Classic yin and yang tonic formula for osteopenia: study protocol for a randomized controlled trial

Feng Yang, De-Zhi Tang, Xue-Jun Cui, Jonathan D Holz, Qin Bian, Qi Shi, Yong-Jun Wang, Feng Yang, De-Zhi Tang, Xue-Jun Cui, Jonathan D Holz, Qin Bian, Qi Shi, Yong-Jun Wang

Abstract

Background: Osteoporosis is a growing worldwide problem, with the greatest burden resulting from fractures. Nevertheless, the majority of fractures in adults occur in those with "osteopenia" (bone mineral density (BMD) only moderately lower than young normal individuals). Since long-term drug therapy is an expensive option with uncertain consequences and side effects, natural herbal therapy offers an attractive alternative. The purpose of this study is to evaluate the effect on BMD and safety of the Classic Yin and Yang Tonic Formula for treatment of osteopenia and to investigate the mechanism by which this efficacy is achieved.

Methods/design: We propose a multicenter double-blind randomized placebo-controlled trial to evaluate the efficacy and safety of the Classic Yin and Yang Tonic Formula for the treatment of osteopenia. Participants aged 55 to 75 with low bone mineral density (T-score between -1 and -2.5) and kidney deficiency in TCM will be included and randomly allocated into two groups: treatment group and control group. Participants in the treatment group will be treated with Classic Yin and Yang Tonic Granule, while the controlled group will receive placebo. Primary outcome measure will be BMD of the lumbar spine and proximal femur using dual-energy X-ray absorptiometry. Secondary outcomes will include pain intensity measured with visual analogue scales, quality of life, serum markers of bone metabolism, indices of Neuro-endocrino-immune network and safety.

Discussion: If the Classic Yin and Yang Tonic Formula can increase bone mass without adverse effects, it may be a novel strategy for the treatment of osteoporosis. Furthermore, the mechanism of the Chinese medical formula for osteoporosis will be partially elucidated.

Trial registration: This study is registered at ClinicalTrials.gov, NCT01271647.

Figures

Figure 1
Figure 1
The flow diagram of this study, including eligibility, screening, randomization and outcome assessment.

References

    1. Woo J, Ji M, Lau E. Population bone mineral density measurements for Chinese women and men in Hong Kong. Osteoporos Int. 2001;12:289–295. doi: 10.1007/s001980170118.
    1. Guang JY. The mode of thinking in Chinese clinical medicine:characteristics, steps and forms. Clin Acupunct Orient Med. 2001;2:23–28. doi: 10.1054/caom.2001.0075.
    1. Lips P, Cooper C, Agnusdei D. et al.Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis. Osteoporos Int. 1999;10(2):150–160. doi: 10.1007/s001980050210.
    1. Badia X, Díez-Pérez A, Alvarez-Sanz C, Díaz-López B, Díaz-Curiel M, Guillén F, Gonzalez-Macias J. Spanish GRECO Study Group. Measuring quality of life in women with vertebral fractures due to osteoporosis: A comparison of the OQLQ and QUALEFFO. Qual Life Res. 2001;10:307–317. doi: 10.1023/A:1012200508847.
    1. Badia X, Prieto L, Roset M, Herdman M. Development of a short osteoporosis quality of life questionnaire by equating items from two existing instruments. J Clin Epidemiol. 2002;55:32–40. doi: 10.1016/S0895-4356(01)00432-2.
    1. Gould D. et al.Visual Analogue Scale (VAS) Journal of Clinical Nursing. 2001;10:697–706. doi: 10.1046/j.1365-2702.2001.00525.x.
    1. Pocock SJ. Clinical trials: A practical approach. 1. Chichester: John Wiley Sons Ltd. England; 1983. pp. 123–141.
    1. Liu GY, Qiu GY, Wu ZH. Racial differences in peak bone mass assessed through NORLAND DXA. Chin J Osteoporosis. 2007;13(2):101–103.
    1. Wei SQ, Yang DZ, Wu T. et al.Evaluation of the efficacy and safety of domestic oral alendronate in the treatment of postmenopausal osteoporosis. Chin J Endocrinol Metab. 1998;14:348–350.
    1. Kanis JA, Johnell O, Oden A, Borgstrom F, Zethraeus N, De Laet C, Jonsson B. The risk and burden of vertebral fractures in Sweden. Osteoporos Int. 2004;15(1):20–26. doi: 10.1007/s00198-003-1463-7.
    1. Cauley JA, Hochberg MC, Lui LY, Palermo L, Ensrud KE, Hillier TA, Nevitt MC, Cummings SR. long-term risk for new fracture. JAMA. 2007;298(23):2761–2767. doi: 10.1001/jama.298.23.2761.
    1. Kung AW, Luk KD, Chu LW, Tang GW. Quantitative ultrasound and symptomatic vertebral fracture risk in Chinese women. Osteoporos Int. 1999;10:456–461. doi: 10.1007/s001980050254.
    1. Cauley JA, Palermo L, Vogt M, Ensrud KE, Ewing S, Hochberg M, Nevitt MC, Black DM. Prevalent vertebral fractures in black women and white women. J Bone Miner Res. 2008;23:1458–1467. doi: 10.1359/jbmr.080411.
    1. Raisz LG. Pathogenesis of osteoporosis: concepts, conflicts, and prospects. J Clin Invest. 2005;115:3318–3325. doi: 10.1172/JCI27071.
    1. Lindsay R, Hart DM, Aitken JM, MacDonald ED, Anderson JB, Clarke AC. Long-term prevention of postmenopausal osteoporosis by oestrogen. Lancet. 1976;1:1038–1041.
    1. Lindsay R, Hart DM, Clark DM. The minimum effective dose of estrogen for prevention of postmenopausal bone loss. Obstet Gynecol. 1984;63:759–763.
    1. Gordon GS, Picchi J, Roof BS. Antifracture efficacy of long-term oestrogens for osteoporosis. Trans Assoc Am Physicians. 1973;86:326–331.
    1. Hutchinson TA, Polansky SM, Feinstein AP. Postmenopausal estrogens protect against fractures of hip and distal radius. Lancet. 1979;2:706–709.
    1. Michaelsson K, Baron JA, Farahmand BY, Johnell O, Magnusson C, Persson PG, Persson I, Ljunghall S. Hormone replacement therapy and risk of hip fracture: Population based case-control study. The Swedish Hip Fracture Study Group. BMJ. 1998;316:1858–1863.
    1. Blank RD, Bockman RS. A review of clinical trials of therapies for osteoporosis using fracture as an end point. J Clin Densitom. 1999;2:435–452. doi: 10.1016/S1094-6950(06)60409-5.
    1. Mackova Z, Koblovska R, Lapcik O. Distribution of isoflavonoids in non-leguminous taxa - an update. Phytochemistry. 2006;67:849–855. doi: 10.1016/j.phytochem.2006.01.020.
    1. Qin L, Zhang G, Shi Y, Lee KM, Leung PC. In: Current Topics of Osteoporosis. Deng HW, Liu YZ, Guo CY, Chen D, editor. World Scientific Publisher, Singapore; 2005. Prevention and treatment of osteoporosis with traditional herbal medicine; pp. 513–531.
    1. Zhang G, Qin L, Shi Y. Epimedium-Derived Phytoestrogen Flavonoids Exert Beneficial Effect on Preventing Bone Loss in Late Postmenopausal Women: A 24-Month Randomized, Double-Blind and Placebo-Controlled Trial. J Bone Miner Res. 2007;22(7):1072–1079. doi: 10.1359/jbmr.070405.

Source: PubMed

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