阿仑膦酸钠联合阿托伐他汀治疗糖尿病性骨质疏松的疗效观察

Efficacy of alendronate combined with atorvastatin in the treatment of type 2 diabetes mellitus with osteoporosis

目的 探讨阿仑膦酸钠联合阿托伐他汀治疗糖尿病性骨质疏松（DOP）的临床疗效.方法 选择DOP患者80例,采用随机数字表法分为观察组（43例）和对照组（37例）.对照组给予阿仑膦酸钠治疗,观察组给予阿仑膦酸钠联合阿托伐他汀治疗.比较两组治疗前后前臂、腰椎正位、股骨颈和股骨粗隆的骨密度值和疼痛数字评分（NRS评分）.结果 治疗前,两组前臂、腰椎正位、股骨颈和股骨粗隆骨密度及NRS评分差异均无统计学意义（均P〉00.05）.治疗后,观察组与对照组前臂[（0.64±0.10）g/cm2比（0.68±0.11）g/cm2]、腰椎正位[（0.82±0.28）g/cm2比（0.70±0.11）g/cm2]、股骨颈[（0.71±0.09）g/cm2比（0.66±0.05）g/cm2]、股骨粗隆[（0.76±0.14）g/cm2比（0.70±0.08）g/cm2]骨密度差异均有统计学意义（t=2.563、2.448、3.002、2.302,均P〈0.05）,观察组NRS评分低于对照组[（1.32±0.10）比（2.47±0.67）],差异有统计学意义（t=23.651,P〈0.05）.治疗过程中,观察组出现2例恶心、1例腹痛和1例肌肉疼痛,对照组出现1例恶心,两组不良反应发生率差异无统计学意义（χ2=1.478,P=0.224）.结论 阿仑膦酸钠联合阿托伐他汀治疗DOP能够更好地升高骨密度,减轻患者疼痛,而且安全性较高,值得临床推广应用.

Objective To explore the therapeutic effect of alendronate combined with atorvastatin in the treatment of patients with type 2 diabetes mellitus complicated with osteoporosis. Methods 80 patients with diabetic osteoporosis（ DOP） treated by endocrinology were selected. They were divided into observation group and control group by random number table method. The patients in the control group were given alendronate sodium, and the patients in the observation group were given alendronate and atorvastatin at the same time. The bone mineral density （ BMD） of the forearm,lumbar vertebra,femoral neck and femoral trochanter Numeric rating scales（ NRS score） were measured before and after treatment. Results Before treatment,the BMD in forearm,lumbar vertebra,femoral neck and femoral trochanter, and NRS score between the two groups had no statistically significant differences （ all P〉0.05）.Aftertreatment,theBMDofforearm[（0.64±0.10）g/cm2vs.（0.68±0.11）g/cm2,t=2.563]andlumbar vertebrae[（0. 82 ± 0. 28） g/cm2 vs. （0. 70 ± 0. 11） g/cm2,t =2. 448],femoral neck[（0. 71 ± 0. 09） g/cm2 vs. （0.66±0.05）g/cm2,t=3.002],femoraltrochanter[（0.76±0.14）g/cm2vs.（0.70±0.08）g/cm2,t=2.302] of the observation group were higher than those of the control group,and the NRS score[（1. 32 ± 0. 10） points vs. （2. 47 ± 0. 67）points]was lower than the control group（t=23. 651,P〈0. 05）. There were 2 cases of nausea,1 case of abdominal pain and 1 case of muscle pain in the observation group,and 1 case of nausea occurred in the control group,the incidence rate of adverse reaction between the two groups had no statistically significant difference （χ2 =1. 478,P=0. 224）. Conclusion Alendronate combined with atorvastatin can improve BMD,relieve pain in patients with DOP,and it is safe and worthy of clinical application.