Search JIM Advanced Search

Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (12): 1394-1399.doi: 10.3736/jcim20121210

• Original Clinical Research • Previous Articles     Next Articles

Effects of Chinese herbal medicine Qianggu Capsule on patients with rheumatoid arthritis-induced osteoporosis: a report of 82 cases

Gui-lin Ouyang, Feng Xiao-hui(), Lian-bo Xiao, Zheng Huang, Qing Xia, Da-peng Han, Fei Zhu #br#   

  1. Department of Orthopaedics, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, 200052, China
  • Received:2012-11-10 Accepted:2012-11-15 Online:2012-12-20 Published:2018-12-15

Background: Rheumatoid arthritis (RA) is a kind of chronic autoimmune disease and osteoporosis is one of its complications.
Objective: To explore the effects of Qianggu Capsule, a compound traditional Chinese herbal medicine, on bone mineral density (BMD) and osteoporosis in patients with RA.
Design, setting, participants and intervention: Eighty-two patients with rheumatoid arthritis and osteoporosis, who were treated in Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine from January 2010 to December 2011, were divided into treatment group (42 cases) and control group (40 cases). The patients in the treatment group were administered with Qianggu Capsule and two disease-modifying antirheumatic drugs. The patients in the control group were administered with two common-used antirheumatic drugs. The course of treatment was 6 months.
Main outcome measures: Blood levels of alkaline phosphatase (ALP), calcium, phosphorus, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were determined before and after the treatment. BMD in the lumbar spine, femur and the left distal radius were also examined before and after the treatment.

Results: The ALP level, a bone metabolic parameter, was significantly increased in patients of the treatment group after treatment compared with before treatment. BMD values in the lumbar spine, femur and the radius were higher after treatment than before treatment (P<0.05). There were no changes in ALP level and BMD in the patients of the control group after the treatment when compared with before treatment.

Conclusion: Treatment with Qianggu Capsule can increase BMD of RA patients, and then ameliorate their osteoporosis.


Key words: drugs,Chinese herbal, rheumatoid arthritis, bone mineral density, osteoporosis, clinical trial

Table 1

Basic condition"

Figure 1

Flow chart of this trial DMARDs: disease-modifying antirheumatic drugs."

Table 2

Bone metabolic marker and inflammatory indices in two groups"

Group n CRP (mg/L) ESR (mm/h) Blood calcium
(mmol/L)
Blood phosphorus
(mmol/L)
ALP (U/L)
Control
Before treatment 40 25.33±9.36 33.96±12.07 2.26±0.14 1.14±0.12 73.43±13.21
After treatment 40 3.65±1.73* 12.81±4.94* 2.28±0.13 1.15±0.14 72.36±12.51
Treatment
Before treatment 40 23.04±10.43 31.96±1.44 2.27±0.15 1.14±0.14 76.15±11.43
After treatment 40 3.27±1.93* 14.56±6.29* 3.02±0.13*△ 1.15±0.13 96.24±12.25*△

Table 3

Bone mineral density in two groups (x±s, g/cm2)"

