老年前期和老年期糖尿病Ⅱ型患者骨密度的变化及其与中医辨证分型间的关系

BONE MINERAL DENSITY CHANGE IN PRESENILE AND SENILE DIABETES MELLITUS OF TYPE Ⅱ AND ITS RELATION TO TCM SYNDROMESDIFFERENTIATING TYPING

为了观察老年前期和老年期糖尿病患者的骨代谢变化及其与中医辨证间的内在联系，采用单光子骨密度仪对老年前期和老年期糖尿病患者６６例及正常对照组５９例进行骨密度测量比较，同时对糖尿病患者进行辨证分型并测定空腹血糖、钙、磷、ＡＫＰ进行组间对照。结果提示：①糖尿病患者无论男性或女性，其骨密度均明显降低（Ｐ＜０．０５），说明糖尿病患者与正常人比较，其肾虚和哀老的程度表现重，进程出现得早。②糖尿病患者各证型组间比较，其骨密度变化无显著性差异（Ｐ＞０．０５），说明糖尿病性骨密度降低，除与肾虚有关外，与其他脏腑功能的改变及气血运行状况均有关联。③糖尿病患者各辨证分型组间血糖、钙、磷、ＡＫＰ比较无显著性差异（Ｐ＞０．０５），说明老年前期和老年期糖尿病患者的一般血生化代谢指标变化不敏感，中医辨证分型与骨代谢生化指标间无特殊关联。

n order to observe the bone metabolism change in presenile and senile patients with diabetes mellitus (NIDDM) and its relation to TCM syndromesdifferentiating typing, the bone mineral densities (BMD) of 66 cases of presenile and senile NIDDM and 59 healthy volunteers were measured and compared by a single photon bone densitometer. At the same time, NIDDM patients were classified based on TCM differentiation of syndromes, and the contents of fasting bloodglucose, bloodcalcium, serum phosphorus and AKP were measured and compared between typing groups. The results showed: (1) In NIDDM, whether male or female, BMD were significantly lowered (P < 0.05), suggesting more severity and earlier progress of kidney sufficiency and aging in NIDDM compared with the healthy; (2) There was no significant difference (P > 0.05) in BMD changes of various typing groups, suggesting that diabetic BMD descending may be related to the functional change of other viscera and the circulation of blood and qi except kidney deficiency; (3) There was no significant difference (P > 0.05) in bloodglucose and calcium, serum phosphorus and AKP between various typing groups of NIDDM, showing no sensitive changes of blood biochemical metabolic indices in senile and presenile NIDDM and no special association between TCM syndromesdifferentiation typing and bone metabolic biochemical indices.