聂焱　郑雪峰　陈明明

【摘 要】 目的：观察温和灸背俞穴对2型糖尿病合并骨质疏松（diabetic osteoporosis，DOP）患者的临床疗效。方法：将60例确诊为DOP患者随机分为治疗组和对照组各30例，其中对照组给予钙尔奇D，治疗组在对照组的基础上进行温和灸“肾俞、脾俞”穴位。观察治疗前后患者骨密度值、临床骨痛积分以及临床中医症侯量化积分变化，酶联免疫吸附法检测患者治疗前后血清中骨碱性磷酸酶（BALP），抗酒石酸酸性磷酸酶（TRACP-5b）和骨钙素（BGP）的含量。结果：治疗后，两组骨密度均无明显变化（P>0.05），治疗组临床骨痛症状明显好转，临床骨痛积分（VAS积分）降低（P<0.01），对照组VAS积分无明显改变（P>0.05）。治疗组血清BALP、BGP含量與治疗前相比升高，TRACP-5b含量降低，均具有统计学差异（P<0.05）；对照组血清BALP含量升高（P<0.05），BGP与TRACP-5b含量均无明显改变（P>0.05）。结论：温和灸“肾俞、脾俞”穴能够改善2型DOP患者的临床症状，增加骨密度，可能与通过上调BALP和BGP的表达与下调TRACP-5b的表达相关。

【关键词】 2型糖尿病；骨质疏松；温和灸；骨密度；酶联免疫吸附法

【中图分类号】R587.1 【文献标志码】 A 【文章编号】1007-8517（2018）08-0128-04

Abstract：Objective The changes of bone mineral density，visual analogue scale（VAS） of clinical pain and TCM symptom scale were observed before and after treatment.At the same time，we observe the changes of bone metabolism indexes before and after the treatment.To investigate the clinical effect of Mild Moxlbustion on patients with 2 Type diabetes Combined with Osteoporosis（DOP）. Methods 60 cases（diagnosed as DOP patients） were divided into treatment group（with mild moxibustion） 30 cases and control group（with Caltrate D） 30 cases.The changes of bone mineral density，visual analogue scale of clinical pain and TCM symptom scale in postmenopausal osteoporosis women were observed before and after treatment.All patients blood was determined by ELISA of BALP，TRACP-5b and BGP content. Results After treatment，There was no significant change in BMD between the treatment group and the control group（P>0.05）.Treatment group of patients with bone pain were improved，The VAS score was decreased（P<0.01），There was no significant change in VAS score in the control group.The content of BALP，BGP in the treatment group was higher than that before treatment， and the content of TRACP-5b was reduced（P<0.05）. The content of BALP in the control group increased（P<0.05）， and there was no significant change in the content of BGP and TRACP-5b（P>0.05）. Conclusion The mild moxibustion of Piyu and Shenyu can improve the clinical symptoms of the patients and increase bone mineral density（BMD）.May be associated with up-regulate the expression of BALP，BGP and down-regulate the expression of TRACP-5b.

Keywords：T2DM；Osteoporosis；Mild moxibustion；BMD；ELISA

随着人口老龄化的进程，糖尿病在世界范围内的发病率呈增高趋势，其急慢性并发症严重危害患者的健康，其中骨质疏松症为慢性并发症之一[1]。2型糖尿病患者并发的骨质疏松称为糖尿病性骨质疏松（diabetic osteoporosis，DOP），是指糖尿病并发骨量减少，骨组织显微结构受损，骨脆性增加，易发骨折的一种全身性代谢性骨病。其严重影响患者日常生活，DOP已然成为严重的公共健康问题。温和灸作为中医学的常用的外治法，在临床中广泛应用，有研究指出，温和灸能明显改善绝经后骨质疏松症患者临床症状[2]。因……