Group n Bone mineral density
Lumbar spine Left femur Left radius
Control
Before treatment 40 0.80±0.08 0.73±0.02 0.60±0.05
After treatment 40 0.79±0.06 0.72±0.01 0.58±0.06
Treatment
Before treatment 40 0.81±0.07 0.72±0.01 0.60±0.06
After treatment 40 1.12±0.07*△ 0.93±0.03*△ 0.84±0.04*△
[1] Hafez EA, Mansour HE, Hamza SH, Moftah SG, Younes TB, Ismail MA . Bone mineral density changes in patients with recent-onset rheumatoid arthritis. Clin Med Insights Arthritis Musculoskelet Disord. 2011 ; 4:87-94.
[2] Kim SY, Schneeweiss S, Liu J, Daniel GW, Chang CL, Garneau K, Solomon DH . Risk of osteoporotic fracture in a large population-based cohort of patients with rheumatoid arthritis. Arthritis Res Ther. 2010; 12(4):R154.
doi: 10.1186/ar3107
[3] Yoon J, Kwon SR, Lim MJ, Joo K, Moon CG, Jang J, Park W . A comparison of three different guidelines for osteoporosis treatment in patients with rheumatoid arthritis in Korea. Korea J Intern Med. 2010; 25(4):436-446.
doi: 10.3904/kjim.2010.25.4.436
[4] Yuan FH, Zhou YH, Yu KJ, Gao KY, Xu W . Association of bone mineral density and bone erosion of rheumatoid arthritis. Zhonghua Feng Shi Bing Xue Za Zhi. 2009 ; 13(12):841-844. Chinese with abstract in English.
doi: 10.3760/cma.j.issn.1007-7480.2009.12.011
袁风红, 周耀红, 俞可佳, 高恺言, 胥魏 . 类风湿关节炎患者骨质疏松与骨侵蚀关系的研究.中华风湿病学杂志. 2009; 13(12):841-844.
doi: 10.3760/cma.j.issn.1007-7480.2009.12.011
[5] Wang LZ, Wang CH, Li XF, Zhao XC, Zhao WP, Wang XR, Su Y, An Y, Zhou YS, Zhu P, Chen LN, Wang GC, Lu X, Jin HT, Wang YF, Yang R, Zhang ZL, Li GT, Liu XY, Sun L, Zhang FX, Tao JM, Li ZB, Yang J, Lin JY, Wei MQ, Cui LF, Shu R, Liu XM, Ke D, Hu SX, Ye C, Yang XY, Li H, Huang CB, Gao M, Lai B, Li XF, Song LJ, Li ZG . A multicenter study of fracture in patients with rheumatoid arthritis in China. Zhonghua Feng Shi Bing Xue Za Zhi. 2012 ; 16(2):102-106. Chinese with abstract in English.
doi: 10.3760/cma.j.issn.1007-7480.2012.02.007
王莉枝, 王彩虹, 李小峰, 赵向聪, 赵文鹏, 王秀茹, 苏茵, 安媛, 周云杉, 朱平, 陈丽娜, 王国春, 卢昕, 靳洪涛, 王永福, 杨荣, 张卓莉, 李光韬, 刘湘源, 孙琳, 张风肖, 陶杰梅, 李振彬, 杨静, 林金盈, 韦美秋, 崔刘福, 舒荣, 刘晓敏, 柯丹, 胡绍先, 叶丛, 杨岫岩, 李昊, 黄慈波, 高明, 赖蓓, 李兴福, 宋立军, 栗占国 . 全国多中心类风湿关节炎患者发生骨折的调查研究.中华风湿病学杂志. 2012; 16(2):102-106.
doi: 10.3760/cma.j.issn.1007-7480.2012.02.007
[6] Sun JX, He WT, Liu K, Shi XL . The research of Drynaria total flavonoids and osteoporosis. Zhongguo Gu Zhi Shu Song Za Zhi. 2008; 14(10):763-766. Chinese with abstract in English.
孙金谞, 何伟涛, 刘康, 史晓林 . 骨碎补总黄酮与骨质疏松症的研究.中国骨质疏松杂志. 2008; 14(10):763-766.
[7] Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS ,et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988; 31(3):315-324.
doi: 10.1002/(ISSN)1529-0131
[8] Kanis JA . Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int. 1994; 4(6) : 368-381.
doi: 10.1007/BF01622200
[9] Ge L, Liang J, Zhang HD . Analysis on pathogenesis of rheumatoid arthritis with osteoporosis. Zhonghua Zhong Yi Yao Za Zhi. 2011; 26(1):100-102. Chinese with abstract in English.
葛林, 梁军, 张华东 . 类风湿关节炎继发骨质疏松症病机探析.中华中医药杂志. 2011; 26(1):100-102.
[10] Deng CC, Ju ZB . Explore treatment of rheumatoid arthritis with osteoporosis from deficiency,toxin and blood-stasis. Xin Zhong Yi. 2012 ; 44(3):3-5. Chinese.
邓长财, 鞠中斌 . 类风湿关节炎继发骨质疏松症从毒、 虚、瘀论治探讨.新中医. 2012; 44(3):3-5.
[11] Shen PA. Pharmacology and clinical application of TCM. Beijing: People’s Medical Publishing House.2006: 189-190. Chinese.
沈丕安 . 中药药理与临床运用.北京: 人民卫生出版社. 2006: 189-190.
[12] Mei QX, Bi HX. Handbook of modern pharmacology of traditional Chinese medicine. Beijing : China Press of Traditional Chinese Medicine. 1998: 423. Chinese.
梅全喜, 毕焕新 . 现代中药药理手册.北京: 中国中医药出版社. 1998: 423.
