【摘要】 目的 探讨补肾壮骨方治疗糖尿病肾病合并骨质疏松症患者的临床疗效及其对Wnt通路调节因子介导的患者尿微量白蛋白(mALB)、骨代谢的影响。方法 选取九江市第一人民医院2022年6月至2023年10月收治的120例糖尿病肾病合并骨质疏松症患者，按照随机数字表法将其分为对照组(采用西药抗骨质疏松治疗)、研究组(采用补肾壮骨方治疗),各60例。结果 研究组总有效率(88.33%)明显高于对照组总有效率(70.00%)(P<0.05)。研究组治疗后血清β-连环蛋白(β-catenin)、钙(Ca)、骨钙素(OC)水平明显高于对照组，血清空腹血糖(FPG)、糖化血红蛋白(HbA1c)、碱性磷酸酶(ALP)、I型胶原交联C端肽(CTX-1)、β胶原交联C端肽(β-CTX)、总I型胶原氨基酸延长肽(t PINP)、基质金属蛋白酶-9(MMP-9)、糖蛋白Dickkopf-1(DKK-1)水平、尿mALB水平明显低于对照组(P<0.05)。糖尿病肾病合并骨质疏松症患者治疗后血清β-catenin与OC呈正相关，与FPG、HbA1c、mALB、ALP、CTX-1、β-CTX、t PINP呈负相关(P<0.05);血清MMP-9与HbA1c、mALB呈正相关，与Ca呈负相关(P<0.05);血清DKK-1与FPG、HbA1c、ALP、β-CTX、t PINP呈正相关，与OC呈负相关(P<0.05)。结论 补肾壮骨方可有效改善糖尿病肾病合并骨质疏松症患者的尿mALB、骨代谢标志物水平，这可能与Wnt通路调节因子表达的变化有关。更多还原

【Abstract】 Objective To investigate the clinical efficacy of Bushen-Zhuanggufang in the treatment of diabetic nephropathy complicated with osteoporosis and its influence on urinary microalbumin(mALB) and bone metabolism mediated by Wnt pathway regulatory factors. Methods A total of 120 patients with diabetic nephropathy complicated with osteoporosis admitted to Jiujiang First People’s Hospital from June 2022 to October 2023 were selected and divided into control group(Western medicine anti-osteoporosis treatment) and study group(Bushen Zhuanggu prescription treatment) according to random number table method, with 60 cases each. Results The study group demonstrated a notably higher total effective rate of 88.33%, in stark contrast to the 70.00% observed in the control group(P < 0.05). The levels of serum β-catenin(β-catenin), calcium(Ca) and osteocalcin(OC) in the study group were significantly higher than those in the control group after treatment. Serum fasting blood glucose(FPG), glycosylated hemoglobin(HbA1c), alkaline phosphatase(ALP), type I collagen cross-linked C-terminal peptide(CTX-1), β collagen cross-linked C-terminal peptide(β-CTX), total type I collagen amino acid lengthening peptide(t PINP), matrix metalloproteinase-9(MMP-9), Dickkopf-1(DKK-1) and urinary mALB were significantly lower than those of control group(P < 0.05). After treatment, serum β-catenin was positively correlated with OC, and negatively correlated with FPG, HbA1c, mALB, ALP, CTX-1, β-CTX and t PINP in patients with diabetic nephropathy complicated with osteoporosis(P < 0.05). Serum levels of MMP-9 exhibited a direct correlation with HbA1c and mALB, whereas an inverse correlation was observed with serum calcium concentrations(P < 0.05). Serum DKK-1 was positively correlated with FPG, HbA1c, ALP, β-CTX and t PINP, and negatively correlated with OC(P < 0.05). Conclusion Tonifying kidney and strengthening bone can effectively improve the levels of urinary mALB and bone metabolic markers in patients with diabetic nephropathy complicated with osteoporosis, which may be related to the changes in the expression of Wnt pathway regulatory factors.更多还原