补肾健脾活血汤联合骨化三醇治疗糖尿病合并骨质疏松症临床研究

Clinical Study on Kidney-Tonifying and Spleen-Strengthening and Blood Circulation-Activating Decoction Combined with Calcitriol Treatment of Patients with Diabetes Combined with Osteoporosis

目的:观察补肾健脾活血汤联合骨化三醇治疗糖尿病合并骨质疏松症患者的临床疗效。方法:86例糖尿病合并骨质疏松症患者随机分为对照组(43例)和观察组(43例)。对照组给予骨化三醇,观察组给予补肾健脾活血汤联合骨化三醇治疗。比较两组患者临床疗效、治疗前后中医证候积分,检测治疗前后空腹血糖(fasting blood-glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、骨密度(bone mineral density,BMD)、血清钙水平,同时观察不良反应。结果:观察组有效率为95.35%,对照组有效率为76.74%,两组有效率比较,差异有统计学意义(P<0.05)。治疗前两组患者主症、次症及中医证候积分比较,差异无统计学意义(P>0.05);治疗后两组以上指标均显著降低(P<0.05),且观察组显著低于对照组(P<0.05)。治疗前两组患者FPG、HbA1c、血清钙、BMD水平比较,差异无统计学意义(P>0.05);治疗后两组患者以上指标均显著改善(P<0.05),且观察组优于对照组,差异具有统计学意义(P<0.05)。观察组与对照组不良反应发生率分别为2.33%、11.63%,但差异无统计学意义(P>0.05)。结论:补肾健脾活血汤联合骨化三醇可有效缓解糖尿病合并骨质疏松症患者临床症状,且可改善患者FPG、HbA1c、Ca、BMD水平,同时减少不良反应。

Objective： To discuss the clinical effect of kidney-tonifying and spleen-strengthening and blood circulation-activating decoction combined with calcitriol treatment of patients with diabetes combined with osteoporosis. Methods： 86 cases of patients with diabetes combined with osteoporosis were randomly divided into the control group(43 cases） and the observation group(43 cases）. The control group was given calcitriol,while the observation group was treated with kidney-tonifying and spleen-strengthening and blood circulation-activating decoction combined with calcitriol. The treatment effect was compared between the two groups,as well as the TCM syndrome scores before and after treatment,changes of fasting blood glucose(FPG）,glycosylated hemoglobin(HbA1c）,bone mineral density(BMD）,serum calcium(Ca） levels,and the adverse reactions were observed at the same time. Results： The effective rate was 95. 35% in the observation group and 76. 74% in the control group. The difference between the two groups was statistically significant(P 〈 0. 05）. The differences in the scores of main symptoms,secondary symptoms and TCM syndrome between the two groups were not statistically significant(P 〉 0. 05）,which were significantly decreased after treatment(P 〈 0. 05）,and the scores in the observation group were significantly lower than those in the control group(P 〈 0. 05）. The differences in the levels of FPG,HbA1c,Ca and BMD were not statistically significant between the two groups before treatment(P 〉 0. 05）,which were significantly improved after treatment(P 〈 0. 05）,and the levels in the observation group were better than those in the control group,between which the differences were statistically significant(P 〈 0. 05）. The incidence rates of adverse reactions in the observation group and control group were respectively 2. 33% and 11. 63%,of which the former was lower than the latter,but the difference was not statistically significant(P 〉 0. 05）. Conclusion： Kidney-tonifying and spleen-strengthening and blood circulation-activating decoction combined with calcitriol treatment of patients with diabetes combined with osteoporosis has good clinical symptoms and effect,which can improve the levels of FPG,HbA1c,Ca,BMD and reduce the adverse reactions at the same time.