[13] Zhang J, Li HP, Yang PL, Liu YH, Yang BH . Effects of total flavonoids from Rhizoma Drynarine medicated serum on proliferation, differentiation, cell cycle and apoptosis of osteoblasts in vitro. Zhong Yao Cai. 2009; 32(7):1090-1093. Chinese with abstract in English.
张军, 李浩鹏, 杨平林, 刘亦恒, 杨保辉 . 骨碎补总黄酮含药血清对成骨细胞增殖、分化、周期及凋亡的影响. 中药材. 2009; 32(7):1090-1093.
[14] Tian K, Yin WZ, Liu W, Xue Z, Zhao JD . Experimental study on the effect of diphosphonate and assemble flavone of Drynaria rhizome on the induced osteoblast. Zhongguo Gu Zhi Shu Song Za Zhi. 2007 ; 13(8):559-563. Chinese with abstract in English.
doi: 10.3969/j.issn.1006-7108.2007.08.008
田坤, 尹文哲, 刘伟, 薛震, 赵金东 . 二磷酸盐和骨碎补总黄酮对诱导后成骨细胞影响的实验研究.中国骨质疏松杂志. 2007; 13(8):559-563.
doi: 10.3969/j.issn.1006-7108.2007.08.008
[15] He ZG . Clinical study of Qianggu Capsule in the treatment of primary osteoporosis (type I) . Zhonghua Lin Chuang Yi Yao. 2003; 4(21):16-17. Chinese with abstract in English.
何正国 . 强骨胶嚢治疗I型原发性骨质疏松症临床研究.中华临床医药. 2003; 4(21):16-17.
[16] Xie YM, Ju DH, Zhao JN . Effects of osteopractic total flavone on bone mineral density and bone histomorphometry in ovariectomized rats. Zhongguo Zhong Yao Za Zhi. 2004; 29(4) : 343-346. Chinese with abstract inEnglish.
doi: 10.3321/j.issn:1001-5302.2004.04.016
谢雁鸣, 鞠大宏, 赵晋宁 . 骨碎补总黄酮对去卵巢大鼠骨密度和骨组织形态计量学影响.中国中药杂志. 2004; 29(4) : 343-346.
doi: 10.3321/j.issn:1001-5302.2004.04.016
[17] Xie YM, Wang HM, Shen L, Gao R, Du BJ, Lin BH, Tian JZ, Wu YN . Effects of Qianggu Capsule in treatment of patients with primary osteoporosis : a 162 cases of multi-center randomized clinical trial. Zhong Yi Za Zhi. 2004; 45(7):506-509. Chinese.
谢雁鸣, 王和鸣, 沈霖, 高蕊, 杜宝俊, 林柄辉, 田金洲, 吴育宁 . 强骨胶嚢治疗原发性骨质疏松症162例多中心随机对照临床研究.中医杂志. 2004; 45(7):506-509.
[1] Ning Guo, Fei Wu, Mei Wu, Yuan Wang, Qing Lang, Xiao Lin, Yi Feng. Progress in the design and quality control of placeboes for clinical trials of traditional Chinese medicine . Journal of Integrative Medicine, 2022, 20(3): 204-212.
[2] Joon-ho Lee, Yuan-ji Wei, Zhong-yan Zhou, Yu-ming Hou, Cheng-long Wang, Li-bo Wang, Hong-jin Wu, Yu Zhang, Wei-wei Dai. Efficacy of the herbal pair, Radix Achyranthis Bidentatae and Eucommiae Cortex, in preventing glucocorticoid-induced osteoporosis in the zebrafish model. Journal of Integrative Medicine, 2022, 20(1): 83-90.
[3] Rui-jin Qiu, Min Li, Jia-yuan Hu, Jing Chen, Hong-cai Shang. Methods for development of a core outcome set for clinical trials integrating traditional Chinese medicine and Western medicine. Journal of Integrative Medicine, 2021, 19(5): 389-394.
[4] Ju-Yeon Park, Young-Won Kwon, Sun-Ah Kim, Sun-Dong Park, Chang-Hyun Kim, Jin-Hee Kim, Ju-Hee Lee. Polyherbal formula SC-E3 inhibits rheumatoid arthritis activity in a mouse model of type-II collagen-induced arthritis. Journal of Integrative Medicine, 2021, 19(3): 265-273.
[5] Pratya Phetkate, Tanawan Kummalue, Prasob-orn Rinthong, Somboon Kietinun, Kusuma Sriyakul. Study of the safety of oral Triphala aqueous extract on healthy volunteers. Journal of Integrative Medicine, 2020, 18(1): 35-40.
[6] Arthur Yin Fan, Hui Ouyang, Xinru Qian, Hui Wei, David Dehui Wang, Deguang He, Haihe Tian, Changzhen Gong, Amy Matecki, Sarah Faggert Alemi. Discussions on real-world acupuncture treatments for chronic low-back pain in older adults. Journal of Integrative Medicine, 2019, 17(2): 71-76.
[7] L. Elisabeth Burton, Fares Qeadan, Mark R. Burge. Efficacy of equine-assisted psychotherapy in veterans with posttraumatic stress disorder. Journal of Integrative Medicine, 2019, 17(1): 14-19.
[8] Syed Nasir Abbas Bukhari, Fahad Hussain, Hnin Ei Thu, Zahid Hussain. Synergistic effects of combined therapy of curcumin and Fructus Ligustri Lucidi for treatment of osteoporosis: cellular and molecular evidence of enhanced bone formation. Journal of Integrative Medicine, 2019, 17(1): 38-45.
