骨质疏松症药物治疗研究进展

随着老龄化社会的来临,骨质疏松症的发病率逐渐升高,成为影响绝经后妇女和中、老年人健康的严重公共卫生问题,造成巨大的经济和社会负担。治疗骨质疏松症的药物的作用机制主要包括两个方面,即抑制骨吸收和促进骨形成。本文综述骨质疏松症药物治疗的研究进展。     

他汀类药物与骨质疏松症的研究进展

随着社会人口的老龄化,骨质疏松症已成为日益严重的危害广大中老年人(尤其是中老年女性)健康的医学和社会问题。目前骨质疏松症的防治药物主要有骨吸收抑制剂及骨形成促进剂两大剂。骨吸收抑制剂难以使已发生的骨质疏松组织恢复正常,而骨形成刺激剂如氟化物虽然可以促进新骨形成,但是可以导致骨质强度降低,仍然不能降低骨折风险。因此,防治骨质疏松症的新药不断地被开发出来。近期研究发现80年代后期应用于临床的降血脂药物——他汀类药物具有促进骨形成的作用,从而成为骨质疏松症药物治疗研究的热点。     

骨质疏松症药物治疗进展

当今与年龄和绝经有关的骨质疏松症的发病率已位居全球常见病的第7位。近年来骨质疏松症的治疗药物研究有了很大进展，主要为骨吸收抑制剂和骨形成促进剂二大类。目前大部分药物为骨吸收抑制剂，对骨形成促进剂的研究将是未来骨质疏松症治疗的重点。本文主要阐述原发性骨质疏松症的药物治疗进展。     

骨质疏松症的药物治疗进展

骨质疏松症现已成为中老年人的一种多发病和常见病,治疗主要以药物治疗为主,临床上主要有骨吸收抑制剂、骨形成促进剂和骨矿化药物。本文就近年来常见治疗骨质疏松症药物的研究进展作一概述。     

治疗骨质疏松症药物研究进展（一）

骨质疏松症（Osteoporosis，OP）分为两类：（1）原发性骨质疏松痛包括Ⅰ型绝经后骨质疏松症和Ⅱ型老年性骨质疏松症：（2）继发性骨质疏松症由其他疾病或由药物等一些因素诱发。治疗骨质疏松症的药物主要有两大类：抑制骨吸收药物和促进骨形成药物。现对治疗骨质疏松症的药物作用机制及研究进展综述如下。     

治疗骨质疏松症的新药米诺膦酸

骨质疏松症是一种以低骨量和骨组织结构性退化为特征的骨疾病。目前临床上使用的骨质疏松症治疗药物,如雌激素类、选择性雌激素调节剂、降钙素和双膦酸盐类主要有利于减少骨吸收;还有一些治疗药物,如氟化物和甲状旁腺激素可增加骨的形成。抗骨吸收疗法在治疗骨质疏松症中非常有效,即便其通常并不能诱导新骨的形成。     

骨质疏松症药物治疗进展

近年来骨质疏松症的药物治疗研究有了很大进展，主要分为骨吸收抑制剂和骨形成促进剂两大类。在此主要介绍原发性骨质疏松症的药物治疗进展。     

骨质疏松症的药物治疗进展

以国内发表的文献为依据，介绍骨质疏松症治疗药物的不同作用机制及代表药物。骨质疏松症治疗药物从作用机制上可分为两大类：骨吸收抑制剂和骨形成促进剂，此外中药在治疗骨质疏松症上有独特地位。该类药物的研究对临床合理用药具有指导意义。     

骨质疏松症的药物治疗概况

骨质疏松症（Osteoporosis）是常见的骨代谢疾病，以低骨量及骨组织微结构退变为主要特征，并伴有骨脆性增加，易发生骨折。骨质疏松症可分为原发性和继发性两类，其中原发性骨质疏松症占90％。它又可分为2种亚型，即Ⅰ型和Ⅱ型。Ⅰ型为绝经后骨质疏松症，Ⅱ型为老年性骨质疏松症。继发性骨质疏松症可继发于其他疾病或由药物引起。目前，临床上常用于治疗骨质疏松症的药物有骨吸收抑制药、骨形成促进药和骨矿化药物以及应用中医药进行治疗等。[第一段]     

