抗酒石酸酸性磷酸酶及25-羟维生素D与老年骨质疏松症中肾阳虚证关系的探讨

发布时间：2018-07-26 12:20

【摘要】：目的：探讨抗酒石酸酸性磷酸酶(TRACP-5b)、25-羟维生素D[25-(OH)-VD]与老年骨质疏松中肾阳虚证的相关联系,为老年骨质疏松症中肾阳虚证的诊断提供新思路。方法：1.依据病例纳入标准,选择我院2015年03月至2015年09月期间,在老年科、康复科的门诊及病房就诊的确诊为非老年骨质疏松患者30例及老年骨质疏松症中医证型中肾阳虚型、非肾阳虚型患者各30例,分别收集各组年龄、身高、体重等基本信息,并测定各组血清TRACP-5、25-(OH)-VD、血清特异性碱性磷酸酶(ALP)、血清钙离子水平。另外采用双能X线检测各组患者腰椎L2-4及股骨颈的骨密度,最后利用SPSS 19.0统计学软件进行数据处理,分析血清TRACP-5b、25-(OH)-VD与老年骨质疏松症中医证型肾阳虚证、非肾阳虚证及非骨质疏松症间的关系。结果：1、老年骨质疏松症肾阳虚型、非肾阳虚型及非骨质疏松症组间的年龄、BMI、血清钙离子水平比较无显著差异性(P0.05),老年骨质疏松症肾阳虚型、非肾阳虚型组间的BMD、ALP无显著差异性(P0.05)。2、老年骨质疏松症肾阳虚型及非肾阳虚型与非骨质疏松症在在血清TRACP-5b、 25-(OH)-VD水平上存在显著差异性(P=0.035)。3、肾阳虚型与非肾阳虚型老年骨质疏松症患者在血清TRACP-5b、25-(OH)-VD水平上存在显著性差异(P0.001),且肾阳虚组的血清TRACP-5b表达水平高于非肾阳虚组,肾阳虚组的血清25-(OH)-VD表达水平低于非肾阳虚组。结论：1.血清TRACP-5b、25-(OH)-VD、ALP水平对于鉴别老年骨质疏松症及非骨质疏松症,具备一定指导意义；2.血清TRACP-5b、25-(OH)-VD可作为鉴别老年骨质疏松肾阳虚型及其余中医证型的客观参考指标,应用于临床研究。
[Abstract]:Objective: to explore the relationship between tartrate-resistant acid phosphatase (TRACP-5b) 25-hydroxyvitamin D [25-(OH)-VD] and kidney yang deficiency syndrome in aged osteoporosis, and to provide a new idea for the diagnosis of kidney yang deficiency syndrome in senile osteoporosis. Method 1: 1. From March 2015 to September 2015, 30 non-senile osteoporosis patients and 30 aged osteoporosis patients diagnosed in outpatient and ward of rehabilitation department in our hospital from March 2015 to September 2015 were selected according to the criteria of inclusion of the cases, and the kidney-yang deficiency type in the TCM syndrome of senile osteoporosis was selected. The basic information of age, height and weight of each group were collected, and the serum levels of TRACP-5 and 25- (OH) -VDand serum calcium ion of (ALP), were measured. In addition, the bone mineral density of lumbar vertebrae L2-4 and femoral neck were detected by dual-energy X-ray. Finally, the data were processed by SPSS 19.0 statistical software, and the serum TRACP-5bF25- (OH) -VD and kidney yang deficiency syndrome of senile osteoporosis were analyzed. Relationship between non-Kidney Yang deficiency Syndrome and non-Osteoporosis. Results: there was no significant difference in age BMIand serum Ca ~ (2 +) levels between aged osteoporosis patients with kidney-yang deficiency, non-kidney-yang deficiency and non-osteoporosis (P0.05). There was no significant difference in BMD-ALP between non-kidney-yang deficiency group and non-kidney-yang deficiency group (P0.05). There were significant differences in serum TRACP-5b, 25- (OH) -VD levels (P0.035) .3between kidney-yang deficiency type and non-kidney-yang deficiency type in aged patients with osteoporosis (P0.035), and between kidney-yang deficiency type and non-kidney-yang deficiency type, there were significant differences in serum TRACP-5b, 25- (OH) -VD levels (P0.035). There was significant difference in serum TRACP-5bF25- (OH) -VD level in patients with osteoporosis (P0. 001), and the level of serum TRACP-5b expression in patients with deficiency of kidney yang was higher than that in patients with non-deficiency of kidney yang (P0. 001). The expression of 25-(OH)-VD in serum of kidney yang deficiency group was lower than that of non-kidney yang deficiency group. Conclusion 1. The level of serum TRACP-5bF25- (OH)-VDN ALP has a certain guiding significance in differentiating senile osteoporosis from non-osteoporosis. Serum TRACP-5bD 25-(OH)-VD can be used as an objective reference index for differentiating kidney yang deficiency type from other TCM syndromes in aged osteoporosis.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R580

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