阿仑膦酸钠与钙尔奇D分别联合二甲双胍治疗2型糖尿病合并骨质疏松症的疗效对比研究

摘要 目的：对比阿仑膦酸钠与钙尔奇D分别联合二甲双胍治疗2型糖尿病（T2DM）合并骨质疏松症的疗效。方法：选取我院于2016年4月~2019年1月期间收治的109例T2DM合并骨质疏松症患者，根据乱数表法将患者分为钙尔奇D组（n=54，钙尔奇D）和阿仑膦酸钠组（n=55，阿仑膦酸钠）。比较两组患者临床疗效、血糖指标、骨代谢相关指标、腰椎L2~L4及股骨颈的骨密度值。结果：阿仑膦酸钠组治疗1个月后的临床总有效率为83.64%（46/55），高于钙尔奇D组的62.96%（34/54）（P<0.05）。两组治疗1个月后腰椎L2~ L4、股骨颈的骨密度值均升高，且阿仑膦酸钠组高于钙尔奇D组（P<0.05）。两组治疗1个月后骨钙素（BGP）升高，且阿仑膦酸钠组高于钙尔奇D组（P<0.05）；血清I型胶原C末端肽（s-CTX）、碱性磷酸酶（BAP）、人抗酒石酸酸性膦酸酶 5b（TRAP-5b）则降低，且阿仑膦酸钠组低于钙尔奇D组（P<0.05）。两组治疗1个月后空腹血糖（FPG）、糖化血红蛋白（HbA1c）均降低（P<0.05），但两组治疗1个月后组间比较无统计学差异（P>0.05）。两组不良反应发生率对比无统计学差异（P >0.05）。结论：与钙尔奇D联合二甲双胍治疗比较，阿仑膦酸钠联合二甲双胍治疗T2DM合并骨质疏松症患者，疗效显著，可有效改善骨代谢指标及骨密度，且不影响降糖效果，具有一定的临床应用价值。

A comparative Study of Alendronate Sodium and Calycid D Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus with Osteoporosis

ABSTRACT Objective: To compare the therapeutic effects of alendronate sodium and calycid D combined with metformin on type 2 diabetes mellitus (T2DM) with osteoporosis. Methods: A total of 109 patients with T2DM with osteoporosis who were admitted to our hospital from April 2016 to January 2019 were selected. According to the random number table, the patients were divided into two groups: calycid group D (n=54, calycid D) and alendronate sodium group (n=55, alendronate sodium). The clinical effect, blood glucose index, bone metabolism index, lumbar L2 ~ L4 and femoral neck bone mineral density of the two groups were compared. Results: The total effective rate of alendronate sodium group was 83.64% (46/55), which was higher than 62.96% (34/54) in calycid group D (P<0.05). The bone mineral density of L2-L4 and femoral neck of the two groups increased at 1 month after treatment, and those of alendronate sodium group was higher than that of calycid group D (P<0.05). 1 month after treatment, the level of bone gla protein (BGP) increased in both groups, and that of alendronate sodium group was higher than that of calycid group D (P<0.05). While the level of type I collagen cross-linked C-terminal peptide (s-CTX), bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase-5b (TRAP-5b) were decreased, and those of alendronate sodium group were lower than those of calycid group D (P<0.05). The fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) of the two groups decreased at 1 month after treatment, and those of alendronate sodium group were lower than those of calycid group D (P<0.05), but there was no difference between the two groups at 1 month after treatment (P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Compared with the treatment of calycid D combined with metformin, alendronate sodium combined with metformin has a significant effect on T2DM patients with osteoporosis, which can effectively improve bone metabolism and bone mineral density, and it does not affect the effect of hypoglycemic, which has a certain clinical application value.