Osteoporosis is a multifactorial disease associated with diet, exercise, genetics and hormones. It is characterised by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk.
Women of post-menopausal age are at particular risk. The role of traditional Chinese medicine (TCM) related modalities in preventing and managing the disease has received little attention in well-designed research in western countries.
This study examined the effects of physical activity in the form of Tai Ji (Tai Chi), acupuncture and Chinese herbal medicine on bone loss by evaluating bone structure and function in menopausal women. At the same time, any changes in the severity of other menopausal signs and symptoms were also monitored.
Outcome measures
Dual Energy X-ray Absorptionmetry (DEXA) provides a measurement of bone mineral density (BMD) (expressed as g/cm2) throughout the whole body and is generally the most reliable means of assessing osteoporosis to date. However, DEXA has limitations in terms of cost and availability of equipment, and requires exposure to potentially harmful X-rays. As an alternative this study used broadband ultrasound attenuation (BUA) as a measure of bone structure and density which is increasingly being used in osteopenic screening programmes. The results of BUA were compared with DEXA at the end of the study. DEXA testing was only available at the end of the study due to the lack of availability of equipment and the need to restrict the number of such tests to minimise exposure to x-rays.
Low bone density results from either a reduction in the rate of bone growth and/or an increase in the rate of bone resorption to a level where there is a net loss of bone. In this study, serum osteocalcin (OSTN) was taken as a biomarker of bone formation while pyridinoline (PYR) and doxypyridinoline (D-PYR) levels in urine were used as markers of bone resorption. TCM diagnosis was also used to measure changes in participants' observable and reported menopausal symptoms.
Research design
A paired crossover group research design was used. Forty women undergoing menopause (average age 49.3 years) were recruited and divided into three groups: 12 into a Tai Ji exercise group, 14 into an acupuncture treatment group, and 14 into a herbal treatment group. Each group was split into two sub-groups of equivalent bone structure and function as determined by their broadband ultrasonic attenuation (BUA) and with reference to their menopausal status and age. One sub group initially became a treatment group while the other maintained a normal lifestyle as the control group. At the conclusion of the initial treatment period of four months, the groups "crossed over" and the control became the experimental groups and the initial experimental groups became the control. The second treatment period also continued for four months. Three sets of tests were administered: at the beginning of the study, after four months and after eight months. Dietary information regarding calcium intake was recorded by questionnaire at the time of testing. This was done to ensure that...