【作者】 詹仓侨；

【导师】 李义凯；

【作者基本信息】 南方医科大学 ， 中西医结合临床骨伤科， 2009， 博士

【摘要】 目的观察淫羊藿对人及大鼠肌系统的影响方法1选择50例肾阳虚型骨质疏松症患者,将50例患者随机分为治疗组、对照组两组,疗程为6个月。治疗组服用单味淫羊藿煎液,共28例;对照组服用福善美(阿仑膦酸钠片Alendronate Sodium Tablets每片含阿仑膦酸钠70mg,由默沙东公司提供),共22例。观察治疗前及治疗后6个月检查骨密度、肾阳虚积分及利手肌力变化.2 SD大鼠,雌性,260～300g,52只,随机分为假手术组16组,模型组12只,阳性组12只,淫羊藿组12只。模型组、阳性组及淫羊藿组行卵巢切除手术;假手术组动物进行开背,但不切除卵巢。手术后7天开始给药,1次/天,连续给药12周,每周测量动物的体重、饮食量各一次。观察的肌肉蛋白含量、超氧化物歧化酶(SOD)活力、谷胱甘肽过氧化物酶(GSH-PX)、丙二醛(MDA)、肌纤维直径、横截面积及周长。结果1通过对50例绝经后骨质疏松症患者的分组对照治疗发现,治疗组经单味淫羊藿煎剂口服治疗后,其症状总有效率(包括显效、有效)为91.67%,与对照组福善美口服后总有效率68.42%相比,两组有显著性差异(P＜0.01)。治疗组治疗前后比较,肾阳虚主要症状腰膝酸软、畏寒肢冷积分值与肾阳虚证总积分值差异均有非常显着性意义(P＜0.01);对照组治疗前后比较,肾阳虚主要症状积分值及肾阳虚总积分值均无明显变化。2组之间治疗后肾阳虚主要症状积分值及肾阳虚证总积分比较差异均有显著性意义。治疗组骨密度值疗前、疗后比较有显著性差异(P＜0.05);对照组骨密度值疗前、疗后比较有显著性差异(P＜0.05)。治疗组与对照组疗后骨密度值比较无显著性差异(P＞0.05)。治疗组与对照组在治疗前与治疗后2个月、4个月及6个月均存在显著差异(P＜0.05),而治疗后2个月、4个月及6个月间的握力比较无显著差异。治疗组与对照组比较,治疗前握力无差异,治疗后各测试阶段治疗组均较对照组高,差异具有显著性(P＜0.05)。2大鼠切除卵巢后,相对于未切除卵巢的大鼠,骨骼肌在组织形态学上发生了改变,主要表现在骨骼肌纤维直径、横截面积、周长上的缩小,同时在单位面积上骨骼肌的数量是增大的,阳性组的大鼠,骨骼肌中的蛋白含量较模型组的大鼠有明显的提高(P＜0.05),抗氧化酶SOD的活力也明显高于去卵巢手术后的大鼠(P＜0.01),GSH-PX的活力更是为各组的最高值,达到105.122活力单位,明显超过卵巢摘除大鼠(P＜0.01),肌肉中的脂质过氧化物MDA含量显著低于模型组(P＜0.01)。为卵巢切除后大鼠的骨骼肌的蛋白质含量为0.600 g/L,SOD的活力为36.353U/mgprot,GSH-PX的活性为70.181活力单位,MDA的含量为28.503mg/prot,高于其它各组。淫羊藿治疗对股直肌各项检测指标的影响显示如下:肌肉蛋白含量和SOD活力是各实验组中最高的,比去卵巢组分别提高了21.50%和82.35%(P＜0.01),而且SOD活力还与其它组之间存在显著性差异(P＜0.05)。GSH-PX的活性高于去卵巢组(P＞0.05),但明显低于阳性组(P＜0.05)。淫羊藿治疗后大鼠肌肉中MDA含量低于其它实验组,比去卵巢组减少了51.06%(P＜0.01)。结论1表明淫羊藿在缓解临床症状及改善患者症状方面较福善美有显著的优势;淫羊藿具有提高骨密度,促进骨形成的、改善患者肌力的作用,而且优于福善美。2淫羊藿能够增强骨质疏松大鼠肌肉抗氧化能力、提高自由基清除率、延缓机体衰老、改善骨骼肌的质量和功能。营养或能够使骨质疏松大鼠模型的肌纤维横截面积增大、直径增大,改善了骨骼肌退变,提高了骨骼肌素质。更多还原

