CN115400184A

CN115400184A - Traditional Chinese medicine composition for treating diabetes complicated with osteoporosis

Info

Publication number: CN115400184A
Application number: CN202211232545.6A
Authority: CN
Inventors: 程建; 张琦; 刘明明; 霍维玲; 冯欢欢; 华臻; 郭杨; 潘娅岚; 马勇; 蔡建平
Original assignee: Xuzhou Central Hospital
Current assignee: Xuzhou Central Hospital
Priority date: 2022-10-10
Filing date: 2022-10-10
Publication date: 2022-11-29

Abstract

The application relates to a traditional Chinese medicine composition for treating diabetes complicated with osteoporosis, which comprises the following raw material medicines: fructus Psoraleae, herba Epimedii, rhizoma Drynariae, eucommiae cortex, semen Cuscutae, colla Cornus Cervi, corni fructus, rhizoma Dioscoreae, radix Codonopsis, atractylodis rhizoma, radix Gentianae Marcrophyllae, notopterygii rhizoma, radix Angelicae Pubescentis, radix rehmanniae Preparata, radix astragali, carthami flos, and Saviae Miltiorrhizae radix. Based on the pathogenesis of kidney deficiency, liver and spleen deficiency, damp arthralgia and blood stasis, the medicine takes the effects of liver and kidney homology and kidney governing bones as follows: the kidney is mainly tonified, the liver and the spleen are considered, the kidney is tonified, the bones are strengthened, the liver and the spleen are regulated, the innate is nourished afterwards, the biochemistry and the transportation and transformation of qi and blood are promoted, and the internal organs are nourished; the traditional Chinese medicine composition can be used for expelling wind-cold-dampness arthralgia, qi deficiency and blood stasis to block collaterals, and is particularly suitable for patients with diabetes complicated with osteoporosis, and medicines for tonifying qi and deficiency are added to nourish the whole body.

Description

Traditional Chinese medicine composition for treating diabetes complicated with osteoporosis

Technical Field

The invention belongs to the technical field of preparation and application of traditional Chinese medicines, and particularly relates to application of a traditional Chinese medicine composition in preparation of a medicine for preventing and treating diabetes complicated with osteoporosis.

Background

Diabetes is a common disease with endocrine dysbolism in clinic, and is mainly characterized in that the blood sugar level is continuously and abnormally increased, so that various complications of patients can be caused, and the complications mainly comprise eye injuries, microvascular injuries and the like. A large number of clinical researches find that patients with diabetes are often accompanied with osteoporosis, mainly due to reduction of bone mineral density and damage of bone strength caused by various reasons, and fracture is easy to occur by slight external force. However, few studies have been made on the mechanism of diabetes complicated with osteoporosis, and no specific therapeutic means have been known to hinder the development of diabetes complicated with osteoporosis. Most of western medicine treatment adopts hypoglycemic drugs and anti-osteoporosis drugs, and the combination of the hypoglycemic drugs and the anti-osteoporosis drugs causes a plurality of adverse reactions after long-term administration, so the cost is high and the compliance of patients is poor.

Diabetes complicated with osteoporosis belongs to diabetes complicated with bone atrophy in traditional Chinese medicine, and the disease is located in the kidney and has certain relevance. The etiology and pathogenesis can be summarized as follows: diabetes, yin deficiency and internal heat, chronic failure, qi consumption and kidney impairment, gradual kidney qi deficiency, qi deficiency failure, kidney channel deficiency, kidney failure in governing bones, bone malnutrition, bone loss and marrow loss, and finally bone withering and bone withering.

The prior art discloses a formula and more dialectical treatment rules, such as astragalus, sweet potato, sugar and bone soup which takes kidney tonifying, qi benefiting, qi regulating, blood circulation activating, collateral dredging and pain relieving as treatment principles. If starting from the pathogenesis of kidney deficiency and blood stasis, the formula for tonifying kidney and activating blood is prepared, the epimedium is used for tonifying kidney yang, the rehmannia is used for tonifying kidney yin, the astragalus is used for tonifying qi and tonifying yang, the salvia miltiorrhiza and the panax notoginseng are used for activating blood and dredging collaterals, deficiency and excess are treated together, the kidney is tonified, the blood is activated and the qi is benefited, the functions of tonifying kidney and replenishing essence and dredging collaterals and relieving pain can be achieved, and the treatment effect is obvious by combining hypoglycemic drugs and VD 3.

By summarizing the classic and famous works of the calendar and combining years of clinical experience, the invention finds that the pathogenesis is concentrated on: kidney deficiency, liver-spleen deficiency, damp arthralgia, blood stasis, so on the basis of liver-kidney homology and kidney governing bone: the kidney is mainly tonified, the liver and the spleen are considered, the kidney is tonified, the bones are strengthened, the liver and the spleen are regulated, the innate is nourished afterwards, the biochemistry and the transportation and transformation of qi and blood are promoted, and the internal organs are nourished; so as to expel wind-cold-dampness arthralgia and deficient blood blocking collaterals, and achieve the purpose of dredging without pain. The medicine for tonifying qi and deficiency is added to nourish the whole body.

Disclosure of Invention

Aiming at the problems in the prior art, the traditional Chinese medicine composition for treating diabetes complicated with osteoporosis is provided: 20-40 parts of fructus psoraleae, 20-40 parts of epimedium herb, 20-40 parts of drynaria rhizome, 20-40 parts of eucommia bark, 10-30 parts of semen cuscutae, 10-30 parts of deerhorn glue, 10-30 parts of dogwood, 8-15 parts of Chinese yam, 8-15 parts of codonopsis pilosula, 8-15 parts of bighead atractylodes rhizome, 8-15 parts of gentiana macrophylla, 8-15 parts of notopterygium root, 8-15 parts of radix angelicae pubescentis, 10-20 parts of prepared rehmannia root, 10-20 parts of astragalus mongholicus, 10-20 parts of safflower carthamus and 10-20 parts of salvia miltiorrhiza.

