Evaluation of the clinical efficacy of Zhuanggu Zhitong Recipe in treatment of postmenopausal osteoporosis and its correlation with the AMPK/mTOR autophagy signaling pathway

评价庄骨止痛方治疗绝经后骨质疏松症的临床疗效及其与AMPK/mTOR自噬信号通路的相关性

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Abstract

OBJECTIVE: To evaluate the efficacy of bone strengthening and pain relieving capsules in the treatment of postmenopausal osteoporosis and its correlation with AMPK/mTOR autophagy signaling pathway. METHODS: Between January 2021 and December 2022, 100 patients with postmenopausal osteoporosis of liver-kidney yin deficiency and qi stagnation and blood stasis type were retrospectively screened in the outpatient and inpatient departments of the Department of Orthopaedics and Traumatology of Liuzhou Hospital of Traditional Chinese Medicine, Guangxi Zhuang Autonomous Region, and were randomly divided into 2 groups of 50 patients each according to the order of the timing of the consultation, namely, the Strong Bone Pain Relief Capsules Treatment Group and the Alendronate Sodium Control Group. Bone mineral density of the left femur, Chinese medicine evidence points, serum AMPK level, E2 level before and after treatment, Ca(2+) level, IL-17, serum phosphorus level, ALP, PTH, OC, PINP, NTX and TRAP-5b level before and after drug intervention were detected in the two groups. RESULTS: Both groups achieved a lower TCM syndrome score, NRS score of low back pain, and AMPK level after treatment (P<0.001). Both groups had increased Ca(2+) concentration and E2 level (P<0.001), and reduced IL-17 and serum P level (P<0.001). Both groups had significantly increased ALP, PTH, OC, PINP level, NTX and TRAP-5b level (P<0.001). The difference between the two groups was significant (P<0.05) and for TRAP-5b levels, (P<0.001). Efficacy for osteoporosis differed between the two groups (P<0.05). CONCLUSION: Strong Bone Pain Relief Capsules may negatively regulate the level of AMPK and increase the level of cellular autophagy so as to play a role in the improvement of osteoporosis.

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