骨质疏松合并2型糖尿病的中西医研究进展

Research Progress of Traditional Chinese and Western Medicine on Osteoporosis Complicated with Type 2 Diabetes Mellitus

摘要: 骨质疏松症与2型糖尿病是常见慢性疾病，已成为严峻的公共健康问题，二者共病增加了骨折风险与临床管理难度。现代医学发现骨质疏松合并2型糖尿病患者存在“高骨密度与高骨折风险”的悖论，机制尚不明了，给临床诊疗带来了巨大挑战。中医认为二者病机以脾肾两虚为本，痰瘀互结为标，筋骨失养而致病。治疗上，现代医学以生活方式干预、控制血糖及使用抗骨松药物(如双膦酸盐、地舒单抗、特立帕肽等)为主，但仍存在不良反应风险；中医药强调辨证论治，采用益肾健脾、活血通络等方药，配合针灸、导引等非药物疗法，在改善骨代谢、提升骨密度及调控血糖方面显示出独特优势。中西医结合治疗是整合双方优势，提供更全面、个性化的治疗策略。未来需进一步规范中医辨证标准、开展多中心临床研究并深入探讨作用机制，以提升循证依据，优化中西医协同防治疾病的模式。

Abstract: Osteoporosis and type 2 diabetes are common chronic diseases, which have become serious public health problems. Their comorbidity increases the risk of fracture and the difficulty of clinical management. Modern medicine finds that osteoporosis patients with type 2 diabetes have the paradox of “high bone density and high fracture risk”, and the mechanism is still unclear, which brings great challenges to clinical diagnosis and treatment. Traditional Chinese medicine believes that the pathogenesis of the two diseases is based on spleen and kidney deficiency, with phlegm and blood stasis as the standard, and the loss of muscle and bone nourishment leading to disease. In terms of treatment, modern medicine mainly focuses on lifestyle interventions, blood sugar control, and the use of anti-osteoporosis drugs (such as bisphosphonates, denosumab, teriparatide, etc.), but there is still a risk of adverse reactions. Traditional Chinese medicine emphasizes syndrome differentiation and treatment. It uses prescriptions such as tonifying the kidney and spleen, promoting blood circulation and unblocking collaterals, together with acupuncture and moxibustion, guidance and other non-drug therapies, and shows unique advantages in improving bone metabolism, increasing bone density and regulating blood sugar. Integrated traditional Chinese and Western medicine treatment integrates the advantages of both parties and provides more comprehensive and personalized treatment strategies. In the future, it is necessary to further standardize the traditional Chinese medicine syndrome differentiation standards, conduct multi-center clinical research, and explore the mechanisms of action in depth, in order to enhance the evidence-based basis and optimize the mode of collaborative prevention and treatment of diseases between Chinese and Western medicine.