The specific medicinal effects are as follows:

deer-horn glue: it enters kidney and liver meridians. Nature and taste: sweet, salty and warm. The functional indications are as follows: to warm and nourish liver and kidney, replenish vital essence and nourish blood. Can be used for treating sexual impotence, spermatorrhea, soreness of waist and knees, asthenia, marasmus, metrorrhagia, hematochezia, hematuria, dorsal furuncle, and swelling and pain.

Dodder seed: it enters liver, kidney and spleen meridians. Nature and taste: sweet and warm. The functional indications are as follows: nourishing liver and kidney, arresting seminal emission, arresting polyuria, preventing miscarriage, improving eyesight, and relieving diarrhea. Can be used for treating sexual impotence, spermatorrhea, enuresis, frequent micturition, soreness of waist and knees, blurred vision, tinnitus, fetal leakage due to kidney deficiency, threatened abortion, and spleen and kidney deficiency; externally treat vitiligo.

Psoralea fruit: it enters kidney and spleen meridians. Nature and taste: pungent, bitter and warm. The functional indications are as follows: to warm kidney and strengthen yang, receive qi and check diarrhea. Can be used for treating sexual impotence, spermatorrhea, frequent micturition, psychroalgia of waist and knee, asthma due to kidney deficiency, and diarrhea before dawn; it is used externally to treat vitiligo and alopecia areata.

Herba epimedii: it enters liver and kidney meridians. Nature and taste: pungent, sweet and warm. The functional indications are as follows: tonify kidney yang, strengthen tendons and bones, dispel wind-damp. Can be used for treating sexual impotence, spermatorrhea, tendons and bones debility, rheumatalgia, numbness and spasm; climacteric hypertension.

Rhizoma drynariae: it enters kidney and liver meridians. Nature and taste: bitter and warm. The functional indications are as follows: tonify kidney, strengthen bone, heal wound and alleviate pain. Can be used for treating lumbago due to kidney deficiency, tinnitus, deafness, odontoseisis, traumatic injury, contusion, and fracture of bones and muscles; it is used externally to treat alopecia areata and vitiligo.

Eucommia ulmoides: it enters liver and kidney meridians. Nature and taste: sweet and warm. The functional indications are as follows: tonify liver and kidney, strengthen tendons and bones, prevent abortion. Can be used for treating lumbago due to kidney deficiency, weakness of bones and muscles, and pregnant bleeding and threatened abortion; hypertension is caused.

Codonopsis pilosula: it enters spleen and lung meridians. Nature and taste: sweet and neutral. The functional indications are as follows: tonify middle-jiao and Qi, invigorate spleen and benefit lung. Can be used for treating spleen and lung deficiency, short breath, palpitation, anorexia, loose stool, asthma, cough, internal heat, and diabetes.

Astragalus root: it enters lung and spleen meridians. Nature and taste: sweet and warm. The functional indications are as follows: tonify qi, strengthen superficies, induce diuresis, expel pus, heal wound and promote tissue regeneration. Can be used for treating deficiency of vital energy, asthenia, anorexia, loose stool, collapse of middle-warmer energy, chronic diarrhea, rectocele, hematochezia, metrorrhagia, exterior deficiency, spontaneous perspiration, qi deficiency, edema, carbuncle, cellulitis, ulcer, chronic ulcer, blood deficiency, debility with jaundice, internal heat, and diabetes; proteinuria due to chronic nephritis and diabetes.

Chinese yam: it enters spleen, lung and kidney meridians. Nature and taste: sweet and neutral. The functional indications are as follows: tonify spleen and stomach, promote the production of body fluid and nourish lung, tonify kidney and astringe essence. Can be used for treating spleen deficiency, anorexia, chronic diarrhea, lung deficiency, cough, asthma, spermatorrhea, leukorrhagia, frequent micturition, and diabetes due to deficiency heat.

White atractylodes rhizome: it enters spleen and stomach meridians. Nature and taste: bitter, sweet and warm. The functional indications are as follows: invigorate spleen, replenish qi, dry dampness, induce diuresis, stop sweating, prevent abortion. Can be used for treating spleen deficiency, anorexia, abdominal distention, diarrhea, phlegm retention, dizziness, palpitation, edema, spontaneous perspiration, and threatened abortion. Tu Bai Zhu strengthens spleen, harmonizes stomach and prevents abortion. Can be used for treating spleen deficiency, anorexia, diarrhea, loose stool, and threatened abortion.

Large-leaved gentian: it enters stomach, liver and gallbladder meridians. Nature and taste: pungent, bitter and mild. The functional indications are as follows: dispel wind-damp, clear damp-heat, stop arthralgia. Can be used for treating rheumatic arthralgia, spasm of tendons and vessels, soreness of bone joints, hectic fever after the day, and infantile malnutrition with fever.

Notopterygium root: it enters bladder and kidney meridians. Nature and taste: pungent, bitter and warm. The functional indications are as follows: dispel cold, expel wind, remove dampness and alleviate pain. Can be used for treating wind-cold type common cold, headache, rheumatalgia, and soreness of shoulder and back.

Radix angelicae pubescentis: it enters kidney and bladder meridians. Property and taste: slightly warm, pungent and bitter. The functional indications are as follows: dispelling pathogenic wind, removing dampness, relieving arthralgia, and relieving pain. Can be used for treating arthralgia due to wind-cold-dampness, lumbago, gonalgia, headache due to wind-cold evil, and toothache.

Red sage root: it enters heart and liver meridians. Nature and taste: bitter and slightly cold. The functional indications are as follows: dispel stasis and alleviate pain, activate blood and dredge meridians, clear heart fire and relieve restlessness. Can be used for treating menoxenia, amenorrhea, dysmenorrhea, abdominal mass, thoracico-abdominal pain, arthralgia due to heat, pyocutaneous disease, swelling and pain, vexation, and insomnia; hepatosplenomegaly, angina pectoris.

