绝经后骨质疏松症的临床中药治疗进展

绝经后骨质疏松症(postmenopausal osteoporosis, PMOP)是绝经后妇女的常见病及多发病, 主要因绝经后妇女的卵巢功能减退、雌激素水平下降，导致骨生成和骨吸收的代谢失衡。其特征是全身骨量减少和骨组织的微细结构破坏，临床主要表现为骨痛和骨折风险增加。大量研究表明，中医药可以提高绝经后骨质疏松症患者的骨密度，改善其疼痛症状，在防治绝经后骨质疏松症方面有其独特的优势。目前对绝经后骨质疏松症的研究主要分为单味中药的实验研究和复方中药的临床研究。通过对近5年国内外对绝经后骨质疏松症的中药治疗进行相关回顾，在单味中药方面，根据绝经后骨质疏松症的病机特点和用药频次，主要从骨测量指标、细胞因子变化、基因水平等方面综述了淫羊藿、杜仲、骨碎补3种常用中药的实验研究进展；在复方中药方面，普遍认为肾虚是绝经后骨质疏松的主要病机，此外与肝脾不足、血瘀痰浊等密切相关，主要论述了补肾法在临床上治疗绝经后骨质疏松中的应用，并探讨未来治疗绝经后骨质疏松症可能的研究方向。

The clinical progress in the treatment of postmenopausal osteoporosis using traditional Chinese medicine

Postmenopausal osteoporosis is a common and popular disease in postmenopausal women. Its basic pathogenesis is metabolic imbalance of bone formation and bone absorption caused by a decline of ovarian function and a drop in estrogen level. The characteristics of the disease are bone mass loss of the whole body, the breakdown of bone microstructure, bone pain, and the increase of fracture risk. A great quantity of research indicates that traditional Chinese medicine treatment for postmenopausal osteoporosis can improve the bone mineral density of postmenopausal women and reduce the symptom of bone pain. It has distinct advantage. Currently, the research in postmenopausal osteoporosis mainly includes the experimental research of single Chinese herb and the clinical research of Chinese compound formula. This paper summarizes recent experiment development of three commonly used Chinese herbs from bone measurement index, the change of cytokines, and gene level aspects according to the pathogenesis and medication frequency of postmenopausal osteoporosis. In Chinese compound use aspects, it is believed that kidney deficiency is the main pathogenesis of postmenopausal osteoporosis. Liver and spleen deficiency and blood stigma are also involved. The paper elucidates the application of kidney-nourishing therapy in postmenopausal osteoporosis, and explores the possible future research direction for postmenopausal osteoporosis therapy.