年齡呈高度正相關(guān),r=0.937、P0.01;腎虛量化評(píng)分與BMD呈高度負(fù)相關(guān),r=-0.962、P0.01;腎虛量化評(píng)分與E2呈高度負(fù)相關(guān),r=-0.868、P0.01;腎虛量化評(píng)分與β-CTx呈高度正相關(guān),r=0.935、P0.01;腎虛量化評(píng)分與PINP呈高度負(fù)相關(guān),r=-0.958、P0.01;4、E2與BMD、年齡、β-CTx、PINP指標(biāo)的相關(guān)性(r):E2與骨密度呈高度正相關(guān),r=0.766,P0.01;E2與年齡呈高度負(fù)相關(guān),r=-0.758,P0.01;E2 與 CTx 呈高度負(fù)相關(guān),r=-0.727,P0.01;E2 與 PINP 呈高度正相關(guān),r=0.745,P0.01;5、年齡與BMD、PINP、β-CTx指標(biāo)的相關(guān)性(r):年齡與BMD呈高度負(fù)相關(guān),r=-0.932,P0.01;年齡與PINP呈高度負(fù)相關(guān),r=-0.931,P0.01;年齡與β-CTx呈高度正相關(guān),r=0.907,P0.01;結(jié)論:女性原發(fā)性骨質(zhì)疏松癥患者,腎虛量化評(píng)分隨著患者年齡的增加呈逐漸加重傾向,而雌激素水平則呈逐漸下降趨勢(shì),破骨細(xì)胞功能活動(dòng)相對(duì)于成骨細(xì)胞逐漸增強(qiáng)。其機(jī)制可能是由于女性絕經(jīng)后雌激素水平逐漸下降導(dǎo)致骨重建發(fā)生變化、骨代謝失常,骨吸收作用相對(duì)骨形成作用而言逐漸增強(qiáng),進(jìn)而形成骨質(zhì)疏松。研究表明腎虛在女性原發(fā)性骨質(zhì)疏松癥發(fā)病過(guò)程中起著非常重要的作用,骨質(zhì)疏松癥腎虛量化評(píng)分可較好地運(yùn)用于臨床,為原發(fā)性骨質(zhì)疏松癥補(bǔ)腎中藥的使用提供一定的參考和依據(jù)。
[Abstract]:Objective: to analyze the correlation between the quantitative score of kidney deficiency in postmenopausal women and the relationship between estradiol E _ 2 (E _ 2) and bone mineral density (BMD). To reveal the correlation between the severity of kidney deficiency syndrome and the level of E2 and bone mineral density, to explore the possible mechanism of osteoporosis caused by kidney deficiency from the perspective of bone metabolism through the analysis of the correlation between E2, quantitative score of kidney deficiency and the markers of bone metabolism. Therefore, it is more objective to grasp the effect of kidney deficiency on bone metabolism, and to provide a better basis for the proper use of clinical kidney tonifying Chinese medicine and the quantification score of kidney deficiency. Methods: 41 patients who met the requirements of this study were included in the study. Each 10 years old was divided into three groups: group A: 54-63yr, group B: 64-73yr, group C: 74-83yr. The age, height and weight of the patients were statistically analyzed. All the patients were included in the study to detect the specific sequences of E2P BMDs (lumbar vertebrae), two biomarkers of bone metabolism: 1 PINP and 尾 -CTX, which were the amino terminal lengthening peptide of type I procollagen and the carboxyl terminal peptide 尾 of type I collagen, respectively, which represented the marker of bone formation. Each patient was scored by kidney deficiency quantification, and each item index value was analyzed by linear correlation analysis. Results in the baseline characteristics (body Mass index, height, weight) of the three groups, the P value of any two groups was greater than 0.05, and there was no statistical difference between the two groups. The results showed that there was comparability between the groups, and the quantitative score of kidney deficiency among the groups. Comparison of bone metabolism marker BMD-E _ 2: comparison of kidney deficiency quantification score between group A and group C: comparison of P0.01 尾 -CTx and P0.01 尾 -CTx in group B and group C; comparison of group A and group B in comparison of P0.01 尾 -CTx and group B; comparison of group B and group C of P0.01A and group C Group B: comparison of P0.05A and Group C; comparison of Group B and Group C; comparison of Group A and Group B; comparison of Group A and Group C; comparison of Group B and Group C; comparison of Group C and Group C; correlation of Kidney deficiency Quantification score with Age of BMDE2, 尾 -CTxPINP: correlation of Kidney deficiency Quantification score and Age There was a high positive correlation between kidney deficiency and 尾 -CTx, a high positive correlation between kidney deficiency score and PINP, a high negative correlation between kidney deficiency score and BMD, a high negative correlation between kidney deficiency score and E2, a high positive correlation between kidney deficiency quantification score and 尾 -CTx, and a high negative correlation between kidney deficiency quantification score and PINP, a significant negative correlation between E2 and BMD-0.95% P0.014, and a negative correlation between kidney deficiency quantification score and PINP, and a high negative correlation between kidney deficiency quantification score and BMD, and a high negative correlation between kidney deficiency quantification score and E 2 and BMD-0.868 P0.01; a high positive correlation between kidney deficiency quantification score and 尾 -CTx P0.01; a high negative correlation between kidney deficiency quantification score and PINP. Age, correlation between 尾 -CTxPINP and BMD: r: E2 is highly positively correlated with bone mineral density; r-0.758P0.01E _ 2 is highly negatively correlated with age; r-0.727; P0.01E _ 2 is highly positively correlated with PINP; age is highly correlated with BMD-PINP, 尾 -CTx; age is highly negative with BMD; and age is highly negatively correlated with BMD-PINP, 尾 -CTx. There was a highly negative correlation between age and PINP, and a high positive correlation between age and 尾 -CTX. Conclusion: the age of female patients with primary osteoporosis is 0.907 and 0.907P0.01.Conclusion: there is no significant correlation between age and PINP, and there is a significant correlation between age and 尾 -CTX. Conclusion: there is a significant correlation between age and 尾 -CTX in female patients with primary osteoporosis. The quantitative score of kidney deficiency increased gradually with the increase of age, while the level of estrogen decreased gradually, and the function of osteoclasts was gradually enhanced compared with osteoblasts. The mechanism may be that the decline of estrogen level in postmenopausal women may lead to changes in bone remodeling and bone metabolism, and bone resorption is gradually enhanced in relation to bone formation, resulting in osteoporosis. Studies have shown that kidney deficiency plays a very important role in the pathogenesis of primary osteoporosis in women. The quantitative score of kidney deficiency in osteoporosis can be used in clinical practice. To provide certain reference and basis for the use of traditional Chinese medicine for tonifying kidney in primary osteoporosis.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R580

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