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目的:观察阿仑膦酸钠联合碳酸钙D3片治疗2型糖尿病性骨质疏松症的疗效和安全性。方法:120例2型糖尿病性骨质疏松症患者随机分为观察组和对照组。两组患者均予常规生活干预、口服降糖药物或胰岛素治疗,同时口服碳酸钙D3片600 mg,qd。观察组在此基础上加用阿仑膦酸钠70 mg,po每周1次。两组的疗程均为6个月。比较两组患者治疗前后骨密度、血清骨代谢指标与疼痛评分的变化情况,以及两组临床疗效及药品不良反应。结果:治疗6月后,两组患者股骨颈、股骨粗隆及Word’s三角区骨密度值均较治疗前改善(P<0.05和P<0.01),且观察组的改善幅度明显优于对照组(P<0.05)。两组患者血清TRACP-5水平均较治疗前明显下降,血清BAP和OC水平则均较治疗前明显上升(P<0.05和P<0.01),且观察组改善幅度明显优于对照组(P<0.05)。两组患者VAS疼痛评分均较治疗前改善(P<0.05和P<0.01),且观察组改善幅度明显优于对照组(P<0.05)。观察组临床总有效率明显高于对照组(P<0.05),两组治疗中药品不良反应发生例数比较差异无统计学意义(P>0.05)。讨论:阿仑膦酸钠联合碳酸钙D3片治疗2型糖尿病性骨质疏松症疗效肯定,安全性较好。
Objective: To observe the efficacy and safety of alendronate combined with calcium carbonate D3 in the treatment of type 2 diabetic osteoporosis. Methods: 120 cases of type 2 diabetic osteoporosis were randomly divided into observation group and control group. Two groups of patients were given routine life interventions, oral hypoglycemic drugs or insulin treatment, while oral calcium carbonate D3 tablets 600 mg, qd. On the basis of the observation group, alendronate sodium 70 mg was added once a week. The two groups of treatment are 6 months. The changes of bone mineral density (BMD), serum markers of bone metabolism and pain score before and after treatment were compared between the two groups. The clinical efficacy and adverse drug reactions were compared between the two groups. Results: After 6 months of treatment, the BMD of the femoral neck, femoral trochanter and Word’s triangle were improved in both groups (P <0.05 and P <0.01), and the improvement in the observation group was significantly better than that in the control group P <0.05). Serum levels of TRACP-5 in both groups were significantly lower than those before treatment, and serum BAP and OC levels were significantly increased (P <0.05 and P <0.01), and the improvement in the observation group was significantly better than the control group (P < 0.05). VAS pain scores in both groups were improved compared with before treatment (P <0.05 and P <0.01), and the improvement in the observation group was significantly better than that in the control group (P <0.05). The total effective rate in the observation group was significantly higher than that in the control group (P <0.05). There was no significant difference in the number of adverse reactions between the two groups (P> 0.05). Discussion: alendronate sodium combined with calcium carbonate D3 treatment of type 2 diabetic osteoporosis positive effect, better security.