补肾健脾活血汤联合西医常规疗法治疗糖尿病骨质疏松症临床研究  

Clinical study of Bushen-Jianpi-Huoxue Decoction combined with western medicine in the treatment of diabetes mellitus with osteoporosis

作　　者：王聪聪 龚敏 王立红 周里钢 王朝迅 赵立[3] Wang Congcong;Gong Min;Wang Lihong;Zhou Ligang;Wang Chaoxun;Zhao Li(Department of Endocrinology,Shanghai Pudong Hospital,Shanghai 201399,China;Department of Dermatology,Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 202150,China;Department of Endocrinology,Shanghai First People's Hospital,Shanghai 200800,China)

机构地区：[1]上海市浦东医院内分泌科,201399 [2]上海交通大学医学院附属新华医院崇明分院皮肤科,202150 [3]上海市第一人民医院内分泌科,200800

出　　处：《国际中医中药杂志》2020年第10期955-959,共5页International Journal of Traditional Chinese Medicine

基　　金：上海市卫计委科研课题(M20170180)。

摘　　要：目的:评价补肾健脾活血汤联合西医常规疗法治疗糖尿病骨质疏松症的疗效。方法:将符合入选标准的2017年11月-2019年6月上海市浦东医院180例糖尿病合并骨质疏松症患者,按随机数字表法分为2组,每组90例。对照组采用西医常规疗法治疗,研究组在对照组基础上服用补肾健脾活血汤。2组均连续治疗3个月。分别于治疗前后进行中医症状评分,采用全自动生化分析仪检测空腹血糖和血清钙水平,采用糖化血红蛋白分析仪检测HbAlc水平,采用双抗体夹心ELISA法检测血清TNF-α、单核细胞趋化蛋白-1(monocyte chemoattractant protein-1, MCP-1)、胰岛素样生长因子-1 (insulin-like growth factor-1, IGF-1)及趋化素水平。采用双能X线测量仪检测骨密度,评价临床疗效。结果:研究组总有效率为95.6%(86/90)、对照组为76.7%(69/90),2组比较差异有统计学意义( χ2=13.425, P<0.01)。治疗后,研究组主症、次症及总分均低于对照组( t值分别为20.851、15.365、27.339, P值均<0.001);空腹血糖、HbAlc水平均低于对照组( t值分别为5.287、10.304, P值均<0.01),骨密度、血清钙水平均高于对照组( t值分别为3.644、3.964, P值均<0.01)。治疗后,研究组血清TNF-α[(6.30±2.05)pg/ml比(10.43±3.26)pg/ml, t=10.174]、MCP-1[(324.38±20.05)pg/ml比(411.14±27.67)pg/ml, t=24.087]及趋化素[(57.74±8.35)ng/ml比(63.34±10.64)ng/ml, t=3.928]水平均低于对照组( P<0.01),IGF-1[(167.79±11.31)μg/L比(142.21±9.34)μg/L, t=16.544]水平高于对照组( P<0.01)。 结论:补肾健脾活血汤联合西医常规疗法可有效改善糖尿病骨质疏松症患者的血糖水平和骨密度,提高临床疗效。Objective To explore the clinical application of Bushen-Jianpi-Huoxue Decoction combined with western medicine in the treatment of diabetes mellitus with osteoporosis.Methods A total of 180 patients with diabetes mellitus complicated with osteoporosis in Pudong Hospital from November 2017 to June 2019 who met the inclusion criteria were divided into two groups according to the random number table method,with 90 patients in each group.The control group was treated with conventional western medicine,the study group was treated with Bushen-Jianpi-Huoxue Decoction on the basis of the control group,and both groups were treated for 3 months.The TCM symptom scores were performed before and after treatment.Fasting blood glucose(FPG)and serum calcium levels were determined by a fully automated biochemical analyzer,HbAlc levels were determined by glycosylated hemoglobin analyzer,and TNF-α,monocyte chemoattractant protein-1(MCP-1),and insulin-like growth factor-1(IGF-1)and Chemerin levels were determined by a double-antibody sandwich ELISA.Bone mineral density(BMD)was measured by dual-energy X-ray apparatus and clinical efficacy was evaluated.Results The total effective rate of the study group was 95.6%(86/90),and that of the control group was 76.7%(69/90),where the difference between the two groups was statistically significant(χ2=13.425,P<0.01).After treatment,the main symptom,secondary symptom and total score of the study group were significantly lower than those in the control group(t=20.851,15.365,27.339,respectively,all Ps<0.01).After treatment,FPG and HbAlc in the study group were significantly lower than those in the control group(t=5.287,10.304,P<0.01),BMD and serum calcium were significantly higher than those in the control group(t=3.644,3.964,P<0.01).After treatment,the levels of serum TNF-α(6.30±2.05 pg/m vs.10.43±3.26 pg/m,t=10.174),MCP-1(324.38±20.05 pg/ml vs.411.14±27.67 pg/ml,t=24.087),Chemerin(57.74±8.35 ng/ml vs.63.34±10.64 ng/ml,t=3.928)in the study group were significantly lower than those in th

关 键 词：糖尿病 骨质疏松 糖尿病并发症 肾虚血瘀证 补肾健脾活血汤 二甲双胍 骨化三醇 治疗 临床研究性 

分 类 号：R587.2[医药卫生—内分泌] R580[医药卫生—内科学]