六味地黄丸治疗2型糖尿病性骨质疏松症的疗效评价

来源:用户上传      作者:安娟　匡浩铭　李振宇　张子鸣　沈玲琳　戎宽　匡建军

　　 〔摘要〕 目的 ^察六味地黄丸对2型糖尿病性骨质疏松症患者的临床疗效。方法 选取在湖南省中医药研究院附属医院门诊就诊的2型糖尿病性骨质疏松症患者60例，按随机数字表法分为治疗组和对照组，每组30例。两组均给予基础治疗，对照组在基础治疗上加用钙尔奇D片和阿仑膦酸钠维D3片，治疗组在对照组的基础上再加服六味地黄丸，观察时限均为3个月。记录治疗前后的中医证候积分及视觉模拟评分（visual analogue scale， VAS），检测血糖水平[空腹血糖（fasting plasma glucose， FPG）、糖化血红蛋白（hemoglobin A1c， HbA1c）和餐后2 h血糖（2 hours postprandial blood sugar， 2hPBG）]、骨密度T值（腰椎L2-4）、骨代谢指标[骨钙素（bone glaprotein， BGP）、Ⅰ型胶原β降解产物（β-C-terminal telopeptide of typeⅠcollagen， β-CTX）]、血清超氧化物歧化酶（superoxide dismutase， SOD）、丙二醛（malondialdehyde， MDA）等指标。结果 治疗组总有效率93.3%，优于对照组的66.7%（P<0.05）。治疗后，治疗组中医证候积分低于对照组（P<0.05）;治疗组的β-CTX、MDA含量及VAS评分明显低于对照组（P<0.05），骨密度T值、BGP含量、SOD含量显著高于对照组（P<0.05）;治疗组血清FPG、2hPBG、HbA1c明显低于对照组（P<0.05）。结论 六味地黄丸可有效治疗2型糖尿病性骨质疏松症，增加骨密度，减轻疼痛症状，抗氧化应激，有助于提高患者生活质量。
　　 〔关键词〕 六味地黄丸;骨质疏松症;2型糖尿病;骨密度;骨代谢;氧化应激;血糖
　　 〔中图分类号〕R259 〔文献标志码〕B 〔文章编号〕doi：10.3969/j.issn.1674-070X.2022.07.027
　　Effect evaluation of Liuwei Dihuang Pill on type 2 diabetic osteoporosis
　　AN Juan1， KUANG Haoming1， LI Zhenyu1， ZHANG Ziming1， SHEN Linglin1， RONG Kuan2， KUANG Jianjun3*
　　（1. Hunan University of Chinese Medicine， Changsha， Hunan 410208， China; 2. Hunan Academy of Traditional Chinese Medicine Affiliated Hospital， Changsha， Hunan 410006， China; 3. Hunan Academy of Traditional Chinese Medicine， Changsha， Hunan 410006， China）
　　〔Abstract〕 Objective To observe the clinical effect of Liuwei Dihuang Pill on type 2 diabetic osteoporosis. Methods A total of 60 patients with type 2 diabetic osteoporosis in the outpatient department of Hunan Academy of Traditional Chinese Medicine Affiliated Hospital were randomly divided into treatment group and control group， with 30 cases in each group. Both groups were given basic treatment. The control group was added with Caltrate D tablets and alendronate vitamin D3 tablets on the basis of basic treatment. The treatment group was added with Liuwei Dihuang Pill on the basis of the control group. The observation time was three months. The traditional Chinese medicine （TCM） syndrome score and visual analogue scale （VAS） before and after treatment were recorded， and the blood glucose levels [fasting plasma glucose （FPG）， hemoglobin A1c （HbA1c） and 2 h postprandial blood sugar （2hPBG）]， bone mineral density T value （lumbar L2-4）， bone metabolism indexes [（bone gla protein （BGP） and β-C-terminal telopeptide of typeⅠcollagen （β-CTX）]， superoxide dismutase （SOD）， malondialdehyde （MDA）， ect. were detected. Results The total effective rate in the treatment group was 93.3%， which was better than 66.7% in the control group （P<0.05）. After treatment， the TCM syndrome score in the treatment group was lower than that in the control group （P<0.05）; the content levles of β-CTX， MDA and VAS in the treatment group were significantly lower than those in the control group （P<0.05）， and the content levels of bone mineral density T value， BGP and SOD were significantly higher than those in the control group （P<0.05）; the serum FPG， 2hPBG and HbA1c in the treatment group were significantly lower than those in the control group （P<0.05）. Conclusion Liuwei Dihuang Pill can effectively treat type 2 diabetic osteoporosis， increase bone mineral density， reduce pain symptoms， resist oxidative stress， and help to improve the quality of life of patients.

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