温针疗法联合玉液汤治疗2型糖尿病合并骨质疏松的疗效观察

Observations on the Efficacy of Warm Needling Therapy plus Yuye Decoction for TypeⅡ Diabetes with Osteoporosis

目的观察温针疗法联合玉液汤治疗2型糖尿病合并骨质疏松(DOP)的临床疗效。方法将88例DOP患者,随机分成对照组和研究组,每组44例。对照组采用常规西医治疗,研究组加用温针灸联合玉液汤治疗。观察两组治疗前后糖脂代谢、血液流变学、骨密度和骨代谢、胰岛β细胞功能变化,并比较两组临床疗效。结果两组治疗后胰岛素抵抗指数(Homa-IR)较治疗前均显著下降(P<0.05),而胰岛素敏感性指数(ISI)、空腹胰岛素(FINS)、胰岛素分泌指数(Homa-β)较治疗前均显著升高(P<0.05);且研究组以上指标均显著优于对照组(P<0.05)。两组治疗后骨特异性碱性磷酸酶(B-ALP)和Ⅰ型前胶原N端前肽(PINP)、骨钙素(OC)较治疗前均显著下降(P<0.05),腰椎和股骨颈骨密度、血钙(Ca)、血磷(P)较治疗前显著升高(P<0.05);且研究组以上指标均显著优于对照组(P<0.05)。两组治疗后空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbAIc)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、全血粘度(高切、中切、低切)、红细胞刚性指数、红细胞聚集指数较治疗前均显著下降(P<0.05);高密度脂蛋白胆固醇(HDL-C)较治疗前升高(P<0.05),且研究组以上指标均显著优于对照组(P<0.05)。研究组显效率和总有效率分别为47.7%、88.6%,显著高于对照组的27.3%、70.4%,差异有统计学意义(P<0.05)。结论温针疗法联合玉液汤治疗DOP能调整糖脂代谢,促进骨密度和骨代谢,改善微循环,促进胰岛β细胞功能,疗效显著。

Objective To observe the clinical efficacy of warm needling therapy plus Yuye decoction for typeⅡdiabetes with osteoporosis(diabetic osteoporosis,DOP).Method Eighty-eight DOP patients were randomized to control and study groups,with 44 cases in each group.The control group received conventional western drug therapy and the treatment group,warm needling therapy in addition.Glucose and lipid metabolisms,hemorheology,bone mineral density,bone metabolism and islet beta cell function were observed in the two groups before and after treatment.The clinical therapeutic effects were compared between the two groups.Result After treatment,the insulin sensitivity index(ISI)and the Homeostatic Model Assessment of Insulin Resistance(HOMA-IR)decreased significantly(P<0.05)and fasting insulin(FINS)and the Homeostasis Model Assessment(HOMA)-βincreased significantly(P<0.05)in the two groups compared with before and the above indicators were better in the study group than in the control group(P<0.05).After treatment,bone specific alkaline phosphatase(B-ALP),procollagen typeⅠN-terminal propeptide(PINP)and osteocalcin(OC)decreased significantly(P<0.05)and lumbar vertebral and femoral neck bone mineral density and blood calcium(Ca)and phosphorus(P)increased significantly(P<0.05)in the two groups compared with before and the above indicators were better in the study group than in the control group(P<0.05).After treatment,fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbAIc),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),whole blood viscosity(high,medium and low shear),erythrocyte rigidity index and erythrocyte aggregation index decreased significantly in the two groups compared with before(P<0.05)and were lower in the study group than in the control group(P<0.05).The marked efficacy rate and the total efficacy rate were 47.7%and 79.2%,respectively,in the study group and 27.3%and 70.4%,respectively,in the control group with statistically significant differences(P<0.05).Conclusion Warm needling therapy plus Yuye decoction can regulate glucose and lipid metabolisms,increase bone mineral density,promote bone metabolism,ameliorate microcirculation and improve islet beta cell function,and has a marked effect in treating DOP.