Safflower: it enters heart and liver meridians. Nature and taste: pungent and warm. The functional indications are as follows: promoting blood circulation, dredging channels, removing blood stasis and relieving pain. Can be used for treating amenorrhea, dysmenorrhea, lochiorrhea, abdominal mass, traumatic injury, and swelling and pain of skin and external diseases.

Prepared rehmannia root: it enters liver and kidney meridians. Nature and taste: sweet and warm. The functional indications are as follows: to nourish yin, enrich blood, replenish essence and replenish marrow. Can be used for treating deficiency of liver-yin and kidney-yin, soreness of waist and knees, hectic fever, night sweat, nocturnal emission, internal heat, diabetes, blood deficiency, sallow complexion, cardiopalmus, severe palpitation, menoxenia, metrorrhagia, metrostaxis, hemorrhage, giddiness, tinnitus, and early white beard and hair.

Dogwood fruit: it enters liver and kidney meridians. Nature and taste: sour, astringent and slightly warm. The functional indications are as follows: tonify liver and kidney, astringe essence and relieve depletion. Can be used for treating vertigo, tinnitus, soreness of waist and knees, sexual impotence, spermatorrhea, enuresis, frequent micturition, metrorrhagia, leukorrhagia, and sweating. Internal heat to quench thirst.

The compatibility takes kidney deficiency, liver and spleen deficiency, damp arthralgia and blood stasis as pathogenesis, and is based on liver and kidney homology and kidney governing bones: the kidney is mainly tonified, the liver and the spleen are considered, the kidney is tonified, the bones are strengthened, the liver and the spleen are regulated, the innate is nourished afterwards, the biochemistry and the transportation and transformation of qi and blood are promoted, and the internal organs are nourished; to expel wind-cold-dampness arthralgia and deficient blood to block collaterals, and to achieve the purpose of no pain in dredging the meridians, the medicine for tonifying qi and deficiency is added to nourish the whole body.

Fructus psoraleae, herba epimedii, rhizoma drynariae and eucommia ulmoides are used for warming and invigorating kidney yang and strengthening muscles and bones; the dodder, the deerhorn glue and the dogwood are added for nourishing the liver and the kidney, replenishing vital essence and nourishing the blood, warming and invigorating the kidney yang and tonifying both yin and yang; chinese yam, codonopsis pilosula and bighead atractylodes rhizome have the effects of tonifying spleen and kidney, promoting the production of body fluid and tonifying qi; radix Gentianae Macrophyllae, notopterygii rhizoma, and radix Angelicae Pubescentis for dispelling pathogenic wind, removing dampness, relieving rigidity of muscles, and activating collaterals; the prepared rehmannia root and the astragalus root are combined to nourish yin and tonify the kidney, invigorate qi and invigorate the spleen, and the safflower and the salvia miltiorrhiza are used for promoting blood circulation and removing blood stasis so as to remove blood stasis and dredge without pain.

Case origin conditions: the cases are selected from Xuzhou medical university subsidiary hospital, nanjing Chinese medicine university subsidiary Xuzhou city center hospital, and 80 people are counted from 7 months in 2018 to 7 months in 2020, wherein 45 men and 35 women have the age of 46-70 years, the average age is 58 +/-5.0 years, and the course of the disease is 5-20 years.

Control group: patients took metformin hydrochloride sustained-release tablets (gelhuazhi), (merck pharmaceuticals (jiangsu) limited (approval document: national drug standard J20171052), alfacalcidol, chongqing drug friend pharmaceutical limited liability company (approval document: national drug standard H10950134), according to the instructions.

Experimental groups: the decoction of the composition is taken by patients on the basis of a control group, and the composition and the preparation method of the medicine are as follows: 20g of fructus psoraleae, 20g of herba epimedii, 20g of rhizoma drynariae, 20g of eucommia ulmoides, 15g of semen cuscutae, 15g of deerhorn glue, 15g of dogwood, 10g of Chinese yam, 10g of codonopsis pilosula, 10g of bighead atractylodes rhizome, 10g of large-leaved gentian, 10g of notopterygium root, 10g of radix angelicae pubescentis, 8g of prepared rehmannia root, 8g of astragalus mongholicus, 8g of safflower carthamus and 8g of salvia miltiorrhiza are decocted with water for administration, 1 dose/d, 1 time in the morning and evening. Both groups of patients were observed after 8 weeks of continuous treatment.

Observation indexes are as follows: the biochemical indicators of the two groups of patients before and 8 weeks after treatment were compared: FPG (fasting plasma glucose), 2h PG (2 h postprandial blood glucose), hbA1c (glycated hemoglobin), P + + + (blood phosphorus), SAP (blood alkaline phosphatase), SC (blood calcium), BGP (serum osteocalcin), BUN (blood urea nitrogen), UA (blood uric acid), urinary creatinine quantification (UCR), urinary Ca/urinary Cr index.

The treatment results are as follows: the effect is shown: various biochemical values are normal without obvious fluctuation, and clinical symptoms disappear; the method has the following advantages: the biochemical values are not fluctuated and tend to be in a normal range, and the clinical symptoms are improved; and (4) invalidation: the fluctuation of various biochemical values is obvious, and the clinical symptoms are not improved or even aggravated. The treatment conditions and the observed biochemical index changes before and after the treatment are shown in tables 1-3 below.

Clinical efficacy comparison of two groups of patients

After treatment, the total effective rate of the experimental group is 95.00 percent which is higher than that of the control group by 80.00 percent, and the two groups have no obvious difference (p is more than 0.05) in comparison, see table 1.

Compared with the treatment before, the indexes of the two groups of patients are changed, the urinary calcium/creatinine is reduced, and the difference has statistical significance (p is less than 0.05). Compared with a control group, the reduction range of the urine calcium/creatinine value of the experimental group is larger, the general variation range of each biochemical value is obviously higher than that of the control group, and the difference has statistical significance (p is less than 0.05).

