中西医结合治疗糖尿病性骨质疏松临床疗效观察  

Clinical Observation on Integrated Traditional and Western Medicine in Treating Diabetes with Osteoporosis

作　　者：刘明慧[1] 龚光明[2] 

机构地区：[1]四川省南充市第五人民医院内三科,南充637100 [2]成都中医药大学附属医院,成都610072

出　　处：《世界中医药》2015年第1期42-45,共4页World Chinese Medicine

基　　金：(2012-2014)四川省科技支撑计划项目:糖尿病性骨质疏松症综合防治优化方案(编号:2011SZ0088)

摘　　要：目的:观察中西医结合治疗糖尿病性骨质疏松的临床疗效。方法:选取糖尿病性骨质疏松患者70例。按照随机对照原则分为中西医结合治疗组(35例)和对照组(35例)。2组均在控制血糖、血压、血脂基础上予以抗骨质疏松治疗。对照组给予补充钙剂和活性Vit D,骨痛明显者予以降钙素;结合治疗组:在对照组基础上,肝肾不足型,以左归丸、右归丸为主加减治疗;脾胃气虚型以六君子汤、补中益气汤为主加减治疗;骨痛明显者,加川芎、延胡索、姜黄。治疗8周后检测疗效、患者糖尿病控制指标(FPG、2h PG、Hb A1c)、骨密度(BMD)、骨代谢相关生化指标(血清钙、磷、碱性磷酸酶ALP、空腹尿钙/肌酐)并对其中医症状进行评价。8周后进入随访阶段,每6个月随访1次,随访1年,并对其远期疗效指标(初次骨折和再次骨折率、症状复发率、生存质量)进行评价。结果:对照组总有效率为74.29%,联合治疗组总有效率为88.75%(P<0.05),2组间差异存在统计学意义。相对于对照组,虽联合治疗组患者糖尿病控制指标(FPG、2h PG、Hb A1c)无统计学意义(P>0.05),BMD、骨代谢相关生化指标(血清钙、磷、碱性磷酸酶、空腹尿钙/肌酐)及中医症状评分均明显下降(P<0.05)。在远期疗效指标方面,联合治疗组患者的初次骨折和再次骨折率、症状复发率明显低于对照组,生活质量高于对照组(P<0.05)。结论:中西医联合治疗糖尿病性骨质疏松的临床疗效好于单纯使用补充钙剂和活性Vit D的西医传统疗法,适合在临床上推广。Objective：To observe the clinical efficacy of integrated traditional Chinese and Western medicine in treating diabetic osteoporosis.Methods：Seventy cases of diabetic patients with osteoporosis were divided into two groups：integrated therapy group （n=35） and control group （n=35） according to the principles of randomization.The control group received calcium supplementa-tion and active VitD.Apart from the same therapy as the control group,patients in the integrated therapy group who had insufficien-cy of liver and kidney were given Zuoguiwan and Youguiwan,and the patients who had insufficiency of spleen and stomach were given Liujunzi decoction and Buzhongyiqi decoction.After 8 weeks of treatment,indexes in terms of efficacy,glycemic index （ FPG, 2hPG,HbA1c）,bone density （BMD）,bone metabolism index and TCM symptom score were tested.After 8 weeks,we started a one-year follow-up,once every 6 months and evaluation of its long-term efficacy endpoint was made （ initial fractures and second fracture rates,the rate of recurrence of symptoms,quality of life）.Results：The control group’s total effective rate was 74.29%,and the integrated therapy group’s the total effective rate was 88.75%（P〈0.05）,and there was statistically significant difference be-tween the two groups.In addition to the diabetes control index,compared with the control group,the other indexes were significantly decreased in the integrated therapy group（P〈0.05）.Conclusion：The clinical efficacy of integrated Chinese and Western medi-cine treating diabetic osteoporosis is better than conventional Western medicine therapy of simple application of supplemental calci-um and active VitD,and it is suitable for clinical promotion.

关 键 词：中西医结合 糖尿病性骨质疏松 糖尿病 

分 类 号：R2-031[医药卫生—中西医结合] R587.2[医药卫生—中医学]