目的 觀察骨松寶膠囊聯(lián)合胰島素注射液治療2型糖尿病性骨質(zhì)疏松癥的臨床療效。方法 選取西安市第五醫(yī)院2013年7月-2014年7月收治的2型糖尿病性骨質(zhì)疏松患者98例,隨機(jī)分為治療組和對(duì)照組,每組各49例。對(duì)照組餐前皮下注射胰島素注射液,起始劑量為4~6 U/次,3次/d。根據(jù)患者血糖監(jiān)測(cè)結(jié)果,適當(dāng)調(diào)整劑量。治療組在對(duì)照組的基礎(chǔ)上口服骨松寶膠囊,2粒/次,3次/d。兩組患者均連續(xù)治療1年。觀察兩組的臨床療效,同時(shí)比較兩組患者治療前后骨密度(BMD)、血鈣、骨鈣素(BGP)、血磷、骨特異性堿性磷酸酶(B-ALP)以及骨痛癥狀評(píng)分的變化。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為79.6%、93.9%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者腰椎、股骨頸、股骨大轉(zhuǎn)子的BMD顯著升高,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些指標(biāo)改善幅度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者B-ALP均顯著降低,BGP均顯著升高,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者骨痛癥狀評(píng)分顯著降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組骨痛癥狀評(píng)分下降明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 骨松寶膠囊聯(lián)合胰島素注射液治療2型糖尿病性骨質(zhì)疏松癥療效較好,能顯著改善患者骨痛癥狀,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of Gusongbao Capsules combined with Insulin Injection in treatment of type 2 diabetic osteoporosis. Methods Patients (98 cases) with type 2 diabetic osteoporosis in the Fifth Hospital of Xi'an City from July 2013 to July 2014 were divided into control and treatment groups, and each group had 49 cases. Patients in the control group were sc administered with Insulin Injection, with the starting dosage of 4-6 U/time, three times daily, and the dose was adjusted according to the results of blood glucose monitoring. Patients in the treatment group were po administered with Gusongbao Capsules on the basis of the control group, 2 grains/time, three times daily. The patients in two groups were treated for 1 year. After treatment, the clinical efficacy was evaluated, and the changes of bone mineral density (BMD), serum calcium, serum osteocalcin (BGP), phosphorus, bone specific alkaline phosphatase (B-ALP) and bone pain symptom score before and after treatment in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 79.6% and 93.9%, respectively, and there were differences between two groups (P > 0.05). After treatment, the BMD of lumbar spine, femoral neck, and greater trochanter of femur in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, B-ALP in two groups were significantly decreased, and BGP in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, bone pain symptom score in two groups were significantly decreased, and difference was statistically significant in the same group (P < 0.05). And bone pain symptom score in the treatment group was significantly better than that in the control group, with significant difference between two groups (P < 0.05). Conclusion Gusongbao Capsules combined with Insulin Injection has clinical curative effect in treatment of type 2 diabetic osteoporosis, can significantly improve the bone pain symptom of patients, which has a certain clinical application value.