Compared with the treatment before, the bone density of the two groups of patients is increased, the bone density value of the experimental group of patients is higher than that of the control group, and the difference has statistical significance (p is less than 0.05).

The traditional Chinese medicine composition with the effect of treating diabetes complicated with osteoporosis can be prepared into oral liquid, granules, capsules, tablets, powder injection or injection dosage form medicines by extracts of all raw material medicines and pharmaceutically acceptable carriers.

Detailed Description

Specific example 1:

a traditional Chinese medicine composition for treating diabetes complicated with osteoporosis is prepared from the following raw materials: 20-40 parts of fructus psoraleae, 20-40 parts of epimedium, 20-40 parts of rhizoma drynariae, 20-40 parts of eucommia bark, 10-30 parts of semen cuscutae, 10-30 parts of deerhorn glue, 10-30 parts of dogwood, 8-15 parts of Chinese yam, 8-15 parts of codonopsis pilosula, 8-15 parts of bighead atractylodes rhizome, 8-15 parts of gentiana macrophylla, 8-15 parts of notopterygium root, 8-15 parts of radix angelicae pubescentis, 10-20 parts of prepared rehmannia root, 10-20 parts of astragalus membranaceus, 10-20 parts of safflower and 10-20 parts of salvia miltiorrhiza, washing, sterilizing, drying, crushing, sieving and uniformly mixing; refining Mel, adding water to make into Mel water, mixing with the medicinal powder, and making into watered honeyed pill.

Specific example 2:

a traditional Chinese medicine composition for treating diabetes complicated with osteoporosis is prepared from the following raw material medicines: 30-40 parts of fructus psoraleae, 30-40 parts of epimedium, 30-40 parts of rhizoma drynariae, 30-40 parts of eucommia bark, 20-30 parts of semen cuscutae, 20-30 parts of deerhorn glue, 20-30 parts of dogwood, 10-15 parts of Chinese yam, 10-15 parts of codonopsis pilosula, 10-15 parts of bighead atractylodes rhizome, 10-15 parts of gentiana macrophylla, 10-15 parts of notopterygium root, 10-15 parts of radix angelicae pubescentis, 15-20 parts of prepared rehmannia root, 15-20 parts of astragalus membranaceus, 15-20 parts of safflower and 15-20 parts of salvia miltiorrhiza are decocted by adding 3-5 times of water, continuously decocted for 3 times, filtered, decompressed and concentrated to obtain extract, and auxiliary materials are added into the extract to prepare an oral preparation.

Specific example 3:

further, taking the following raw material medicines: 40 parts of fructus psoraleae, 40 parts of epimedium, 40 parts of rhizoma drynariae, 40 parts of eucommia bark, 30 parts of semen cuscutae, 30 parts of deerhorn glue, 30 parts of dogwood, 15 parts of Chinese yam, 15 parts of codonopsis pilosula, 15 parts of bighead atractylodes rhizome, 15 parts of large-leaved gentian, 15 parts of notopterygium root, 15 parts of radix angelicae pubescentis, 20 parts of prepared rehmannia root, 20 parts of astragalus mongholicus, 20 parts of safflower carthamus and 20 parts of salvia miltiorrhiza, washing, microwave sterilizing, drying, crushing, sieving with a 110-120-mesh sieve, and uniformly mixing; refining honey to 135-150 deg.C, water content of 10-11%, and mixing with honey: 1 part of water: 3.2-1:4.2, adding water into the mixture according to the weight ratio to prepare honey water, and then mixing the medicinal powder: the honey water is 1:1.35-1.45, and evenly mixing the raw materials, and making the mixture into a pill making machine to obtain water-honeyed pills, wherein 300 particles of the water-honeyed pills are 45 g in weight.

Clinical typical case 1:

patient Yu Mou, male, 85 years old, hospitalization number 036

Occupation: retire

And (3) address: xuzhou city fenghua south aster

The admission time is as follows: 2018-3-6

Discharge time: 2018-3-10

The main complaints are: general pain for 2 months

The current medical history: patients have waist pain after sprain, and are accompanied with limited movement, and the patients are in the clinic of our hospital and examined the lumbar MR flat scan: lumbar vertebrae hyperosteogeny; fresh compression fracture of lumbar 1 vertebral body; degeneration of nucleus pulposus of lumbar intervertebral disc; lumbar 4-sacral 1 intervertebral disc mild herniation; lumbar subcutaneous fasciitis. The orthopedic department in Xuzhou city central hospital carries out percutaneous balloon dilatation vertebroplasty in 2018, 1 month and 4 days, and the postoperative lumbago symptom is relieved and discharged. The patient takes 2.5 mg/day of methylprednisolone for a long time due to pemphigus, and the medicine is taken for 4 years. The patient feels the general pain and discomfort, the pain of the waist and the back is obvious, the doctor visits the hospital and examines the bone density as follows: osteoporosis. The patient is expected to be suffering from senile osteoporosis for further diagnosis and treatment and is collected in our family. Since the patients have no relapse cramp of the lower limbs, no fever, no cough, expectoration, no gastrointestinal discomfort, no abdominal distension, diarrhea, no asthma after activity, no edema of the lower limbs, no hematuria, proteinuria, oliguria and nocturia, and the patients have no common conditions at present, can be eaten or sleepy, and have no abnormal defecation and urination.

History of the past: the diabetes mellitus is treated by insulin injection for 30 years, and the control is good. Methylprednisolone is taken for pemphigus, 2.5 mg/day and 4 years of medication.

History of surgery: the hernia and appendicitis operations (the specific time is unknown) exist. "percutaneous balloon dilatation vertebroplasty" was performed in 2018, 1 month and 4 days in xu, city central hospital.

