Kidney governing bone theory plays an important role in treating bone metabolic disease such as osteoporosis, and many tonifying kidney prescriptions/herbs are widely used in Traditional Chinese Medicine(TCM). However, the exact biological basis of kidney governing bone theory in the context of new advances in biology is still not fully established. In this paper, the content of kidney governing bone theory in biology has been fully demonstrated from different aspects. We first propose that bone and kidney mutually affect each other in pathology and physiology, particularly through homeostasis of calcium, phosphorus and fibroblast growth factor-23(FGF-23). Next, we identify that tonifying kidney prescriptions/herbs exert bone protective effects, thus treating osteoporosis by regulating bone formation and bone resorption.Furthermore, the exact molecular mechanisms of tonifying kidney prescriptions, herbs and their effective components in treating osteoporosis have been systematically reviewed. Finally, we come into the conclusion that kidney regulating bone mineral homeostasis, bone protective effects of tonifying kidney herbs and regulatory effects on bone homeostasis are all the manifestations of kidney governing bone theory.Therefore, the new insights into kidney governing bone theory in biology will promote the development of clinical practices, and drugs discovery in treating osteoporosis.
Dong-feng ZhaoYong-jian ZhaoCheng-long WangYan-ping YangYong-jun Wang
目的探讨金黄膏联合新癀片治疗膝关节滑膜炎的临床疗效。方法选取膝关节滑膜炎患者120例,随机对照方法分联合治疗组和对照组(n=60)。两组均口服新癀片0.96 g/次,一日3次,联合治疗组外敷金黄膏,每3 d 1贴,对照组外敷不含任何药物的黄凡士林,每3 d 1贴,两组均治疗4周。分别于治疗前、治疗2周、4周和治疗结束后4周,采用膝关节肿胀评分、视觉模拟量表(VAS)评分、西大略湖和麦克马斯特大学骨关节炎指数(WOMAC)各项评分及总有效率评定患者的临床疗效。结果与治疗前相比,两组治疗2周、4周和治疗结束后4周,膝关节肿胀评分、VAS评分、WOMAC各项评分及总评分均显著降低(P<0.05,P<0.01);与对照组比较,联合治疗组治疗2周、4周和治疗结束后4周,膝关节肿胀评分、VAS评分、WOMAC各项评分及总评分均显著降低(P<0.05,P<0.01)。治疗2周,联合治疗组和对照组有效率分别为83.33%和75.00%;治疗4周,联合治疗组和对照组有效率均有增加,分别为95.00%和88.33%;治疗结束后4周随访,联合治疗组和对照组有效率分别为95.00%和85.00%,两组比较差异有统计学意义(P<0.05)。治疗期间两组均未发生明显不良反应。结论金黄膏联合新癀片治疗能够减轻膝关节滑膜炎患者的肿胀及疼痛症状,改善膝关节功能,疗效优于单纯口服新癀片治疗,具有较高的安全性。
目的:观察益气化瘀补肾方治疗膝骨关节炎的临床疗效,比较益气化瘀补肾方与美洛昔康治疗早中期膝骨关节炎的临床疗效差异。方法:128例早中期膝骨关节炎患者随机分为治疗组和对照组各69例。治疗组采用益气化瘀补肾方汤剂每日1剂分2次口服;对照组口服美洛昔康片7.5 mg,每日1次,两组均治疗6周。分别于治疗前、治疗3周、治疗6周结束后、12周和24周随访,评定西安大略麦克马斯特大学骨性关节炎指数(The Western Ontario and Mc Master University Osteoarthritis Index,WOMAC)量表、疼痛视觉模拟量表(Visual Analo g Scale for Pain,VAS)、5次坐立试验、生存质量SF-36量表及有效率。结果:两组早中期原发性膝骨关节炎治疗后WOMAC量表各项积分均下降(P<0.01),治疗组较对照组下降更明显(P<0.01);两组早中期原发性膝骨关节炎治疗后较治疗前疼痛视觉模拟量表评分均显著降低(均P<0.01),治疗组较对照组降低更明显(P<0.05);两组早中期原发性膝骨关节炎治疗后5次坐立试验所用时间较治疗前均缩短(均P<0.05),治疗组较对照组缩短更明显(P<0.05);两组治疗后生存质量评分较治疗前明显提高(均P<0.05),治疗组较对照组提高更明显(P<0.01);治疗6周后治疗组有效率为95.65%,对照组有效率为89.71%。结论:益气化瘀补肾方与美洛昔康片治疗早中期膝骨关节炎均有效,益气化瘀补肾方既可以明显的缓解患者疼痛又可以一定程度的改善膝关节活动度;益气化瘀补肾方在缓解疼痛、改善功能及恢复膝关节内部力学平衡方面疗效明显优于口服美洛昔康片。
目的观察不同浓度的苦杏仁苷对IL-1β诱导的大鼠椎间盘软骨终板细胞的影响,并进一步探讨其作用的可能机制。方法从1月龄SD大鼠椎间盘中分离软骨终板并培养,经鉴定后,随机分组为正常组、诱导组、苦杏仁苷10-2、10-3、10-4、10-5mol·L-1给药组,CCK-8法检测各组对大鼠椎间盘软骨终板细胞增殖的影响。Real-time PCR(RTPCR)检测聚集蛋白聚糖(aggrecan-1)、Ⅱ型胶原(type II collagen,Col2a1)、Ⅹ型胶原(type X collagen,Col10al)、基质金属蛋白酶-13(matrix metalloproteinase 13,MMP-13)基因的表达情况。细胞免疫荧光检测分析Col2a1、Col10al的表达,流式细胞仪检测其对软骨终板细胞凋亡的影响。结果苦杏仁苷10-2mol·L-1给药组能够抑制椎间盘软骨终板细胞的增殖,与正常组比较差异有统计学意义(P<0.05)。流式分析,其细胞凋亡比例较诱导组及正常组均较高。RT-PCR检测结果显示一定浓度的苦杏仁苷能够上调Aggrecan、Col2a1mRNA的表达,下调Col10al、MMP-13 mRNA的表达,与诱导组比较,差异有统计学意义(P<0.05)。一定浓度的苦杏仁苷能够上调Col2a1蛋白的表达,下调Col10al蛋白的表达。结论一定浓度的苦杏仁苷能够抑制IL-1β诱导大鼠椎间盘软骨终板细胞发生退变,起到延缓椎间盘退变的作用。
