糖尿病性骨质疏松患者血清自由基代谢与糖骨康的影响*

张颖1，于文浩2，王秀玲

课题背景：课题组前期研究表明，糖骨康具有调节患者血清炎性细胞因子释放，降低空腹血糖和糖化血红蛋白，提高骨密度的作用。2007年被河北省中医药管理局批准为河北省中医药管理局科学研究计划项目(2007203)，予以立项资助。

应用要点：本组结果表明，①与健康正常组比较，糖尿病骨质疏松患者存在着显著的氧化水平升高，抗氧化能力下降，自由基代谢失衡的状态，这可能是糖尿病并发骨质疏松的原因之一。②糖骨康可降低血清丙二醛含量和血糖水平，提高超氧化物歧化酶活性，具有调节糖尿病骨质疏松患者自由基代谢，降低血糖，抑制骨质疏松的作用。

相关链接：糖尿病骨质疏松属于中医“消渴”“骨痿”范畴，其形成与肾虚密切相关。糖骨康，依照古方虎潜丸的组成改进而成，方中熟地黄、山萸肉、山药、锁阳、龟板可补肾填精；丹参、川芎可活血化瘀，具有全方共奏补肾活血之功效。�

摘要
目的：糖尿病患者常伴有体内过氧化脂质水平的明显升高,而自由基增多可加重糖尿病并发症的发生和发展。糖骨康为治疗糖尿病骨质疏松症的临床验方，观察糖骨康对糖尿病骨质疏松患者骨密度、空腹血糖、糖化血红蛋白和血清超氧化物歧化酶、丙二醛含量的影响。
方法：①对象及分组：选择2003-03/2006-03在邯郸市第一医院老年病科和涉县中医院骨科收治的糖尿病骨质疏松患者139例。随机分为治疗组74例（年龄60~82岁），对照组65例（年龄60~85岁）。另设健康体检人员为正常组40名。上述人员对所用的治疗及检测指标均知情同意。③用药：治疗组服用中药糖骨康汤剂（由熟地黄、山萸肉、山药、锁阳、龟板、丹参、川芎组成，采用自动煎药机水煎包装）；对照组服用盖天力片(江苏启东盖天力制药厂生产)，两组同时口服西药常规降糖药，30 d为1疗程。④评估：治疗前后检测两组患者空腹血糖、糖化血红蛋白变化；比较正常组与两组患者治疗前骨密度、超氧化物歧化酶活性、丙二醛含量的差异。
结果：①两组患者空腹血糖以及糖化血红蛋白的比较：与治疗前比较，两组治疗后空腹血糖以及糖化血红蛋白均明显下降（P < 0.05或P < 0.01），但两组治疗后比较差异无统计学意义（P > 0.05）。②两组患者骨密度的比较：与治疗前比较，两组治疗后骨密度均明显上升（P < 0.05或P < 0.01），治疗组在升高骨密度方面优于对照组（P < 0.05）。③两组患者超氧化物歧化酶活性、丙二醛含量的比较：治疗后两组血清超氧化物歧化酶活性显著上升（P < 0.05或P < 0.01），丙二醛含量显著下降（P < 0.05或P < 0.01），治疗组在升高超氧化物歧化酶活性和降低丙二醛含量方面优于对照组（P < 0.05）。④正常组与治疗组、对照组患者骨密度、超氧化物歧化酶活性、丙二醛含量的比较：与正常组比较，治疗组、对照组患者骨密度和血清超氧化物歧化酶活性显著降低，丙二醛含量显著升高（P < 0.01）。
结论：糖骨康具有调节糖尿病骨质疏松患者自由基代谢，降低血糖，抑制骨质疏松的作用。
关键词：中药疗法；糖尿病；骨质疏松；丙二醛；超氧化物歧化酶；组织构建

张颖，于文浩，王秀玲.糖尿病性骨质疏松患者血清自由基代谢与糖骨康的影响[J].中国组织工程研究与临床康复，2008，12(7):1251-1254 [www.zglckf.com/zglckf/ejournal/upfiles/08-7/7k-1251(ps).pdf]