Physical examination: normal development, moderate nutrition, clear mind, mental function, and the wheelchair is pushed into the ward to perform autonomous posture and physical examination and cooperation. The mucous membrane of the whole skin has no yellow stain, and superficial lymph nodes are not enlarged. The skull has no deformity, the eyelid has no edema, the conjunctiva has no congestion, the sclera has no yellow stain, the pupils on both sides have the same size and the diameter is about 2.5mm, and the light reflection is sensitive. No deformity of auricle and no abnormal secretion in external auditory canal. The external nose has no malformation, the nasal septum has no deflection, and each paranasal sinus region has no pressure pain. The lips are not pale, the pharynx is not congested, and the tonsil is not swollen. The neck is soft, the jugular vein is not full of anger, the trachea is centered, the thyroid gland is not swollen, and the bilateral neck is not palpated with swollen lymph nodes. Bilateral thoracic symmetry, no deformity and no varicose veins; no pleura rubbing sensation was felt, percussion showed clear sound, auscultation of both lung respiratory sound was clear, and there was no dry and moist rale sound. There was no protrusion in the precordial region, no tremor and friction sensation, no enlargement of the palpation heart boundary, and auscultation heart rate of 90 times/min, regular, and no pathological noise heard in the auscultation region of each valve. The abdomen is flat and soft, the gastrointestinal peristalsis wave and the bump of the tumor are not generated, the whole abdomen is soft, the pressure pain and the rebound pain are not generated, the lower part of the rib of the liver and the spleen is not reached, the tumor is not touched, the percussion pain is not generated in the liver area and the double kidney area, the mobility voiced sound is negative, the bowel sound is 4 to 5 times per minute, and the vascular noise is not generated. The bladder is not full and the suprapubic area is not tender. The external genitalia develops normally. Physiological curvature of the spine, no deformity, tenderness, percussion pain (+), no deformity of the joints of the limbs and free movement. Physiological reflexes exist, and pathological reflexes do not lead out.

Auxiliary inspection: 6 days 3 and 6 in 2018, the institute shows that the dual-energy X-ray examination is as follows: osteoporosis. X-ray examination of the thoracolumbar vertebra and pelvis shows that: chest 12 vertebral body compression sample change, chest lumbar degenerative change after lumbar 1 vertebral body forming, and double hip joint degenerative change.

And (3) diagnosis: senile osteoporosis, post-lumbar 1 vertebroplasty, type 2 diabetes

The treatment process comprises the following steps: perfecting relevant examination after patient admission, and checking electrocardiogram: sinus rhythm, left ventricular high voltage. X-ray film of thoracic and lumbar vertebrae: thoracic 12 vertebral body compression-like changes. After lumbar 1 vertebroplasty, the thoracolumbar vertebrae and the double hip joints are degenerated. The dual-energy X-ray bone mineral density examination shows: osteoporosis, T-value-2.52. Hepatorenal glycolipid electrocardio: calcium (CA) CA 2.42mmol/L, phosphorus (P) P0.97 mmol/L, creatinine (CREA) CREA 53.0umol/L. Creatinine clearance was 40.4ml/min. Calcitonin assay (CT) JGSCD 0.84pg/ml. Bone metabolism markers 6 items: 25 hydroxyvitamin D ₃ 16.53ng/ml, beta-collagen degradation product (beta-CTX) 863.60pg/ml, total type I collagen amino terminal propeptide (NTX) 65.62ng/ml, N terminal osteocalcin (N-MID) 11.96ng/ml, parathyroid hormone 50.60pg/ml, bone type alkaline phosphatase GXJLM 34.67ug/l. The diagnosis of the diabetic osteoporosis is clear, and the traditional Chinese medicine preparation (the traditional Chinese medicine composition) in the hospital has a smooth treatment process and causes no special discomfort such as fever and the like to patients. Pain of the patient's back and waistAnd (4) relieving, and discharging.

Discharge situation: patients can have normal conditions, diet and sleep, and have no abnormal stool and urine.

Ordering for discharge: 1. fortifying, high calcium, low salt diet, appropriate outdoor activities and sun exposure; 2. continuously taking the Chinese medicinal preparation for treating diabetic osteoporosis; 3. please review the bone metabolism markers in our department clinic on empty stomach in the 7 th, 6 th and 9 th morning of 4 th and 7 th, 6 th and 7 th.

2018-4-7 review

Bone metabolism markers: the beta-collagen degradation product (beta-CTX) 91.43pg/ml is obviously reduced. The pain of the waist and the back of the patient is relieved.

2019-3-12 double diagnosis

2019-3-12 patients are admitted to the hospital again for general arthralgia and receive anti-osteoporosis treatment. Perfecting related examination after hospitalization, and checking the double-energy X-ray bone mineral density examination show: bone mass decreased with a T value of-1.86. Bone metabolism markers item 6: 25 hydroxyvitamin D ₃ 14.13ng/ml, beta-collagen degradation product (beta-CTX) 119.20pg/ml, total type I collagen amino-terminal propeptide (NTX) 21.24ng/ml, N-terminal osteocalcin (N-MID) 7.41ng/ml, parathyroid hormone PTH 30.80pg/ml, bone alkaline phosphatase GXJLM 12.99ug/l. The diagnosis is definite, and the traditional Chinese medicine preparation (the traditional Chinese medicine composition) in the hospital has smooth treatment process and causes no discomfort such as fever and the like. The patient consciously relieves the pain of the joints of the whole body, improves the activity and is discharged.

2019-4-13 review

Bone metabolism markers: beta-collagen degradation product (beta-CTX) 72.34pg/ml, which is reduced compared with the former. The pain of the joint of the whole body of the patient is obviously relieved, and the movement is improved.

The checking result changes:

bone density:

2018-3-6, hospital, dual energy X-ray: osteoporosis, T value-2.52

2019-3-13, hospital, dual energy X-ray: reduced bone mass, T value-1.86

Bone metabolism markers:

2018-3-7, hospital: 25 hydroxy vitamin D3.53 ng/ml, beta-collagen degradation product (beta-CTX) 863.60pg/ml, total type I collagen amino-terminal propeptide (NTX) 65.62ng/ml, N-terminal osteocalcin (N-MID) 11.96ng/ml, parathyroid hormone PTH 50.60pg/ml, bone alkaline phosphatase GXM 3262 zxft JL62 ug/l.

