身痛逐瘀汤联合右归丸治疗老年糖尿病合并骨质疏松症92例
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摘要
目的:观察身痛逐瘀汤联合右归丸治疗老年糖尿病合并骨质疏松症(DOP)的临床疗效。方法:按照入院次序将184例DOP患者均分为2组,对照组以右归丸、钙尔奇D_3治疗,观察组在对照组治疗的基础上加服身痛逐瘀汤。对比2组治疗前后中医证候积分、血清骨钙素(BGP)、尿液中Ⅰ型胶原交联氨基末端肽(NTX)含量、X线骨密度(BMD)值及血液流变性变化情况,评估2组临床疗效。结果:中医证候积分、血清BGP及尿液中NTX含量治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组间比较差异也有统计学意义(P<0.05)。华氏三角区、股骨近端及腰椎L_2、L_3、L_4节段处的BMD值治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较差异也有统计学意义(P<0.05)。血液流变学指标治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较差异也有统计学意义(P<0.05)。对照组总有效率70.65%;观察组总有效率92.39%,临床疗效2组比较,差异有统计学意义(P<0.05)。结论:在常规控制血糖治疗的基础上,以右归丸和身痛逐瘀汤联合治疗,可有效缓解DOP患者临床症状,提高骨密度,加速骨形成,改善血液流变性,提高临床疗效。
Objective:To survey clinical effects of ShenTong ZhuYu decoction and YouGui pills in treating senile diabetic osteoporosis. Methods: According to the visiting sequence, 184 patients were randomized into two groups, the control group were treated by YouGui pills and Caltrate D_3, and the observation group took ShenTong ZhuYu decoction on the foundation of the therapy the control group accepted. To compare TCM syndrome scores,BGP, urinary NTX contents, BMD values and hemorheology changes between both groups before and after treating,and assess clinical effects of both groups. Results: The difference was statistically significant in the comparisons of TCM syndrome scores, BGP, urinary NTX contents within two groups before and after treating(P<0.05); the difference was statistically significant in the comparison between both groups after treating(P<0.05). There were the significant differences in the comparisons of BMD values of ward′s triangle, proximal femur, lumbar L_2, L_3 and L_4 segments within two groups before and after treating(P<0.05); the difference was statistically significant in the comparison between both groups after treating(P <0.05). The difference was statistically significant in the comparison of hemorheological indexes within two groups before and after treating(P<0.05); the difference showes statistical meaning in the comparisons between both groups after treating(P<0.05). total effective rates of the control group and the observation groups were 70.65% and 92.39%. The difference had statistical meaning in the comparisons of clinical effects between both groups(P <0.05). Conclusion: Based on conventional therapy of controlling blood glucose, the combination of ShenTong ZhuYu decoction and YouGui pills in treating senile diabetic osteoporosis could effectively relieve clinical symptoms, raise BMD, enhance bone formation, improve hemorheology and raise clinical effects.
Objective:To survey clinical effects of ShenTong ZhuYu decoction and YouGui pills in treating senile diabetic osteoporosis. Methods: According to the visiting sequence, 184 patients were randomized into two groups, the control group were treated by YouGui pills and Caltrate D_3, and the observation group took ShenTong ZhuYu decoction on the foundation of the therapy the control group accepted. To compare TCM syndrome scores,BGP, urinary NTX contents, BMD values and hemorheology changes between both groups before and after treating,and assess clinical effects of both groups. Results: The difference was statistically significant in the comparisons of TCM syndrome scores, BGP, urinary NTX contents within two groups before and after treating(P<0.05); the difference was statistically significant in the comparison between both groups after treating(P<0.05). There were the significant differences in the comparisons of BMD values of ward′s triangle, proximal femur, lumbar L_2, L_3 and L_4 segments within two groups before and after treating(P<0.05); the difference was statistically significant in the comparison between both groups after treating(P <0.05). The difference was statistically significant in the comparison of hemorheological indexes within two groups before and after treating(P<0.05); the difference showes statistical meaning in the comparisons between both groups after treating(P<0.05). total effective rates of the control group and the observation groups were 70.65% and 92.39%. The difference had statistical meaning in the comparisons of clinical effects between both groups(P <0.05). Conclusion: Based on conventional therapy of controlling blood glucose, the combination of ShenTong ZhuYu decoction and YouGui pills in treating senile diabetic osteoporosis could effectively relieve clinical symptoms, raise BMD, enhance bone formation, improve hemorheology and raise clinical effects.
