【摘要】 目的探讨西格列汀二甲双胍片联合唑来膦酸治疗2型糖尿病并发骨质疏松症的临床疗效。方法选取本院2015年6月至2016年8月收治的2型糖尿病并发骨质疏松症患者94例为研究对象,按照随机数表法将其分为观察组与对照组,每组各47例。在常规治疗基础上,对照组患者采用唑来膦酸治疗,观察组患者采用唑来膦酸联合西格列汀二甲双胍片治疗。两组疗程均为1年。比较两组患者疗效、治疗前后糖代谢指标、骨密度、疼痛及骨代谢水平变化情况。结果观察组患者治疗总有效率显著高于对照组(P<0.05)。两组患者治疗后空腹血糖(fasting plasma glucose,FPG)、餐后2小时血糖(2h plasma glucose,2hPG)及糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平均显著低于治疗前(P_均<0.05),上述指标组间比较均无显著差异(P_均>0.05)。治疗后,两组患者腰椎骨和股骨颈骨密度均显著增加(P_均<0.05),且观察组患者腰椎骨和股骨颈骨密度均显著高于对照组(P_均<0.05);两组患者视觉模拟评分法(visual analogue scale,VAS)评分均显著降低(P_均<0.05),且观察组患者VAS评分显著低于对照组(P<0.05);两组患者碱性磷酸酶水平显著降低而骨钙素水平显著升高(P_均<0.05),且观察组患者碱性磷酸酶水平显著低于对照组而骨钙素水平显著高于对照组(P_均<0.05)。结论西格列汀二甲双胍片联合唑来膦酸治疗2型糖尿病并发骨质疏松症具有较好的临床疗效。更多还原

【Abstract】 Objective To investigate the clinical efficacy of Sitagliptin phosphate/metformin hydrochloride tablets combined with Zoledronic acid on the type 2 diabetes mellitus patients with osteoporosis. Method 94 patients with type 2 diabetes mellitus complicated with osteoporosis admitted to our hospital from June 2015 to August 2016 were selected as the subjects. They were divided into observation group and control group according to the random table method, 47 cases in each group. On the basis of routine treatment, control group patients were treated with Zoledronic acid, while observation group patients were treated with Zoledronic acid combined with Sitagliptin phosphate/metformin hydrochloride tablets. Both the two groups patients were treated for 1 year. The curative effect, glycometabolism index, bone mineral density, pain and bone metabolism level were compared between the two groups before and after treatment. Result Total effective rate of observation group was higher than that of control group（P < 0.05）. After treatment, fasting plasma glucose（FPG）, 2 h plasma glucose（2 h PG） and glycosylated hemoglobin（Hb A1 c） of the two groups were lower than before treatment(P_all< 0.05), but there were no significant differences between the two groups in above indexes(P_all> 0.05). After treatment, the bone mineral density of lumbar vertebra and femoral neck increased significantly in both groups(P_all< 0.05), and the bone mineral density of lumbar vertebra and femoral neck in observation group were significantly higher than those in control group(P_all< 0.05); the visual analogue scale（VAS） scores of the two groups were significantly decreased(P_all< 0.05), and the VAS scores of observation group were significantly lower than those of control group(P_all< 0.05); the level of alkaline phosphatase was decresed and the level of osteocalcin was increased in the two groups(P_all< 0.05), and the level of alkaline phosphatase in observation group was significantly lower than that in control group（P < 0.05）, while the level of osteocalcin in observation group was significantly higher than that in control group（P < 0.05）. Conclusion The clinical efficacy of Sitagliptin phosphate/metformin hydrochloride tablets combined with Zoledronic acid on type 2 diabetes mellitus patients with osteoporosis is obvious.更多还原