特立帕肽治疗骨质疏松症的研究进展

骨质疏松症是一种骨代谢失衡导致的全身退行性骨病,其治疗药物主要有骨吸收抑制剂、骨形成促进剂和中药等。近年来国内外骨质疏松症患者日益增多,如何提高其治疗效果且减少药物不良反应成为当前研究重点。特立帕肽是目前多个国家获准治疗骨质疏松症的唯一促骨形成类药物,对骨质疏松症的治疗效果较为显著,逐渐成为增加骨密度、预防骨质疏松性骨折的研究热点。该文就特立帕肽对绝经后骨质疏松症、老年骨质疏松症及男性骨质疏松症的临床疗效,对糖皮质激素性骨质疏松症的动物实验结果及临床疗效,对糖尿病性骨质疏松症动物实验等方面的研究进展进行综述,以期为临床治疗各类原发性及继发性骨质疏松症提供理论依据。     

健康教育干预对社区骨质疏松症患者的影响

目的探讨社区健康教育对骨质疏松症患者不良生活方式、骨密度的影响以及对骨质疏松症认识。方法选取定海社区骨质疏松症患者200例为研究对象,对其进行骨质疏松症的健康教育,通过问卷调查,了解干预前后患者生活方式改变情况以及对骨质疏松症认识,并检测干预前后骨密度(BMD)。结果干预后坚持喝牛奶、户外晒台阳、锻炼的人数增多了,而吸烟、饮酒的人数减少了,对骨质疏松症知晓率提高了,且通过生活方式的改变,使得骨密度高于干预前。结论健康教育对于骨质疏松症防治具有积极的意义。     

Prevention and treatment of nonpostmenopausal osteoporosis.

PURPOSE: The causes, prevention, and treatment of osteoporosis in specific populations are discussed. SUMMARY: Osteoporosis and osteopenia affect 44 million women and men ages 50 years or older. Fractures are the most devastating consequence of this disease and significantly affect quality of life, activities of daily living, survival, and health care costs. Most osteoporosis research has focused on postmenopausal women, but several other populations are at risk for osteoporosis, such as patients taking certain medications that affect bone health and those with various health conditions that cause bone loss, including anorexia nervosa, hyperthyroidism, organ transplantation, chronic obstructive pulmonary disease, and inflammatory bowel disease. Glucocorticoids are the most common secondary cause of osteoporosis. Other medications that have been implicated as secondary causes include anticonvulsants, heparin, warfarin, and methotrexate. Preventing osteoporosis may be even more important in adolescence than after menopause. CONCLUSION: Osteoporosis needs to be recognized, monitored, and appropriately treated in patients taking medications that affect bone health and in patients with conditions that increase the risk of osteoporosis.     

糖尿病骨质疏松的健康干预

目的探讨健康干预对糖尿病骨质疏松患者的影响。方法对146例糖尿病骨折疏松患者随机分为两组,即治疗组和治疗加健康干预组进行比较。结果经过3年骨密度T值测定,骨折疏松好转率达39.5%。结论轻度骨折疏松可以通过治疗和健康干预使患者骨密度发生改变,严重骨折疏松是不可逆的病理过程,只有做好预防才能有效地降低骨折疏松的发生率及危害。     

农村社区卫生服务中心妇科医师骨质疏松症知识描述性流行病学问卷调查

目的了解农村社区卫生服务中心妇科医师进行骨质疏松症知识的了解程度和诊治情况。方法使用针对社区改良的骨质疏松症问卷对苏州市6家农村社区卫生服务中心工作21名的妇科医师进行骨质疏松症认知度调查。结果骨质疏松症知识不够普及,妇科相关工作人员普遍对骨质疏松症的认识存在一些误区和盲点。结论应对农村社区卫生服务中心工作的妇科医师进行专业化的骨质疏松症教育。     

老年性骨质疏松症中医内治法的研究进展

老年性骨质疏松症是老年人群中常见的疾病之一,严重的威胁着老年人群的身体健康及生活质量。长期以来,在积累丰富经验的同时,应用中医中药防治老年性骨质疏松症取得了较好的成果。中医理论提出补肾壮骨、健脾益气、活血通络三个基本治疗原则,对中医内治法治疗老年性骨质疏松症具有重要的指导意义。随着人们对老年性骨质疏松症认识的不断提高,相关临床研究不断深入,中医内治法在防治骨质疏松症中将得到更广泛的应用。及早防治,合理用药,可有效延缓老年性骨质疏松症的发生、发展,提高老年人群的整体健康水平。     

The high prevalence of inadequate serum vitamin D levels and implications for bone health

