二甲双胍联合阿仑膦酸钠治疗骨质疏松症合并2型糖尿病的临床疗效

目的观察二甲双胍联合阿仑膦酸钠对骨质疏松症合并2型糖尿病的影响。方法将120例绝经后骨质疏松症合并2型糖尿病患者随机分为治疗组(n=60)和对照组(n=60)。对照组给予阿仑膦酸钠治疗,治疗组给予阿仑膦酸钠联合二甲双胍治疗,为期治疗6个月。检测治疗后两组患者髋部及腰椎骨密度和视觉模拟评分法(visual analogue scale,VAS)评分改变,同时测定血清骨代谢指标骨特异性碱性磷酸酶(bone-specific alkaline phosphatase,B-ALP)和抗酒石酸酸性磷酸酶-5b(tartrate resistant acid phosphatase-5b,TRACP-5b)水平的变化,记录药物的不良反应。结果治疗前两组的骨密度、骨代谢指标和VAS评分比较没有统计学意义(P0.05)。治疗3个月和6个月后,两组髋部及腰椎密度都有不同程度的升高(P0.05),治疗组的骨密度提高较对照组更为显著(P0.05)。同时,各组血清B-ALP和TRACP-5b水平、VAS评分均降低(P0.05),治疗组的骨代谢指标和VAS评分改善较对照组更为显著(P0.05)。而两组之间的不良反应比较无明显差异(P0.05)。结论二甲双胍增加阿仑膦酸钠治疗骨质疏松症合并2型糖尿病临床疗效显著。

Metformin combined with alendronate in the treatment of osteoporosis complicated with type 2 diabetes

Objective To study the effect of metformin in combination with alendronate in the treatment of osteoporosis complicated with type 2 diabetes. Methods 120 postmenopausal osteoporosis patients complicated with type 2 diabetes were randomly divided into treatment group (n=60) and control group (n=60). The control group was given alendronate sodium treatment, and the treatment group was given alendronate sodium combined with metformin treatment for a period of 6 months. The visual analogue scale (VAS) scores and BMD of the hip and lumbar vertebrae were measured in the two groups after the treatment. The levels of serum bone-specific alkaline phosphatase (B-ALP) and tartrate-resistant acid phosphatase-5b (TRACP-5b) were also measured and the adverse drug reactions were recorded. Results Before treatment, there were no statistically significant differences in bone mineral density, bone metabolic index and VAS scores between the two groups (P>0.05). After 3 and 6 months of treatment, the BMD of hip and lumbar increased in both groups (P<0.05), and BMD in the treatment group was significantly higher than that in the control group (P<0.05). At the same time, the levels of serum B-ALP and TRACP-5b and VAS scores decreased in both groups (P<0.05). The bone metabolic index and VAS scores in the treatment group had significantly great improvements than those in the control group (P<0.05). There was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion Metformin increased the clinical efficacy of alendronate in the treatment of osteoporosis complicated with type 2 diabetes.