2019-3-13, hospital: 25 hydroxyvitamin D3.13 ng/ml, beta-collagen degradation product (beta-CTX) 119.20pg/ml, total type I collagen amino-terminal propeptide (NTX) 21.24ng/ml, N-terminal osteocalcin (N-MID) 7.41ng/ml, parathyroid hormone PTH 30.80pg/ml, bone alkaline phosphatase GXJLM 12.99ug/l.

Case 2:

patient Liu, woman, 72 years old, hospitalization number 049

2019-2-14

Occupation: retire

And (3) address: xu city railway 33 dormitory

The admission time is as follows: 2019-2-14

Discharge time: 2019-2-18

The main complaints are: lumbosacral pain for more than 1 month

The current medical history: the patient enters the digestive department of our hospital for abdominal and waist pain before 1 month, and the examination indicates acute gastritis. The dual-energy X-ray bone density examination during hospitalization showed: osteoporosis, lowest T value: -2.54. After the patient is discharged, the traditional Chinese medicine preparation (the traditional Chinese medicine composition) is applied to the patient to improve the bone mineral density. At present, patients complain of pain at the waist and sacrococcygeal region and enter the hospital for further diagnosis and treatment. The clinic is to treat osteoporosis. The patient has no fever, cough, expectoration, abdominal distension, diarrhea, asthma after no activity, edema of both lower limbs and occasional left lower abdominal pain since the disease. At present, the common conditions are that diet and sleep are enough, and the bowels are not abnormal.

The past medical history: the metformin sustained-release tablet is taken for 10 years of diabetes mellitus all year round, and the control is good.

History of surgery: in 1987, a total hysterectomy was performed due to endometriosis.

Physical examination: normal development, moderate nutrition, clear mind, mental capacity, walking into ward, autonomous posture, and physical coordination. The mucous membrane of the whole skin has no yellow stain, and superficial lymph nodes are not enlarged. The skull has no deformity, the eyelid has no edema, the conjunctiva has no congestion, the sclera has no yellow stain, the pupils on both sides have the same size and the diameter is about 2.5mm, and the light reflection is sensitive. No deformity of auricle and no abnormal secretion in external auditory canal. The external nose has no malformation, the nasal septum has no deflection, and each paranasal sinus region has no pressure pain. The lips are pale, the pharynx is not congested, and the tonsil is not swollen. The neck is soft, the jugular vein is not full of anger, the trachea is centered, the thyroid gland is not swollen, and the bilateral neck is not palpated with swollen lymph nodes. Bilateral thoracic symmetry, no deformity and no varicose veins; no pleura rubbing sensation was felt, percussion showed clear sound, auscultation of both lung respiratory sound was clear, and there was no dry and moist rale sound. There was no protrusion in the precordial region, no tremor and friction sensation, no enlargement of the palpation heart boundary, and the auscultation heart rate was 85 times/min and regular, and there was no pathological noise in the auscultation region of each valve. The abdomen is flat and soft, the stomach and intestine wriggling wave and the bump are not generated, the whole abdomen is soft, the pressure pain and the rebound pain are not generated, the liver and spleen rib is not in the reach and the bump is not contacted, the percussion pain is not generated in the liver area and the double kidney area, the mobility voiced sound is negative, the bowel sound is 4 to 5 times/minute, and the vascular noise is not generated. The bladder is not full and the suprapubic area is not tender. The external genitalia develops normally. Physiological curvature of the spine, no deformity, tenderness, percussion pain (+), no deformity of the joints of the limbs and free movement. Physiological reflex exists, and pathological reflex is not led out.

Special examination: physiological curvature of the spine, no deformity, tenderness and percussion pain (+) of the lumbosacral part, slightly limited movement, no deformity of joints of limbs and free movement. Physiological reflex exists, and pathological reflex is not led out.

Auxiliary inspection: 1 month in 2019, home, dual-energy X-ray film show: bone density examination shows: osteoporosis, T-value: -2.54.

And (3) diagnosis: postmenopausal osteoporosis, senile brain atrophy and type II diabetes

The treatment process comprises the following steps: and (3) perfecting related examination after patient admission, and checking 6 bone metabolism markers: 25 hydroxy vitamin D3.95 ng/ml, beta-collagen degradation product (beta-CTX) 1302.00pg/ml, total type I collagen amino-terminal propeptide (NTX) 100.20ng/ml, N-terminal osteocalcin (N-MID) 43.01ng/ml, parathyroid hormone PTH 38.30pg/ml, bone alkaline phosphatase GXJLM 19.24ug/l. Blood homocysteine HCY-N40.99 umol/l. The right side of the lumbar vertebra: the degenerative change of the chest and the lumbar is accompanied by the mild lateral bending of the lumbar, the degenerative change of the double hip joints, and the examination of the bone density of the double-energy X-ray: osteoporosis. The Chinese medicinal preparation (the Chinese medicinal composition) is used for treating osteoporosis in 2019-02-15 days. After treatment, the patient has fever reaction, and the symptoms are improved compared with the former symptoms. At present, the lumbosacral pain of the patient is relieved, the movement is improved, the patient is required to be discharged from a hospital, and the patient is asked to be handled after the patient is shown to the higher level.

Discharge situation: patients can have normal conditions, diet and sleep, and have no abnormal stool and urine. Physical examination: shenqing, spiritual and heart-lung auscultation without obvious abnormality.

Ordering for discharge: 1. and (3) adjusting the life style: (1) A balanced diet rich in calcium, low salt and appropriate amount of protein. (2) Suitable outdoor activities and sunshine are beneficial to physical exercise and rehabilitation therapy of bone health. (3) Avoid smoking and drinking too much, and use cautiously the drugs that affect bone metabolism. (4) Various measures are taken to prevent falls, taking care whether there are diseases and drugs that increase the risk of falls. (5) Strengthening self and environmental protection measures (including various joint protectors), and the like. 2. The basic dosage is as follows: the traditional Chinese medicine preparations of the hospital are taken 1 time each in the morning and evening, 1 month and half a year later and then are reviewed in an outpatient clinic; 3. if the patient is uncomfortable, the patient is followed up in the clinic.