BACKGROUND: Inadequate serum vitamin D is associated with secondary hyperparathyroidism, increased bone turnover, and bone loss, which increased fracture risk. Osteomalacia has also been observed in severe cases. Indeed, vitamin D and calcium are essential components of management strategies for the prevention and treatment of osteoporosis. Despite this, many people currently do not have adequate vitamin D levels. This problem has been documented in many studies around the world, regardless of age, health status, or latitude, and is especially common among older adults, who are also likely to have osteoporosis. Factors that contribute to low vitamin D include low exposure to sunlight, decreased synthesis in skin and reduced intestinal absorption related to aging, and limited dietary sources. Supplementation is the most effective means of correcting poor vitamin D nutrition. However, few patients with osteoporosis currently take sufficient vitamin D supplements. SCOPE: This review article discusses the role of vitamin D in osteoporosis and skeletal health, and summarizes what is known about the high prevalence of inadequate serum vitamin D and recommendations for supplementation. CONCLUSION: Greater awareness of the importance of vitamin D for skeletal health and more aggressive supplementation efforts are urgently needed to address this important public health problem.     

The relationship of calcium intake and exercise to osteoporosis health beliefs in postmenopausal women.

BACKGROUND: Little is known about postmenopausal women's health beliefs and preventative behaviors regarding osteoporosis. Determining their beliefs and behaviors regarding osteoporosis can be helpful in developing effective interventions for osteoporosis prevention. OBJECTIVES: To use the Health Belief Model to assess the associations between postmenopausal women's osteoporosis health beliefs and osteoporosis preventative behaviors. METHODS: Using a self-administered survey, data were obtained from a convenience sample of 187 postmenopausal (> or =65 years of age) women, with no history of osteoporosis at a community pharmacy and senior nutrition sites in central Texas. The independent variables included health beliefs (susceptibility to osteoporosis, severity of osteoporosis, benefits and barriers of calcium intake, benefits and barriers of exercise, health motivation, self-efficacy of calcium intake and exercise) and modifying factors (demographics and risk factors). Calcium intake and exercise were the dependent variables. Multiple regression was used to assess the relationships between health beliefs and modifying factors with calcium intake and exercise. RESULTS: The respondents' mean age was 75.4+/-6.5 years, and Mexican Americans comprised approximately 40% (39.6%) of the sample. Their reported calcium intake (mean+/-SD) was 1604.7+/-907mg/d and they engaged in 5 hours ([mean+/-SD]: 5.1+/-5.3) of weight-bearing exercise per week. Self-efficacy of calcium intake and self-efficacy of exercise had significant (P<.05) positive relationships with calcium intake behavior. In addition, self-efficacy of exercise was significantly (P<.05) and positively related to exercise behavior. CONCLUSIONS: Self-efficacy was significantly associated with postmenopausal women's performance of osteoporosis preventative behaviors. Improving postmenopausal women's confidence in engaging in appropriate calcium intake and weight-bearing exercise behaviors may be beneficial to osteoporosis prevention.     

不同健康教育方式对社区绝经后骨质疏松症患者的干预效果

目的探讨社区绝经后骨质疏松症患者应用不同健康教育模式的效果。方法随机抽取2012年1月至2014年1月本院接诊的160例社区绝经后骨质疏松症患者按数字表法随机为观察组和对照组,每组各80例,对照组患者予以一般健康教育,观察组患者予以个体化教育,比较两组骨质疏松症的知识、健康信念、自我效能。结果干预前两组患者自我效能评分、认知度评分、依从信念评分无明显差异(P>0.05),干预后均有改善,观察组自我效能评分、认知度评分、依从信念评分高于对照组,差异具有统计学意义(P<0.05)。结论一般健康教育结合个体化健康教育有助于提高绝经妇女的健康信念、骨质疏松症知识及自我效能。     

上海长风社区骨质疏松防治健康宣教效果评析

目的评价上海长风社区团队式健康宣教干预后,骨质疏松防治的效果.方法对社区骨健康流行病学调查中,经双能X射线骨密度测定仪检查确诊的,年龄为51～80岁的骨量减少及骨质疏松症居民105名,进行团队服务式健康教育干预.为期8个月,并对干预前、后骨质疏松防治知识知晓度进行比较。结果经团队模式服务,社区居民骨质疏松相关防治知识的认知程度有明显提高.结论以团队式服务有计划、有针对性地开展有关骨质疏松防治知识的健康教育和指导有助于社区居民充分认识疾病本身及其危害性,建立健康的生活行为方式,全面提高生活质量.