二甲双胍联合雷尼酸锶治疗糖尿病性骨质疏松的临床研究

Therapeutic effects of metformin combined with strontium ranelate on diabetic osteoporosis

目的观察二甲双胍联合雷尼酸锶治疗糖尿病性骨质疏松(DOP)的临床疗效。方法将120例DOP患者随机分为2组,每组60例。对照组行二甲双胍治疗,研究组在对照组治疗的基础上加服雷尼酸锶治疗,2组均治疗6个月。观察并记录2组患者治疗前后骨密度及骨代谢指标血钙、血磷、骨钙素(BGP)、抗酒石酸酸性磷酸酶-5b(TRACP-5b)、骨源性碱性磷酸酶(BAP)、及疼痛评分的变化情况。结果研究组临床总有效率为85.00%,对照组为70.00%,研究组临床疗效更佳(P<0.05)。治疗后对2组股骨颈、股骨粗隆及ward’s三角区处的骨密度进行检测显示,均较本组治疗前明显增加(P<0.05),且研究组显著高于对照组(P<0.05)。治疗后检测显示,研究组骨代谢相关的血钙、BAP及TRACP-5b水平均较本组治疗前降低(P<0.05),BGP升高(P<0.05),且BGP、BAP及TRACP-5b水平较对照组治疗后差异有统计学意义(P<0.05);对照组治疗后血钙、血磷较本组治疗前无明显变化(P<0.05),BGP、BAP及TRACP-5b较本组治疗前变化差异有统计学意义(P<0.05)。治疗后2组疼痛评分均较本组治疗前下降(P<0.05),且研究组评分低于对照组(P<0.05)。结论二甲双胍联合雷尼酸锶治疗DOP临床疗效确切。

Objective To observe the clinical efficacy of metformin combined with strontium ranelate in treatment of diabetic osteoporosis (DOP). Methods One hundred and twenty patients with DOP were randomly divided into control group ( n =60) and research group ( n =60).The patients in control group were treated by metformin, however,the patients in research group,on the basis of control group,were treated by strontium ranelate,with a treatment course of 6 months for both groups.The changes of bone mineral density ,bone metabolism indexes,serum calcium,serum phosphorus,osteocalcin (BGP),tartrate- resistant acid phosphatase-5b (TRACP-5b),bone-derived alkaline phosphatase (BAP),and the changes in pain scores before and after treatment were observed and compared between the two groups. Results The total effective rate was in research group was 85.00%,which was superior to that (70.00%) in control group ( P <0.05). After treatment,the bone mineral density at the femoral neck,femoral tuberosity,and ward'd triangles in both groups was significantly higher than that before treatment ( P <0.05),which in research group was significantly higher than that in control group ( P <0.05).After treatment ,the levels of serum calcium, BAP and TRACP-5b in research group were significantly lower than those before treatment ( P <0.05),however,the BGP levels were significantly increased ( P <0.05),moreover,there were significant differences in the levels of BGP,BAP,and TRACP-5b between the two groups ( P <0.05).In addition there were no significant differences in the levels of serum calcium and serum phosphorus in control group before and after treatment ( P >0.05), however, there were significant differences in the levels of BGP,BAP,and TRACP-5b in control group before and after treatment ( P <0.05).Besides,the pain scores after treatment in both groups were significantly decreased,as compared with those before treatment ( P < 0.05),moreover,which in research group were significantly lower than those in control group ( P <0.05). Conclusion The metformin combined with strontium ranelate has definite therapeutic effects on DOP.