邯郸市第一医院， 1老年病科， 2骨科，河北省邯郸市 056002；3河北省涉县中医院骨科，河北省涉县
056400

张颖，女，1973年生，河北省涉县人，汉族，2003年河北医科大学毕业，主治中医师，主要从事糖尿病骨质疏松的研究。
ywtawen@163.com

河北省中医药管理局科学研究计划项目(2007203)*

中图分类号:R681.4
文献标识码:B
文章编号:1673-8225
(2008)07-01251-04

收稿日期：2007-05-24
修回日期：2007-09-10
(07-50-5-3011/W·Q)

Effects of Tanggukang on serum free radical metabolism in patients with diabetic osteoporosis

Abstract

AIM：Diabetic patients are often combined with significant increase of lipid peroxide level. Increase of free radical can severe the development of diabetic complications. Tanggukang is the clinical prescription for diabetic osteoporosis. This study was aimed to investigate the effects of Tanggukang on bone mineral density, fasting blood glucose, glycosylated hemoglobin, the activity of superoxide dismutase and the content of malondialdehyde in serum of patients with diabetic osteoporosis.
METHODS: ①139 cases of diabetic osteoporosis were enrolled at Department of Gerontology of Handan First Hospital and Department of Orthopaedics of Shexian Traditional Chinese Hospital from March 2003 to March 2006. They were divided into two groups, treatment group（n =74）(aged 60-82 years) and control group (n =65) (aged 60-85 years). Forty healthy persons doing body examination were enrolled as normal group. All the subjects signed the informed consent. ②The patients of the treatment group were treated with Tanggukang (composed of prepared rehmannia root, fructus corni, dioscorea root, caulis cynomori, tortoise plastron, salvia miltiorrhiza and szechwan lovage rhizome; water decoction, and packed by automatic decocting medicine machine). Patients of the control group were treated with Gaitianli tablet produced by Jiangsu Qidong Gaitianli Pharmaceutical Factory. All the subjects orally took conventional hypoglycemic agents, 30 days as a course. ③Changes in fasting blood sugar and glycosylated hemoglobin were determined before and after the treatment. The differences in bone mineral density, activity of superoxide dismutase and the content of malonaldehyde between the persons of normal group and the patients were measured before and after the treatment.
RESULTS: ①Compared with that before treatment, fasting blood glucose and glycosylated hemoglobin levels were obviously reduced after treatment in the two groups (P < 0.05 or P < 0.01), but no significant difference was found after the comparison between two groups (P > 0.05). ②Compared with that before treatment, bone mineral density were markedly increased after treatment in two groups (P < 0.05 or P < 0.01), and the increase of bone mineral density in the treatment group surpassed the control group（P < 0.05）. ③Compared with that before treatment, the activity of serum superoxide dismutase was significantly increased (P < 0.05 or P < 0.01) and the content of malondialdehyde was decreased (P < 0.05 or P < 0.01) in two groups. The treatment group surpassed the control group（P < 0.05）. ④Compared with normal group, bone mineral density and activity of serum superoxide dismutase were remarkably decreased, and content of malondialdehyde was distinctly increased in the treatment group and control group (P < 0.01).
CONCLUSION: Tanggukang can decrease blood sugar，and prevent the osteoporosis through regulating the free radical metabolism of patients with diabetic osteoporosis.

Zhang Y, Yu WH, Wang XL.Effects of Tanggukang on serum free radical metabolism in patients with diabetic osteoporosis.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(7):1251-1254(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-7/7k-1251(ps).pdf]

Department of Spinal Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China

Luan Jun-wei★, Studying for master's degree, Resident physician, Department of Spinal Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China
ljw_003@hotmail.
com

Correspondence to: Chen Xiao-liang, Professor, Chief physician, Tutor of master, Department of Spinal Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China

Received: 2007-09-07
Accepted: 2007-10-26