2019-3-15 review:

bone metabolism markers: the beta-collagen degradation product (beta-CTX) is 142.3pg/ml, which is obviously reduced compared with the previous method. The lumbosacral pain of the patient is relieved, and the movement is improved.

Case 3:

patient wang, woman, 62 years old, hospitalization number 709

2016-12-21

Occupation: retirement

And (3) address: xuzhou city Huaihai Xilu No. 195

The admission time is as follows: 2016-12-21

Discharge time: 2016-12-24

A chief complaint: pain in the left hip and lumbosacral region is not enough for more than half a year.

The current medical history is as follows: the patients have no obvious inducement to the gradual appearance of the ache of the left hip and the lumbosacral part, the difficulty of squatting and rising and the weakness of the two lower limbs. Physical examination ultrasonic bone mineral density examination shows: osteoporosis. The patient is collected into the department for further diagnosis and treatment. The patient has no pain and discomfort of hip joint and lumbosacral part, no fever, cough, expectoration, no gastrointestinal discomfort, no abdominal distension, diarrhea, no asthma after activity, no edema of both lower limbs, no hematuria, proteinuria, oliguria and nocturia since the patient is sick, and the patient can eat, sleep and defecate without abnormality at present under common conditions.

The past medical history: the acarbose tablet is taken for 15 years in diabetes mellitus, and insulin treatment is given in severe cases, so that the control is good at present.

History of surgery: "appendectomy" was performed in 2004 at the Xuzhou medical school affiliated hospital.

Physical examination: normal development, moderate nutrition, clear mind, mental capacity, walking into ward, autonomous posture, and physical coordination. The mucous membrane of the whole skin has no yellow stain, and superficial lymph nodes are not enlarged. The skull has no deformity, the eyelid has no edema, the conjunctiva has no congestion, the sclera has no yellow stain, the pupils on both sides have the same size and the diameter is about 2.5mm, and the light reflection is sensitive. No deformity of auricle and no abnormal secretion in external auditory canal. The external nose has no malformation, the nasal septum has no deflection, and each paranasal sinus region has no pressure pain. The lips are not pale, the pharynx is not congested, and the tonsil is not swollen. Soft neck, no anger in jugular vein, centered trachea, no enlargement of thyroid gland, no palpation of swollen lymph nodes in the neck on both sides. Bilateral thoracic symmetry, no deformity and no varicose veins; no pleura rubbing sensation was felt, percussion showed clear sound, auscultation of both lung respiratory sound was clear, and there was no dry and moist rale sound. There was no protrusion in the precordial region, no tremor and friction sensation, no enlargement of the palpation heart boundary, and auscultation heart rate of 72 times/min, regular rhythm, and no pathological noise heard in the auscultation region of each valve. The abdomen is flat and soft, the stomach and intestine wriggling wave and the bump are not generated, the whole abdomen is soft, the pressure pain and the rebound pain are not generated, the liver and spleen rib is not in the reach and the bump is not contacted, the percussion pain is not generated in the liver area and the double kidney area, the mobility voiced sound is negative, the bowel sound is 4 to 5 times/minute, and the vascular noise is not generated. The bladder is not full and the suprapubic area is not tender. The external genitalia develops normally. Physiological curvature of the spine, no deformity, tenderness, percussion pain (+), no deformity of the joints of the limbs and free movement. Physiological reflexes exist, and pathological reflexes do not lead out.

Auxiliary inspection: the dual-energy X-ray examination at Xuzhou city central hospital in 12 months and 21 days in 2016 shows: bone mass reduction, lowest T value (L2): -2.46.

And (3) diagnosis: postmenopausal osteoporosis, type II diabetes

The treatment process comprises the following steps: after the patient is admitted, relevant examination is perfected, the blood routine and the liver and kidney functions are approximately normal, the serum creatinine is 44.3Umol/L, and the creatinine clearance rate is approximately normal. Ca 2.53mmol/L, P1.04 mmol/L. Bone metabolism markers: 25 hydroxy vitamin D3.45 ng/ml, beta-collagen degradation product (beta-CTX) 504.80pg/ml, total type I collagen amino-terminal propeptide (NTX) 35.40ng/ml, N-terminal osteocalcin (N-MID) 15.83ng/ml, parathyroid hormone PTH 22.60pg/ml, bone alkaline phosphatase GXJLM 15.98ug/l. Electrocardiogram: sinus rhythm. Thoracic X-ray films: degenerative change of thoracic vertebrae, and osteoporosis. Double-energy X-ray bone mineral density examination: the bone mass is reduced. Definite diagnosis, exclusion of contraindication, and intravenous drip treatment with sodium zoledronate, and smooth treatment process, and no special discomfort such as fever, etc. After the treatment is finished, the patient is required to be discharged. The superior physician is asked to discharge.

Advice of hospital discharge: 1. and (3) adjusting the life style: (1) A balanced diet rich in calcium, low salt and appropriate amount of protein. (2) Suitable outdoor activities and sunshine are beneficial to physical exercise and rehabilitation therapy of bone health. (3) Avoid smoking and drinking too much, and use cautiously the drugs that affect bone metabolism. (4) Various measures are taken to prevent falls, taking care whether there are diseases and drugs that increase the risk of falls. (5) Strengthening self and environmental protection measures (including various joint protectors), and the like. 2. The basic dose is as follows: the traditional Chinese medicine preparation (the traditional Chinese medicine composition) is taken 1 time in the morning and at night, and is used for outpatient service and reexamination after 1 month and half a year. 3. If the patient is uncomfortable, the patient is followed up in the clinic.