【Abstract】 Objective:To observe the influence of epimedium on muscle system of human and ratMethods:1 We randomly divide 50 osteoporosis patients who were insufficiency of kidney-YANG types into treatment groups and control groups and these patients received treatment for 6 months.The treatment groups were 28 and received single epimedium fluid.And control groups were 22 and treated with Fosamax(Alendronate Sodium Tablets70mg).Bone density,index of insufficiency of kidney-YANG type and muscle force of hand were determined pro and post 6 months of treatment.2 52 SD rats(female,260-300g) were randomly divided into pseud-operation groups(16),model groups(12),positive groups(12),epimedium groups(12). ovariectomy was performed in model,positive and epimedium groups.The rats in pseudo-operation group were cut on the back and ovariectomy was not performed. Medicine(once a day) were given in 7 day after operation up to 12 weeks,the heavy and appetite of rats were measured once a week.Protein level in muscle,SOD activity, GSH-PX,MDA,diameter,cross section area and perimeter of muscle were measured.Results:1 From analysis the treatment of 50 postmenopause osteoporsis patients,we found that the total effective rate were 91.67%in treatment groups and 68.42%in control which is significantly difference(P＜0.01).E2 index in pro and post treatment were significantly difference in treatment groups(P＜0.01) and no difference were found in control group(P＞0.05).the major syndrome index and total syndrome index of insufficiency of kidney-YANG types showed no difference in control groups but showed significantly difference in two groups.Bone density of pro and post treatment showed significantly difference in treatment and control groups(P＜0.05).It is not difference found in bone density in treatment and control groups(P＞0.05).it is significantly difference between pro treatment and 2,4,6 months after treatment in treatment and control groups(P＜0.05) and no difference were found in grasp force between pro treatment and 2,4,6 months after treatment.ALP and BGP showed no difference in pro and post treatment(P＞0.05).grasp force in treatment groups were significantly higher than in control in all time points.(P＜0.05).2 After ovariectomy,some histomorphologies were found in muscle including diminution diameter,cross section and peridiameter of muscle fibre and increasion of muscle pre area.protein level and SOD activity of muscle in positive groups increased significantly compared to model groups(P＜0.05,P＜0.01).GSH-PX activity was 105.122 unit which was highest in all groups and higher than ovariectomy rats(P＜0.01).MDA content in muscle was significantly lower than model groups(P＜0.01).Protein level in muscle of ovariectomy rats were 0.600g/L,SOD activity was 36.353U/mgprot,GSH-PX activity was 70.181 unit,MDA content was 28.503mg/prot which higher than other groups.The influence of epimedium on rectus femoris were shown follow as:protein level and SOD activity were highest in all groups which elevated to21.05%and 82.35%respectively(P＜0.01),moreover,the SOD activity was significantly higher than other groups(P＜0.05).GSH-PX activity were higher than ovariectomy groups(P＞0.05),but significantly lower than positive groups(P＜0.05).after epimedium treatment,MDA content in rat muscle decreased by 51.06%than ovariectomy groups and lower than other groups(P＜0.01).Conclusions:1 We found that epimedium have obviously superiority on relief clinical syndrome and cure patients syndrome than Fosamax.Epimedium could increase bone density and bone formation and strength muscle force and better than Fosamax.2 Epimedium could promote muscle ability of antioxygen,increase free radical deletion,delay muscle aging,improve quality and function of muscle of rats. moreover,Epimedium could enlarge diameter,cross section area of muscle fibre, inhibit muscle cataplasid and promote muscle quality.更多还原