摘要
目的分析探讨碳酸钙D3、骨化三醇联合唑来膦酸对2型糖尿病(type 2 diabetes mellitus,T2DM)合并原发性骨质疏松症老年患者骨密度和骨痛的影响。方法选取我院2014年5月至2015年5月期间收治的T2DM合并原发性骨质疏松症老年患者220例,将所有患者按照随机数字表法随机分为对照组和试验组,所有患者均给予骨化三醇和碳酸钙D3进行治疗,其中试验组患者使用碳酸钙D3、骨化三醇联合唑来膦酸进行治疗。所有患者均持续治疗3年,3年后观察两组患者的骨密度(bone mineral density,BMD)及骨痛视觉模拟评分(visual analogue scale,VAS)评分情况,比较两组患者的不良反应发生情况。结果两组患者治疗前的骨密度情况并无明显差异(P均>0. 05);治疗三年后,两组患者的骨密度均比治疗前有所增加(P<0. 05),试验组患者的骨密度显著优于同期对照组患者(P均<0. 05)。两组患者治疗前的VAS评分并无明显差异(P> 0. 05);经过三年的治疗后,两组患者的VAS评分均显著低于本组治疗前(P<0. 05),试验组患者的VAS评分显著低于同期对照组患者(P<0. 05)。试验组患者在治疗期间没有新发骨折出现,而对照组患者则有1例出现左侧股骨颈骨折;试验组患者在静注唑来膦酸注射液后有5例出现轻微的头疼、乏力、发热、感冒等症状,在服用塞来昔布洛索洛芬后症状缓解。结论对T2DM合并原发性骨质疏松症老年患者采取碳酸钙D3、骨化三醇联合唑来膦酸进行治疗能够有效增加患者的骨密度,改善其骨痛VAS评分,效果显著,值得在临床上加以推广运用。
Objective To investigate the effects of calcium carbonate D3 and calcitriol combined with zoledronic acid on bone mineral density and bone pain in elderly patients with T2DM complicated with primary osteoporosis. Methods 220 cases elderly patients treated in our hospital from May 2014 to May 2015 with T2DM complicated with primary osteoporosis were selected. All patients according to random number table method were randomly divided into control group and experimental group,all patients were given calcitriol and calcium carbonate D3 treatment,and patients in experimental group also received zoledronic acid treatment. All patients were treated continuously for 3 years. Bone density and VAS score of bone pain in the two groups were observed after 3 years of treatment,and adverse reactions in the two groups were compared. Results There was no significant difference in BMD between the two groups before treatment(all P>0. 05). After three years of treatment,BMD in both groups was higher than that before treatment(all P<0. 05). After three years of treatment,BMD of patients in the experimental group was significantly higher than that of the control group(all P<0. 05). There was no significant difference in VAS score between the two groups before treatment(P > 0. 05).After three years of treatment,VAS scores of patients in both groups were significantly lower than those before treatment(all P<0. 05).After three years of treatment,the VAS score of patients in the experimental group was significantly lower than that of the control group(P<0. 05). No new fractures occurred in the experimental group during the treatment period,while one case of left femoral neck fracture occurred in the control group. In the experimental group,5 patients presented mild headache,fatigue,fever,cold and other symptoms after intravenous injection of zoledronic acid,and the symptoms were relieved after taking celecoxibulosolfene. Conclusion In elderly patients with T2DM complicated with primary osteoporosis,treatment with calcium carbonate D3,calcitriol and zoledronic acid could effectively increase bone density and improve the VAS score of bone pain. The result were significant and worthy of clinical application.
作者
陈清河
曾维铨
黄少辉
向明
陈闻佳
CHEN Qinghe;ZENG Weiquan;HUANG Shaohui;XIANG Ming;CHEN Wenjia(People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350004;Fujian University of Traditional Chinese Medicine,Fuzhou 350122;Fujian Provincial Government Hospital,Fuzhou 350003)
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2020年第2期202-204,226,共4页
Chinese Journal of Osteoporosis
基金
中华中医药学会中医治未病标准项目(SATCM-2015-BZ〔352〕)