2018-3-12 hospitalization and return visit

The pain of the lumbosacral part and the hip joint of the patient is relieved, the movement is better, and the double-function X-ray examination shows are rechecked: bone mass reduction, lowest T value (lumbar): -1.78. Bone metabolism 6 items: 25 hydroxyvitamin D3 62.43ng/ml, beta-collagen degradation product (beta-CTX) 237.70pg/ml, total type I collagen amino-terminal propeptide (NTX) 19.93ng/ml, N-terminal osteocalcin (N-MID) 11.71ng/ml, parathyroid hormone PTH 24.7pg/ml, bone alkaline phosphatase GXJLM 9.92ug/l. The bone density and the bone metabolism index are better improved.

2019-3-8 hospitalization for further diagnosis:

the pain of the lumbosacral part and the hip joint of the patient is obviously relieved, the daily life is not influenced, and the double-energy X-ray examination is rechecked: bone mass reduction, lowest T value (lumbar): -1.08. Bone metabolism 6 items: 25 hydroxyvitamin D3 41.18ng/ml, beta-collagen degradation product (beta-CTX) 212.30pg/ml, total type I collagen amino-terminal propeptide (NTX) 16.86ng/ml, N-terminal osteocalcin (N-MID) 14.61ng/ml, parathyroid hormone PTH 24.4pg/ml, bone alkaline phosphatase GXJLM 9.93ug/l. The bone metabolism index of the patient is obviously improved, and the bone density is close to a normal value.

The invention provides application of a traditional Chinese medicine composition with the effect of treating diabetes complicated by osteoporosis in preparation of a medicine for preventing and treating the diabetes complicated by osteoporosis.

As a preferred scheme, the traditional Chinese medicine composition provided by the invention is applied to preparation of medicines for preventing and treating diabetes complicated with osteoporosis.

It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative embodiments, and that the present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof. The present embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein.

Furthermore, it should be understood that although the present description refers to embodiments, not every embodiment may contain only a single embodiment, and such description is for clarity only, and those skilled in the art should integrate the description, and the embodiments may be combined as appropriate to form other embodiments understood by those skilled in the art.

Claims

1. A traditional Chinese medicine composition for treating diabetes complicated with osteoporosis comprises the following raw material medicines in parts by weight: 20-40 parts of fructus psoraleae, 20-40 parts of epimedium herb, 20-40 parts of drynaria rhizome, 20-40 parts of eucommia bark, 10-30 parts of semen cuscutae, 10-30 parts of deerhorn glue, 10-30 parts of dogwood, 8-15 parts of Chinese yam, 8-15 parts of codonopsis pilosula, 8-15 parts of bighead atractylodes rhizome, 8-15 parts of gentiana macrophylla, 8-15 parts of notopterygium root, 8-15 parts of radix angelicae pubescentis, 10-20 parts of prepared rehmannia root, 10-20 parts of astragalus mongholicus, 10-20 parts of safflower carthamus and 10-20 parts of salvia miltiorrhiza.

2. A traditional Chinese medicine composition for treating diabetes complicated with osteoporosis comprises the following raw material medicines in parts by weight: 30-40 parts of fructus psoraleae, 30-40 parts of epimedium, 30-40 parts of rhizoma drynariae, 30-40 parts of eucommia bark, 20-30 parts of semen cuscutae, 20-30 parts of deerhorn glue, 20-30 parts of dogwood, 10-15 parts of Chinese yam, 10-15 parts of codonopsis pilosula, 10-15 parts of bighead atractylodes rhizome, 10-15 parts of gentiana macrophylla, 10-15 parts of notopterygium root, 10-15 parts of radix angelicae pubescentis, 15-20 parts of prepared rehmannia root, 15-20 parts of astragalus membranaceus, 15-20 parts of safflower and 15-20 parts of salvia miltiorrhiza.

3. The traditional Chinese medicine composition of claim 1 or 2, which comprises the following raw material medicines in parts by weight: 40 parts of fructus psoraleae, 40 parts of epimedium, 40 parts of rhizoma drynariae, 40 parts of eucommia ulmoides, 30 parts of semen cuscutae, 30 parts of deerhorn glue, 30 parts of dogwood, 15 parts of Chinese yam, 15 parts of codonopsis pilosula, 15 parts of bighead atractylodes rhizome, 15 parts of gentiana macrophylla, 15 parts of notopterygium root, 15 parts of radix angelicae pubescentis, 20 parts of prepared rehmannia root, 20 parts of astragalus mongholicus, 20 parts of safflower carthamus and 20 parts of salvia miltiorrhiza.

4. The preparation method of the Chinese medicinal composition as claimed in any one of claims 1-3, taking the above raw materials, washing with water, sterilizing, drying, pulverizing, sieving, and mixing; refining Mel, adding water to make into Mel water, mixing with the medicinal powder, and making into water-honeyed pill.

5. The preparation method of the traditional Chinese medicine composition according to claims 1 to 3, which comprises the following specific steps: weighing the traditional Chinese medicine raw materials according to the prescription amount, adding 3-5 times of water for decocting, continuously decocting for 3 times, filtering, concentrating under reduced pressure to obtain extract, adding auxiliary materials into the extract, and preparing into oral dosage forms.

6. The preparation method of the Chinese medicinal composition as claimed in claim 4, washing with water, microwave sterilizing, drying, pulverizing, sieving with 110-120 mesh sieve, and mixing; refining honey to 135-150 ℃, wherein the water content is 10-11%, and then adding honey: 1 part of water: 3.2-1:4.2, adding water into the mixture according to the weight ratio to prepare honey water, and then mixing the medicinal powder: the honey water is 1:1.35-1.45, and evenly mixing the raw materials, and making the mixture into a pill making machine to obtain water-honeyed pills, wherein 300 particles of the water-honeyed pills are 45 g in weight.

7. The use of the Chinese medicinal composition of any one of claims 1-6 in the preparation of a medicament for treating osteoporosis complicated with diabetes.