世界中医药
世界中醫藥
세계중의약
WORLD CHINESE MEDICINE
2015年
1期
42-45
,共4页
中西医结合%糖尿病性骨质疏松%糖尿病
中西醫結閤%糖尿病性骨質疏鬆%糖尿病
중서의결합%당뇨병성골질소송%당뇨병
Integrative Medicine%Diabetic osteoporosis%Diabetes
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VitD，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、2hPG、HbA1c）、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、2hPG、HbA1c）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VitD的西医传统疗法，适合在临床上推广。
目的：觀察中西醫結閤治療糖尿病性骨質疏鬆的臨床療效。方法：選取糖尿病性骨質疏鬆患者70例。按照隨機對照原則分為中西醫結閤治療組（35例）和對照組（35例）。2組均在控製血糖、血壓、血脂基礎上予以抗骨質疏鬆治療。對照組給予補充鈣劑和活性VitD，骨痛明顯者予以降鈣素；結閤治療組：在對照組基礎上，肝腎不足型，以左歸汍、右歸汍為主加減治療；脾胃氣虛型以六君子湯、補中益氣湯為主加減治療；骨痛明顯者，加川芎、延鬍索、薑黃。治療8週後檢測療效、患者糖尿病控製指標（FPG、2hPG、HbA1c）、骨密度（BMD）、骨代謝相關生化指標（血清鈣、燐、堿性燐痠酶ALP、空腹尿鈣／肌酐）併對其中醫癥狀進行評價。8週後進入隨訪階段，每6箇月隨訪1次，隨訪1年，併對其遠期療效指標（初次骨摺和再次骨摺率、癥狀複髮率、生存質量）進行評價。結果：對照組總有效率為74．29％，聯閤治療組總有效率為88．75％（ P＜0．05），2組間差異存在統計學意義。相對于對照組，雖聯閤治療組患者糖尿病控製指標（FPG、2hPG、HbA1c）無統計學意義（P＞0．05），BMD、骨代謝相關生化指標（血清鈣、燐、堿性燐痠酶、空腹尿鈣／肌酐）及中醫癥狀評分均明顯下降（P＜0．05）。在遠期療效指標方麵，聯閤治療組患者的初次骨摺和再次骨摺率、癥狀複髮率明顯低于對照組，生活質量高于對照組（ P＜0．05）。結論：中西醫聯閤治療糖尿病性骨質疏鬆的臨床療效好于單純使用補充鈣劑和活性VitD的西醫傳統療法，適閤在臨床上推廣。
목적：관찰중서의결합치료당뇨병성골질소송적림상료효。방법：선취당뇨병성골질소송환자70례。안조수궤대조원칙분위중서의결합치료조（35례）화대조조（35례）。2조균재공제혈당、혈압、혈지기출상여이항골질소송치료。대조조급여보충개제화활성VitD，골통명현자여이강개소；결합치료조：재대조조기출상，간신불족형，이좌귀환、우귀환위주가감치료；비위기허형이륙군자탕、보중익기탕위주가감치료；골통명현자，가천궁、연호색、강황。치료8주후검측료효、환자당뇨병공제지표（FPG、2hPG、HbA1c）、골밀도（BMD）、골대사상관생화지표（혈청개、린、감성린산매ALP、공복뇨개／기항）병대기중의증상진행평개。8주후진입수방계단，매6개월수방1차，수방1년，병대기원기료효지표（초차골절화재차골절솔、증상복발솔、생존질량）진행평개。결과：대조조총유효솔위74．29％，연합치료조총유효솔위88．75％（ P＜0．05），2조간차이존재통계학의의。상대우대조조，수연합치료조환자당뇨병공제지표（FPG、2hPG、HbA1c）무통계학의의（P＞0．05），BMD、골대사상관생화지표（혈청개、린、감성린산매、공복뇨개／기항）급중의증상평분균명현하강（P＜0．05）。재원기료효지표방면，연합치료조환자적초차골절화재차골절솔、증상복발솔명현저우대조조，생활질량고우대조조（ P＜0．05）。결론：중서의연합치료당뇨병성골질소송적림상료효호우단순사용보충개제화활성VitD적서의전통요법，괄합재림상상추엄。
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.
