六味地黄汤加减对肝肾阴虚型2型糖尿病绝经后女性患者骨密度的影响  

Effect of modified Liuwei Dihuang Decoction on bone mineral density in postmenopausal women with liver and kidney yin deficiency type 2 diabetes

作　　者：刘美琴 贾诺彤 钟继富 LIU Mei-qin;JIA Nuo-tong;ZHONG Ji-fu(Department of Endocrinology,Shanxi Hospital of Integrated Traditional Chinese and Western Medicine,Taiyuan 030013,China.;不详)

机构地区：[1]山西省中西医结合医院内分泌科,太原030013 [2]山西中医药大学,太原030013

出　　处：《中国处方药》2024年第4期159-162,共4页Journal of China Prescription Drug

基　　金：山西省中医药管理局课题(2023ZYYDA2032)。

摘　　要：目的探讨六味地黄汤加减对肝肾阴虚型2型糖尿病绝经后女性患者骨密度影响。方法选取某院2022年5月~2023年5月收治的204例肝肾阴虚型2型糖尿病绝经后女性患者,随机分为两组。对照组102例使用常规控制血糖及补钙对症治疗,观察组102例患者在对照组基础上联合使用六味地黄汤加减治疗。两组患者均治疗6个月。比较两组患者治疗前后血糖情况[糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹血糖(fasting plasma glucose,FPG)]、腰椎L2~4及左侧股骨颈骨密度(bone mineral density,BMD)、骨代谢标志物[总型胶原氨基酸延长肽(Total type I collagen amino terminal lengthening peptide,PINP)、β-胶原特殊序列(β-Crosslaps,β-CTX)]、中医证候积分。结果两组患者入院时血糖情况、腰椎及股骨颈骨密度、骨代谢标志物及中医证候积分差异无统计学意义(P>0.05)。治疗后,两组患者各指标均有好转(P<0.05),观察组患者HbA1c、FPG、PINP、β-CTX水平、中医证候积分较低(P<0.05),腰椎L2~4及左侧股骨颈骨BMD值较高(P<0.05)。结论肝肾阴虚型2型糖尿病绝经后女性患者使用常规治疗联合六味地黄汤加减可改善患者中医证型积分,有效控制患者血糖控制情况,提升患者骨密度,改善骨代谢标志物水平。Objective To explore the effect of modified Liuwei Dihuang Decoction on bone mineral density of postmenopausal women with type 2 diabetes mellitus of liver and kidney yin deficiency.Methods From May 2022 to May 2023,204 postmenopausal women with type 2 diabetes mellitus with liver and kidney yin deficiency were selected and randomly divided into two groups.102 cases in the control group were treated symptomatic treatment with routine blood glucose control and calcium supplementation,while 102 cases in the observation group were treated with modified Liuwei Dihuang Decoction on the basis of the control group.Both groups were treated for 6 months.The blood glucose[glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG)],lumbar L2~4 and bone mineral density(BMD)of the left femoral neck,bone metabolism markers[total type I collagen amino terminal lengthening peptide(PINP),β-collagen special sequence(β-Crosslaps,β-CTX)],TCM syndrome score were compared between the two groups before and after treatment.Results There was no significant difference in blood glucose,bone mineral density of lumbar vertebrae and femoral neck,bone metabolism standard and TCM syndrome score between the two groups upon admission(P>0.05).After treatment,all the indexes of patients in both groups improved(P<0.05).After treatment,the levels of HbA1c,FPG,PINP,β-CTX and TCM syndrome score in the observation group were lower(P<0.05),while the BMD values of lumbar L2~4 and left femoral neck bone were higher(P<0.05).Conclusion The conventional treatment combined with modified Liuwei Dihuang Decoction can improve the TCM syndrome score,effectively control the blood glucose control,improve the bone mineral density and improve the level of bone metabolism markers in postmenopausal women with type 2 diabetes mellitus with liver and kidney yin deficiency.

关 键 词：六味地黄汤加减 2型糖尿病 绝经后骨质疏松 肝肾阴虚 

分 类 号：R259[医药卫生—中西医结合]