[9] Ubiratan Cardinalli Adler, Ana Carolina Acorinte, Fernando Oliveira Calzavara, Adriano Andréda Silva, Amarilys de Toledo Cesar, Maristela Schiabel Adler, Edson Zangiacomi Martinez, José Carlos Fernandes Galduróz. Double-blind evaluation of homeopathy on cocaine craving: A randomized controlled pilot study. Journal of Integrative Medicine, 2018, 16(3): 178-184.
[10] Shahnaz Karkon Varnosfaderani, Fataneh Hashem-Dabaghian, Gholamreza Amin, Mahbubeh Bozorgi, Ghazaleh Heydarirad, Esmaeil Nazem, Mohsen Nasiri Toosi, Seyed Hamdollah Mosavat. Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: A double-blind, randomized, placebo-controlled clinical trial. Journal of Integrative Medicine, 2018, 16(2): 126-131.
[11] Maryam Sharifi-Ardani, Leili Yekefallah, Saeed Asefzadeh, Marjan Nassiri-Asl. Efficacy of topical chamomile on the incidence of phlebitis due to an amiodarone infusion in coronary care patients: A double-blind, randomized controlled trial. Journal of Integrative Medicine, 2017, 15(5): 373-378.
[12] Susana Seca, Sebastian Kirch, António S.Cabrita, Henry J.Greten. Evaluation of the effect of acupuncture on hand pain, functional deficits and health-related quality of life in patients with rheumatoid arthritis—A study protocol for a multicenter, double-blind, randomized clinical trial. Journal of Integrative Medicine, 2016, 14(3): 219-227.
[13] Arthur Yin Fan. The methodology flaws in Hinman’s acupuncture clinical trial, Part III: Sample size calculation. Journal of Integrative Medicine, 2015, 13(4): 209-211.
[14] Arthur Yin Fan. The methodology flaws in Hinman’s acupuncture clinical trial, Part II: Zelen design and effectiveness dilutions. Journal of Integrative Medicine, 2015, 13(3): 136-139.
[15] Arthur Yin Fan. The methodology flaws in Hinman’s acupuncture clinical trial, Part I: Design and results interpretation. Journal of Integrative Medicine, 2015, 13(2): 65-68.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[2] Hao Li, Ming-jiang Yao, Wen-ming Zhao, Jie Guan, Lin-lin Cai, Ling Cui. A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment. Journal of Chinese Integrative Medicine, 2008, 6(1): 25-31
[3] Zhi-chun Jin. Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 5-8
[4] SUN Ming-yu, ZUO Jian, DUAN Ji-feng, HAN Jun, FAN Shi-ming, ZHANG Wei, ZHU Li-fang, YAO Ming-hui. Antitumor activities of kushen flavonoids in vivo and in vitro. Journal of Chinese Integrative Medicine, 2008, 6(1): 51-59
[5] Min Cheng, Qiong Feng, Shu-wen Qian, Hui Gao, Cui-qing Zhu. Preliminary assay of p-amyloid binding elements in heart-beneficial recipe. Journal of Chinese Integrative Medicine, 2008, 6(1): 68-72
[6] Ning-qun Wang, Liang-duo Jiang, Zong-xing Li. Research progress in asthma-related quality of life. Journal of Chinese Integrative Medicine, 2008, 6(1): 93-97
[7] Jing-yuan Mao, Chang-xiao Liu, Heng-he Wang, Guang-li Wei , Zhen-peng Zhang, Jie Xing, Wang Xian liang , Ying-fei Bi . Effects of Shenmai Injection on serum concentration and pharmacokinetics of digoxin in dogs with heart failure. Journal of Chinese Integrative Medicine, 2010, 8(11): 1070-1074
[8] Zhi-mei Wang, Bin Zhang. A study on translation of ellipses in Huangdi Neijing from perspective of hermeneutic theory. Journal of Chinese Integrative Medicine, 2010, 8(11): 1097-1100
[9] Gui Yu, Jie Wang. Thinking on building the network cardiovasology of Chinese medicine. Journal of Chinese Integrative Medicine, 2012, 10(11): 1206-1210
[10] Pedro Saganha João, Doenitz Christoph, Greten Tobias, Efferth Thomas, J. Greten Henry. Qigong therapy for physiotherapists suffering from burnout: a preliminary study. Journal of Chinese Integrative Medicine, 2012, 10(11): 1233-1239