依“治未病”理论用补肾强骨中药治疗糖尿病骨量减少妇女骨密度改善观察

According to Theory of Disease Prevention Treating Diabetic Osteopenia Women with Herbs for Nourishing Kidney and Strengthening Bone

目的:探讨依"治未病"理论用补肾强骨中药治疗糖尿病骨量减少妇女的骨密度改善情况。方法:将2013年3月—2014年3月因糖尿病并骨量减少在门诊治疗的患者随机分为使用补肾强骨中药治疗的治疗组和无中药治疗的对照组。参照《中药新药临床研究指导原则(试行)》中骨质疏松的疗效标准评估临床疗效。测量治疗前后骨密度BMD、T值,血清骨钙素和血钙评估骨密度改善情况。结果:(1)治疗后治疗组显效14例,有效17例,有效率为81.58%,显著高于有效率40.54%的对照组,相比差异有统计学意义(P<0.05)。(2)治疗后,治疗组L1-L3椎体和Ward三角区BMD以及L1-L4椎体、股骨颈、Ward三角区和大转子T值较治疗前显著提高,相比差异有统计学意义(P<0.01或0.05),对照组L1-L4椎体、股骨颈、Ward三角区和大转子BMD和T值较治疗前无明显变化,相比差异无统计学意义(P>0.05);治疗组L1-L3椎体和Ward三角区BMD显著高于对照组,相比差异有统计学意义(P<0.01或0.05),治疗组L1-L4椎体、股骨颈、Ward三角区和大转子T值显著高于对照组,相比差异有统计学意义(P<0.01或0.05)。(3)治疗后,治疗组BGP显著低于治疗前,相比差异有统计学意义(P<0.01),对照组BGP高于治疗前,相比差异无统计学意义(P>0.05);治疗组BGP显著低于对照组,差异有统计学意义(P<0.01)。两组患者组内及组间治疗前后血钙相比,差异无统计学意义(P>0.05)。结论:补肾强补骨中药能改善糖尿病骨量减少妇女骨密度,临床疗效满意。

Objective： To investigate the bone density improvement according to the theory of disease prevention research in the treatment of diabetic osteopenia women with herbs for nourishing kidney and strengthening bone.Methods： Between March 2013 and March 2014,diabetic osteopenia patients in the outpatient were randomly divided into the therapy group treated with herbs for nourishing kidney and strengthening bone and the control group treated without herbs.Clinical efficacy was evaluated according to the osteoporosis curative standard of Guiding Principles of Clinical Research on New Herbs（ Trial）.Improvement of bone density was evaluated by BMD and T value.The serum bone gla protein and serum calcium measured before and after treatment.Results：（ 1） After treatment in therapy group,14 cases were excellence and 17 effective and the effective rate was 81.58%,significantly higher than the control group＇s 40.54%.The difference was statistically significant（ P〈0.05）.（ 2） After treatment in therapy group,BMD of L1-L3 vertebral body and Ward＇s triangle and the T value of L1-L4 vertebral body,femoral neck,Ward＇s triangle and greater trochanter were significantly higher than those pretherapy and the difference was statistically significant（ P〈0.01 or P〈0.05）.In control group,the BMD and T value of L1-L4 vertebral body,femoral neck,Ward＇s triangle and greater trochanter had no obvious change and there was no statistically significant difference（ P〈0.05）.In therapy group,BMD of L1-L3 vertebral body and Ward＇s triangle was significantly higher than that in the control group and the difference was statistically significant（ P〈0.01 or P〈0.05）.In therapy group,the T value of L1-L4 vertebral body,femoral neck,Ward＇s triangle and greater trochanter was significantly higher than that in the control group and the difference was statistically significant（ P〈0.01 or P〈0.05）.（ 3） After treatment in therapy group,BGP was significantly lower than that pretherapy and the difference was statistically significant（ P〈0.01）.In control group,BGP was higher than that pretherapy and there was no statistically significant difference（ P〈0.05）.In therapy group,BGP was significantly lower than that of the control group and the difference was statistically significant（ P〈0.01）.Compared serum calcium before and after treatment intergroup and intragroup of two groups,there was no statistically significant difference（ P〈0.05）.Conclusion： Herbs for nourishing kidney and strengthening bone can improve the bone density of diabetic osteopenia women and the clinical efficacy was satisfied.