绝经妇女骨质疏松的多层次个体化防治

目的　探讨绝经妇女骨质疏松的有效防治措施和方法。方法　采用双能X线骨密度仪测定股骨颈骨密度 ,采用肌肉功能分析仪测定下肢肌力及股骨颈抗骨折能力 ,根据WHO的标准综合分析诊断骨质疏松的程度 ;选择诊断为骨量减少或骨质疏松的绝经健康妇女 ,有绝经相关症状需要激素补充治疗 ,又无激素补充治疗的禁忌证者 60例 ,随机分为 3组 :A组为激素补充治疗 +定量营养 +运动 ;B组为单纯激素补充治疗 ;C组为对照组 (没进行任何治疗者 )。于治疗前和治疗后 1年分别测定各组股骨颈骨密度 ,下肢肌力及股骨颈抗骨折能力等 ,比较各组疗效。结果　A组股骨颈骨密度平均增加 5 72 % ,下肢肌力增加 2 1 97% ,股骨颈抗骨折能力增加 1 6 % ;B组上述指标分别增加2 57% ,1 3 9% ,1 2 % ;C组上述指标分别下降 3 6 % ,2 8% ,5 6 %。A组股骨颈骨密度、下肢肌力及股骨颈抗骨折能力均明显优于B组 (P <0 0 5) ,B组上述指标均明显优于C组 (P <0 0 5)。结论　对绝经妇女骨质疏松症防治采用激素补充治疗 ,合理定量营养及适当运动等多层次个体化的措施和方法可能是目前最有效而安全的选择。合理的激素补充疗法对防治绝经妇女骨质疏松症亦有一定疗效

Multiple prevention and treatment on osteoporosis of postmenopausal women

Objective To explore the effective method for prevention and treatment of osteoporosis in postmenopausal women Methods The degrees of osteoporosis were analyzed comprehensively and diagnosed according to WHO criteria The bone mineral density (BMD) of the femoral neck was estimated by a Lunar Expert DEXA apparatus The muscle force of lower limbs and the anti fracture power of the femoral neck were estimated by MES Sixty healthy postmenopausal women diagnosed as having bone loss or osteoporosis were recruited who have the symptoms related to menopause, indications of HRT, and no contraindication to HRT They were divided randomly into 3 groups: group A, HRT plus adequate nutrition and exercises one hour per day; group B, HRT alone; group C, control no treatment The therapeutic effects were compared between the groups on the changes in the BMD of femoral neck, the muscle force of lower limbs, and the anti fracture power of femoral neck before and one year after treatment Results In group A the BMD of femoral neck increased 5 72% on average, the muscle force of lower limbs increased 21 97%,and the anti fracture power of femoral neck increased 16% The values in group B increased 2 57%,13 9% and 12%,respectively, and those in group C declined 3 6%,2 8% and 5 6% respectively The indexes in group A, including the BMD, the anti fracture power of femoral neck, and the muscle force of lower limbs were significantly better than those in group B ( P <0 05), the values in group B were significently better than those in group C ( P <0 05) Conclusion The multiple measures for prevention and treatment of osteoporosis in postmenopausal women, including HRT, adequate nutrition, and appropriate exercises, may be the most effective and safest choice Reasonable HRT is also effective