二甲双胍联合雷尼酸锶治疗糖尿病性骨质疏松症的临床效果研究  

Clinical effect of metformin combined with strontium ranelate in the treatment of diabetic osteoporosis

作　　者：谷丽平[1] 谢小琪 平立静 韩玉兰 刘淑敏 GU Liping;XIE Xiaoqi;PING Lijing;HAN Yulan;LIU Shumin(Department of Endocrinology,The People's Hospital of Dingzhou,Dingzhou Hebei 073000,China)

机构地区：[1]定州市人民医院内分泌科,河北定州073000 [2]定州市人民医院影像科,河北定州073000

出　　处：《空军医学杂志》2019年第2期174-177,共4页Medical Journal of Air Force

基　　金：河北省卫生和计生委员会计划内项目(20181781)

摘　　要：目的探讨二甲双胍联合雷尼酸锶治疗糖尿病性骨质疏松症的临床效果。方法选取2015年10月—2017年8月定州市人民医院收治的糖尿病性骨质疏松症患者120例,根据治疗方法不同分为对照组及观察组,每组60例。对照组予以二甲双胍联合阿仑膦酸钠治疗,观察组予以二甲双胍联合雷尼酸锶治疗,2组患者均治疗6个月,治疗结束后对2组临床疗效、骨密度、骨代谢相关指标、痛疼程度不良反应进行比较。结果观察组治疗的临床总有效率高于对照组,差异有统计学意义(P<0.05);2组患者经过治疗后Ward三角区、股骨大转子、股骨颈、腰椎L2-4区点骨密度较治疗前均明显升高(P<0.05),且观察组较对照组升高更明显(P<0.05);2组患者经过治疗后血清骨特异性碱性磷酸酶(bone-specific alkalinephosphatase,BA P)、骨钙素[骨谷氨酸蛋白(boneglaprotei n,BGP)]含量较治疗前明显升高(P<0.05),且观察组升高更明显(P<0.05);观察组患者治疗后血清人抗酒石酸酸性磷酸酶-5b(tartrate-resistant acid phosphatase-5b,TRAP-5b),血清Ⅰ型胶原C末端肽(serum C-terminal telopeptide of typeⅠcollagen,sCTX)和VAS评分较治疗前明显降低(P<0.05),且观察组降低更明显(P<0.05);2组患者不良反应发生率比较差异无统计学意义(χ~2=0.097,P=0.948)。结论二甲双胍联合雷尼酸锶治疗糖尿病性骨质疏松患者临床疗效显著,骨密度、骨代谢相关指标得到明显改善,疼痛明显减轻,且安全可靠,可在临床上推广应用。Objective To investigate the clinical effect of metformin combined with strontium ranelate in the treatment of diabetic osteoporosis.Methods One hundred and twenty cases of diabetic osteoporosis treated in our hospital between October 2015 and August 2017 were selected as the subjects,who were divided into the control group and the observation group,with 60 cases in each.The control group was treated with metformin combined with alendronate,while the observation group was given metformin combined with strontium ranelate.Patients were followed up for 6 months.The clinical effect,BMD,bone metabolism related indexes,pain degree,adverse reactions were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,BMD,Ward trigonum,and lumbar L2-4 area of the two groups were significantly increased(P<0.05),especially in the observation group(P<0.05).After treatment,serum contents of BAP and BGP were significantly increased in both groups(P<0.05),particularly in the observation group(P<0.05).After treatment,serum TRAP-5b,sCTX,and VAS score of the two groups significantly decreased(P<0.05),especially in the observation group(P<0.05).There was no statistically significant difference in the rate of adverse reactions between the two groups(χ^2=0.097,P=0.948).Conclusion Metformin combined with strontium ranelate is quite effective in the treatment of diabetic osteoporosis BMD and bone metabolism related indexes can be significantly improved,and pain is obviously relieved.This approach is s afe a nd w orthy of clinical a pplication..

关 键 词：糖尿病性骨质疏松 二甲双胍 雷尼酸锶 阿仑膦酸钠 临床疗效 

分 类 号：R587.2[医药卫生—内分泌] R6[医药卫生—内科学]