引文
[1]林玺,许旭昀,陈子睿.统计分析糖尿病性骨质疏松症的病机及用药规律[J].新中医,2016,48(7):261-263.
[2]杨茜,张海雄,韩雪梅,等.糖尿病患者胰岛功能与低血钙诱发骨质疏松症关系的临床研究[J].陕西医学杂志,2015,44(9):1193-1195.
[3]王颢,潘剑.仙灵骨葆胶囊治疗老年骨质疏松性腰椎压缩骨折40例[J].西部中医药,2017,30(8):89-91.
[4]李兆楠,裴瑞霞.六味地黄汤加味治疗2型糖尿病合并骨质疏松症60例[J].陕西中医,2015,36(9):1174-1175.
[5]董林,雷宁波,邢涛,等.损伤胶囊对绝经后骨质疏松症患者疼痛、骨密度及骨代谢生化指标的影响[J].西部中医药,2017,30(11):8-11.
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[8]林奇生,邹学农.骨化三醇加阿伦磷酸钠治疗骨质疏松疗效观察及不良反应[J].河北医学,2017,23(1):128-131.
[9]郭定聪,何生.原发性骨质疏松症中医证型分布及其与骨折关系研究[J].中国医院药学杂志,2016,36(5):103.
[10]林德涛.中西医结合治疗糖尿病性骨质疏松症疗效观察[J].新中医,2017,49(2):57-59.
[11]柴仪,李倩,田伟明,等.补肾活血方对骨质疏松引发的压缩性椎体骨折患者骨代谢和动脉氧合的影响研究[J].河北医学,2015,21(8):1467-1471.
[12]曾昭洋,胡文斌,魏学玲,等.中老年人原发性骨质疏松症与中医体质类型的Logisti回归分析[J].西部中医药,2018,31(2):66-70.
[13]张卫涛,黄炜,殷杰,等.补肾壮骨汤联合阿托伐他汀治疗糖尿病性骨质疏松症临床研究[J].中医学报,2016,31(23):1880-1884.
[14]孟玥,任艳玲,孙月娇,等.左归丸及其拆方对去卵巢骨质疏松症模型大鼠肾脏碱性磷酸酶、骨钙素表达的影响[J].中医杂志,2016,57(5):423-427.
[15]李凌汉,麦培根,陈宝红.右归丸对原发性骨质疏松症患者骨密度、骨代谢及脆性骨折发生率的影响[J].现代中西医结合杂志,2017,26(19):2088-2090.
[16]唐永琼,唐茂山,罗荣兰.复方当归注射液治疗痔术后疼痛的临床观察[J].河北医学,2007,13(5):620-621.
[17]袁菱梅,李艳明,陈丽妹,等.电针结合加味身痛逐瘀汤治疗原发性骨质疏松症40例[J].针灸临床杂志,2015,31(8):12-14.
[18]曾荣,张曦.低分子肝素钙联合身痛逐瘀汤预防股骨骨折后深静脉血栓的临床疗效[J].中国临床医生杂志,2015,43(12):69-72.
[19]张延辉,刘琳琳,郝琳娜.身痛逐瘀汤对腰椎间盘突出症患者疼痛程度和生存质量评定的影响[J].中国食物与营养,2014,20(7):84-87.
[20]冯宇,杨明会,窦永起,等.身痛逐瘀汤对DOMS模型大鼠骨骼肌微损伤和炎症因子的影响[J].环球中医药,2017,10(4):416-418.
[21]何升华,任之强,王建,等.从血瘀对骨代谢的影响探讨血瘀在女性原发性骨质疏松症发病中的作用机制[J].中国骨质疏松杂志,2017,23(1):69-73.
