芪精益肾健骨方联合碳酸钙D3片对肝肾亏损型糖尿病性骨质疏松症患者中医证候积分、骨密度及血清骨代谢指标的影响

Effects of Qiyijingshenjiangu Decoction Combined with Calcium Carbonate D3 Tablets on Traditional Chinese Medicine Syndrome Score,Bone Density and Serum Bone Metabolism Index in Patients with Liver and Kidney Deficiency Type Diabetic Osteoporosis

目的:观察芪精益肾健骨方联合碳酸钙D3片对肝肾亏损型糖尿病性骨质疏松症(DOP)患者中医证候积分、骨密度及血清骨代谢指标的影响。方法:按照随机数字表法将2021年5月~2022年12月期间常州市中医医院及无锡市中医医院收治的132例肝肾亏损型DOP患者分为研究组(n=66,接受芪精益肾健骨方联合碳酸钙D3片治疗)、对照组(n=66,接受碳酸钙D3片治疗)。对比两组疗效、中医证候积分、血糖指标[空腹血糖(FBG)、葡萄糖负荷2h血糖水平(2hPG)、糖化血红蛋白(HbA1c)]、骨密度指标[股骨颈、腰椎骨L1~4和Ward三角区骨密度]及血清骨代谢指标[骨碱性磷酸酶(BALP)、骨钙素(BGP)、β-胶原片段(β-CTX)]。结果:与对照组的临床总有效率77.27%相比,研究组的95.45%更高(P<0.05)。治疗12周后,两组中医证候积分(主症、次症、总分)、血糖指标(FBG、2hPG、HbA1c)、血清骨代谢指标(BALP、BGP、β-CTX)下降,且研究组低于对照组(P<0.05)。治疗12周后,两组股骨颈、腰椎骨L1~4、Ward三角区骨密度升高,且研究组高于对照组(P<0.05)。结论:芪精益肾健骨方联合碳酸钙D3片治疗肝肾亏损型DOP,可促进患者症状改善,可能与降低血糖,降低中医证候积分,调节骨密度及血清骨代谢指标有关。

Objective:To observe the effects of qiyijingshenjiangu decoction combined with calcium carbonate D3 tablets on traditional chinese medicine syndrome score,bone density and serum bone metabolism index in patients with liver and kidney deficiency type diabetic osteoporosis(DOP).Methods:132 patients with liver and kidney deficiency type DOP admitted to Changzhou Hospital of Traditional Chinese Medicine and Wuxi Hospital of Traditional Chinese Medicine from May 2021 to December 2022 were divided into study group(n=66,received the treatment of qiyijingshenjiangu decoction combine with calcium carbonate D3 tablets)and control group(n=66,received the treatment of calcium carbonate D3 tablets)according to the random number table method.The efficacy,traditional chinese medicine syndrome score,blood glucose indexes[fasting blood glucose(FBG),glucose load 2h blood glucose level(2hPG),glycosylated hemoglobin(HbA1c)],bone density indexes[bone density of femoral neck,lumbar vertebrae L1~4 and Ward triangle]and serum bone metabolism indexes[bone alkaline phosphatase(BALP),osteocalcin(BGP),β-collagen fragment(β-CTX)]were compared between two groups.Results:Compared with the total clinical effective rate of 77.27%in control group,95.45%in study group was higher(P<0.05).12 weeks after treatment,traditional chinese medicine syndrome score(main symptoms,secondary symptoms,total scores),blood glucose indexes(FBG,2hPG,HbA1c)and serum bone metabolism indexes(BALP,BGP,β-CTX)in two groups decreased,and study group were lower than those of control group(P<0.05).12 weeks after treatment,the bone density in the L1-4 and Ward triangle regions of the femoral neck and lumbar spine increased in two groups,and study group were higher than those of control group(P<0.05).Conclusion:The combination of Qijingyishenjiangu decoction combined with calcium carbonate D3 tablets can promote the improvement of symptoms in DOP patients with liver kidney deficiency type, which may be related to reduce the blood sugar, reducetraditional chinese medicine syndrome score, regulate bone density, and serum bone metabolism indexes.