摘要
目的探讨阿仑膦酸钠联合钙尔奇D对糖尿病性骨质疏松症患者骨密度、骨代谢指标的影响及疗效观察。方法选取2017年1月~2018年4月在该院就诊的90例2型糖尿病性骨疏松症患者,随机分为观察组(n=45)与对照组(n=45)。两组患者均予以口服降糖药物或胰岛素控制血糖,并予以钙尔奇D 600 mg/次,1次/d,餐前口服。观察组加用阿仑膦酸钠70 mg/次,每周1次,口服,疗程6个月。观察两组治疗前和治疗6个月后骨密度、血清骨代谢指标[骨钙素N端中分子片段(N-MID)和骨特异性碱性磷酸酶(BALP)]水平的变化,并比较其临床疗效。结果治疗6个月后,两组股骨颈、股骨粗隆及华氏三角区骨密度值较前均明显改善(P<0.05或P<0.01),且观察组改善幅度较对照组更明显(P<0.05);两组血清N-MID指标较前明显上升,BALP指标较前明显下降(P<0.05或P<0.01),且观察组变化幅度优于对照组(P<0.05);同时观察组临床总有效率(95.56%)明显高于对照组(82.22%)(χ2=4.05,P<0.05)。结论阿仑膦酸钠联合钙尔奇D治疗糖尿病性骨质疏松症的疗效较确切,能明显改善其疼痛症状,增加其骨密度值,作用机制可能与其能升高血清N-MID指标,降低BALP指标,抑制骨吸收和促进骨形成密切相关。
Objective To investigate the effect of alendronate sodium combined with Caltrate D on bone mineral density and bone metabolism in patients with diabetic osteoporosis and efficacy observation. Methods 90 cases of type 2 diabetic osteoporosis in the hospital from January 2017 to April 2018 were enrolled. The patients were randomLy divided into observation group(n=45) and control group(n=45). Both groups of patients were given oral hypoglycemic drugs or insulin to control blood sugar, and also given Caltrate D 600 mg/time, 1 time/d, oral before meals. The observation group was treated with alendronate sodium 70 mg/time, once a week, orally, for 6 months. Changes in the levels of bone mineral density, serum bone metabolism index(molecular fragment of osteocalcin N-terminus) and bone-specific alkaline phosphatase(BALP) before treatment and at 6 months after treatment, and their clinical efficacy was compared.Results After 6 months of treatment, the bone mineral density of the femoral neck, femur trochanter and Fahrenheit triangle were significantly improved(P<0.05 or P<0.01). And the improvement of observation group was more obvious than that of the control group(P<0.05). The serum N-MID index of the two groups was better than that before(P<0.05).BALP indicator was significantly lower than that before(P<0.05 or P<0.01). And the change of the observation group was better than that of the control group(P<0.05). At the same time, the clinical total effective rate of the observation group(95.56%) was significantly higher than that of the control group(82.22%)(χ2=4.05, P<0.05). Conclusion Lendronate sodium combined with Caltrate D in the treatment of diabetic osteoporosis has exact efficacy, which can significantly improve the pain symptoms, increase its bone density value. The mechanism of action may be closely related to its ability to raise serum N-MID, reduce BALP, inhibit bone resorption and promote bone formation.
作者
杨群菲
张征宇
YANG Qunfei;ZHANG Zhengyu(Department of Pharmacy,Lishui Hospital of Traditional Chinese Medicine in Zhejiang Province,Lishui323000,China)
出处
《中国现代医生》
2020年第3期126-129,共4页
China Modern Doctor
基金
浙江省中医药科技计划项目(2017ZA145)。
关键词
2型糖尿病
骨质疏松症
阿仑膦酸钠
钙尔奇D
骨密度
骨代谢指标
Type 2 diabetes
Osteoporosis
Alendronate sodium
Caltrate D
Bone mineral density
Bone metabolism index