[22]任之强,赵志强,晋大祥,等.骨质疏松症肾虚血瘀量化评分与性激素和血细胞参数关系研究[J].中国骨质疏松杂志,2015,21(5):560-563.
[2]杨茜,张海雄,韩雪梅,等.糖尿病患者胰岛功能与低血钙诱发骨质疏松症关系的临床研究[J].陕西医学杂志,2015,44(9):1193-1195.
[3]王颢,潘剑.仙灵骨葆胶囊治疗老年骨质疏松性腰椎压缩骨折40例[J].西部中医药,2017,30(8):89-91.
[4]李兆楠,裴瑞霞.六味地黄汤加味治疗2型糖尿病合并骨质疏松症60例[J].陕西中医,2015,36(9):1174-1175.
[5]董林,雷宁波,邢涛,等.损伤胶囊对绝经后骨质疏松症患者疼痛、骨密度及骨代谢生化指标的影响[J].西部中医药,2017,30(11):8-11.
[6]薛延.骨质疏松症防治指南[M].北京:人民卫生出版社,2008:62-62.
[7]张晶.关于修订《中药新药临床研究指导原则》的建议[J].中药新药与临床药理,2000,11(2):67-68.
[8]林奇生,邹学农.骨化三醇加阿伦磷酸钠治疗骨质疏松疗效观察及不良反应[J].河北医学,2017,23(1):128-131.
[9]郭定聪,何生.原发性骨质疏松症中医证型分布及其与骨折关系研究[J].中国医院药学杂志,2016,36(5):103.
[10]林德涛.中西医结合治疗糖尿病性骨质疏松症疗效观察[J].新中医,2017,49(2):57-59.
[11]柴仪,李倩,田伟明,等.补肾活血方对骨质疏松引发的压缩性椎体骨折患者骨代谢和动脉氧合的影响研究[J].河北医学,2015,21(8):1467-1471.
[12]曾昭洋,胡文斌,魏学玲,等.中老年人原发性骨质疏松症与中医体质类型的Logisti回归分析[J].西部中医药,2018,31(2):66-70.
[13]张卫涛,黄炜,殷杰,等.补肾壮骨汤联合阿托伐他汀治疗糖尿病性骨质疏松症临床研究[J].中医学报,2016,31(23):1880-1884.
[14]孟玥,任艳玲,孙月娇,等.左归丸及其拆方对去卵巢骨质疏松症模型大鼠肾脏碱性磷酸酶、骨钙素表达的影响[J].中医杂志,2016,57(5):423-427.
[15]李凌汉,麦培根,陈宝红.右归丸对原发性骨质疏松症患者骨密度、骨代谢及脆性骨折发生率的影响[J].现代中西医结合杂志,2017,26(19):2088-2090.
[16]唐永琼,唐茂山,罗荣兰.复方当归注射液治疗痔术后疼痛的临床观察[J].河北医学,2007,13(5):620-621.
[17]袁菱梅,李艳明,陈丽妹,等.电针结合加味身痛逐瘀汤治疗原发性骨质疏松症40例[J].针灸临床杂志,2015,31(8):12-14.
[18]曾荣,张曦.低分子肝素钙联合身痛逐瘀汤预防股骨骨折后深静脉血栓的临床疗效[J].中国临床医生杂志,2015,43(12):69-72.
[19]张延辉,刘琳琳,郝琳娜.身痛逐瘀汤对腰椎间盘突出症患者疼痛程度和生存质量评定的影响[J].中国食物与营养,2014,20(7):84-87.
[20]冯宇,杨明会,窦永起,等.身痛逐瘀汤对DOMS模型大鼠骨骼肌微损伤和炎症因子的影响[J].环球中医药,2017,10(4):416-418.
[21]何升华,任之强,王建,等.从血瘀对骨代谢的影响探讨血瘀在女性原发性骨质疏松症发病中的作用机制[J].中国骨质疏松杂志,2017,23(1):69-73.
[22]任之强,赵志强,晋大祥,等.骨质疏松症肾虚血瘀量化评分与性激素和血细胞参数关系研究[J].中国骨质疏松杂志,2015,21(5):560-563.