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1.岳阳市中医医院,湖南 岳阳 414000
2.广州中医药大学,广州 510000
3.广州中医药大学 第一附属医院,广州 510000
Received:02 June 2021,
Published Online:07 January 2022,
Published:05 March 2022
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易生辉,招文华,任辉等.中西医治疗绝经后骨质疏松症的研究进展[J].中国实验方剂学杂志,2022,28(05):274-282.
YI Sheng-hui,ZHAO Wen-hua,REN Hui,et al.Traditional Chinese and Western Medicine in Treatment of Postmenopausal Osteoporosis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(05):274-282.
易生辉,招文华,任辉等.中西医治疗绝经后骨质疏松症的研究进展[J].中国实验方剂学杂志,2022,28(05):274-282. DOI: 10.13422/j.cnki.syfjx.20220597.
YI Sheng-hui,ZHAO Wen-hua,REN Hui,et al.Traditional Chinese and Western Medicine in Treatment of Postmenopausal Osteoporosis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(05):274-282. DOI: 10.13422/j.cnki.syfjx.20220597.
绝经后骨质疏松症(PMOP)是女性绝经后雌激素分泌不足,导致骨量减少、骨组织微结构损坏而产生的以骨脆性增加为特征的全身性疾病。临床主要表现为腰背的疼痛、骨质疏松性骨折、脊柱畸形及多脏器功能障碍等。PMOP直接导致了高发病率、高死亡率及生活质量的下降。不仅经常被漏诊,而且常常不能得到及时治疗。近年来对于PMOP的发病相关因素的研究取得了显著的进展,该文以近几年的文献为基础,阐述了PMOP的3大发病机制:肠道菌群失调、氧化应激及骨髓间充质干细胞(BMMSCs)异常分化。分析PMOP的治疗现状,主要包括中医药方面的中药辨证论治、针灸治疗、练功疗法、中医外治法及西医方面的基础措施、药物干预和物理治疗等,其中西医治疗中药物干预按作用机制一般分为骨吸收抑制剂、骨形成促进剂、其他机制类药物。笔者通过归纳中医药及西医两者在临床上治疗PMOP的具体方法及作用效果或机制,希望能够为今后制定合理的健康管理模式及药物治疗提供借鉴参考。
Postmenopausal osteoporosis (PMOP) is a systemic disease characterized by increased bone fragility caused by insufficient estrogen secretion in women after menopause,resulting in decreased bone mass and damage to the microstructure of bone tissues. The main clinical manifestations are low back pain,osteoporotic fractures,spinal deformities,and multiple organ dysfunction. PMOP directly leads to high morbidity, high mortality, and a decline in the quality of life. In addition to miss diagnosis, it is often not treated in time. In recent years, significant progress has been made in the research on factors related to the pathogenesis of PMOP. Based on the previous findings in recent years,this article described three major pathogenesis of PMOP, including intestinal flora imbalance,oxidative stress,and abnormal differentiation of bone marrow mesenchymal stem cells (BMMSCs), and analyzed the current status of PMOP treatment, such as syndrome differentiation and treatment,acupuncture and moxibustion,exercise therapy, and external treatment in traditional Chinese medicine (TCM), and basic measures,drug intervention,and physical therapy in western medicine. Among them,drug intervention in western medicine treatment is generally divided into bone resorption inhibitors,bone formation promoters,and other mechanism drugs according to the mechanism of action. This article summarized the specific methods and effects or mechanisms of TCM and western medicine in the clinical treatment of PMOP,which is expected to provide a reference for formulating reasonable health management models and drug treatments in the future.
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