中老年女性糖尿病肾虚证及骨代谢紊乱的防治研究

Study on Prevention and Treatment of Middle and Aged Women Diabetes with Kidney Deficiency and Bone Metabolic Disturbance

目的：研究益气活血补肾中药对中老年女性糖尿病肾虚证及骨代谢紊乱的防治作用。方法：将５２例中老年女性糖尿病肾虚证患者，分组进行了单用降糖西药及在降糖西药基础上加用益气活血补肾中药治疗的效果观察。结果：治疗前，两组患者血清雌二醇（Ｅ２）水平明显低于正常，血清碱性磷酸酶（ＡＫＰ）、血、尿β２微球蛋白（β２－ＭＧ）及２４ｈ尿钙磷水平明显高于正常水平。治疗３个月后，两组患者血清Ｅ２水平与治疗前比较，无明显变化。两组患者血清ＡＫＰ，血、尿β２－ＭＧ水平及２４ｈ尿钙磷水平均有不同程度下降，但以中西医结合治疗的Ｂ组患者下降更明显。结论：中西医结合治疗的效果优于单纯西药治疗的效果。说明益气活血补肾中药对于防治和改善中老年女性糖尿病患者的肾虚证及骨矿物质丢失具有一定疗效，中西医结合具有相互协同和增效作用。

Objective: To Study the therapeutic effect of Chinese herbal medicine (CHM) for supplementing Qi, activating blood circulation and tonifying Kidney on prevention and treatment of middle and aged women diabetes with Kidney Deficiency and bone metabolic disturbance. Methods: Clinical observation was taken in 52 patients, who were divided into two groups, the control group (treated with hypoglycemic agent alone) and the treated group (treated with hypoglycemic agent and CHM). Results: Before treatment, patients of both groups showed obvious higher blood alkaline phosphatase, β 2 microglobulin (β 2 MG) level, urinary β 2 MG, calcium and phosphorus level, but lower serum estradiol level than those in normal subjects. After 3 months' treatment, no apparent change on serum estradiol level was observed, but other parameters were all lowered obviously in the two groups, the changes revealed more obvious in the treated group. The symptoms of Kidney Deficiency, such as lumbodorsal pain, general fatigue, palpitation and vertigo, were improved after treatment, and the improvement was also more obvious in the treated group. Conclusion: CHM for supplementing Qi, activating blood circulation and tonifying Kidney was effective in improving Kidney Deficiency and mineral substance loss of bone in middle and aged women diabetes patients. The CHM and western drugs may acted synergistically.