Objective: To compare the therapeutic effect on postmenopausal osteoporosis (PMOP) between Lingnan Chen's needling technique and calcitriol soft capsules and investigate the effect mechanism in view of serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1).
Methods: Seventy patients of PMOP were randomized into an observation group (35 cases, 4 cases dropped off ) and a control group (35 cases, 3 cases dropped off ). The patients of both groups were treated with calcium carbonate D3 tablets orally (600 mg each time, once daily). In the observation group, acupuncture was delivered at Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4), Sanyinjiao (SP 6), etc. with the specific reinforcing-reducing technique and qi-conducting technique of Lingnan Chen's acupuncture, once every two days, three times a week. In the control group, calcitriol soft capsules were taken orally, 0.25 μg each time, twice a day. The intervention measures of two groups all lasted 12 weeks. Before and after treatment, the bone mineral density (BMD), the levels of serum GH and IGF-1 were assessed in two groups. Before treatment and 4, 8 and 12 weeks after treatment, TCM symptoms score and the MOS item short form health survey (SF-36) score were evaluated and the therapeutic effects were compared between groups.
Results: In both within-group and between-group comparisons, the difference in BMD was not significant before and after treatment (P>0.05). After treatment, the levels of serum GH and IGF-1 were increased in the observation group (P<0.05), and higher than the control group (P<0.05). After 4, 8 and 12 weeks of treatment, the scores of TCM symptoms were reduced in both groups compared with those before treatment (P<0.05), and the score in the observation group was lower than that in the control group (P<0.05). After 4, 8 and 12 weeks of treatment, except the score of general health 4 weeks after treatment in the control group, the scores of the other domains in SF-36 were increased in both groups compared with those before treatment (P<0.05). After 12 weeks of treatment, except the score for the general health and social functions, the scores of the other domains of SF-36 in the observation group were all higher than those in the control group (P<0.05). The total effective rate was 83.9% (26/31) in the observation group, higher than 59.4% (19/32) in the control group (P<0.05).
Conclusion: Lingnan Chen's needling technique is effective on postmenopausal osteoporosis. This therapy may relieve the symptoms of osteoporosis and improve the quality of life, better than calcitriol soft capsules, and the effect mechanism may be related to the up-regulation of serum GH and IGF-1 in the patients.
目的：比较岭南陈氏针法与骨化三醇胶丸治疗绝经后骨质疏松症（PMOP）的疗效，从血清生长激素（GH）、胰岛素样生长因子1（IGF-1）角度探讨其作用机制。方法：将70例PMOP患者随机分为观察组（35例，脱落4例）与对照组（35例，脱落3例）。两组均口服碳酸钙维D3元素片（每次600 mg，每天1次）；观察组针刺肾俞、脾俞、关元、三阴交等穴，行岭南陈氏分级补泻法和导气法，隔日治疗1次，每周3次；对照组口服骨化三醇胶丸，每次0.25 μg，每天2次，两组均治疗12周。治疗前后，观察两组骨密度（BMD）及血清GH、IGF-1水平；治疗前及治疗4、8、12周后，观察两组中医症状评分和健康调查简表（SF-36）评分，并比较两组疗效。结果：两组患者治疗前后BMD组内、组间比较，差异无统计学意义（P>0.05）。治疗后，观察组患者血清GH、IGF-1水平升高（P<0.05），且高于对照组（P<0.05）。治疗4、8、12周后，两组患者中医症状评分均较治疗前降低（P<0.05），且观察组低于对照组（P<0.05）。治疗4、8、12周后，除对照组治疗4周后总体健康维度外，两组其余SF-36各项评分及总分均较治疗前升高（P<0.05）；治疗12周后，除总体健康、社会职能维度外，观察组其余SF-36各项评分及总分均高于对照组（P<0.05）。观察组总有效率为83.9%（26/31），高于对照组的59.4%（19/32，P<0.05）。结论：岭南陈氏针法治疗PMOP可改善骨质疏松症状与患者生活质量，优于骨化三醇胶丸，其作用机制可能与上调患者血清GH及IGF-1水平有关。.
Keywords: Lingnan Chen's acupuncture; acupuncture; growth hormone; insulin-like growth factor-1; postmenopausal osteoporosis; randomized controlled trial (RCT).