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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
Blood phosphorus
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
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
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
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.
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