肌肉、骨骼与骨质疏松专家共识

骨质疏松症已成为全球性的公共健康问题和前沿研究难题。老年人骨骼肌肉系统的衰退会造成肌肉萎缩、骨质减少,进而引起肌力减退、运动能力、平衡能力下降、步行缓慢、骨脆性增大、易骨折,最终导致老年人生活质量下降。如何从肌肉、骨骼方面研究其与骨质疏松的关系非常迫切和重要。为此,中国老年学学会骨质疏松委员会成立了肌肉、骨骼与骨质疏松学科组,组织专家编写《肌肉、骨骼与骨质疏松专家共识》,为骨质疏松症的临床诊疗和科学研究提供参考。共识认为:骨质疏松与肌肉、骨骼密切相关。骨质疏松症和肌少症存在着很多共同的风险因素。肌骨代谢生化指标可反映肌骨代谢状态,对代谢性肌肉骨骼疾病的诊断和疗效评价有指导作用。推荐使用DXA测量肌肉质量和骨密度。肌力和平衡能力评定有助于判断跌倒风险。肌肉、骨骼存在潜在的药物作用共同靶点。肌肉骨骼运动可以增加峰值骨量,调节骨代谢信号通路,促进骨形成。骨质疏松人群应注重个体化运动锻炼。中医学认为肌肉、骨骼与脾、肝、肾关系密切,骨质疏松症的病位主要在肾、脾、经络,主要与肾虚、脾虚和血瘀有关,强调骨筋肉并重,动静结合,治疗原则宜补肾、健脾、活血。

Expert consensus on muscle, bone and osteoporosis

Osteoporosis has become a global public health problem and cutting-edge research problem. The senility of the musculoskeletal system in the elderly can cause muscle atrophy, osteopenia, resulting in lossing of muscle tone, droping of motoricity and balance, walking slowly, increasing osteopsathyrosis, easily fracture, eventually lead to lower quality of life in the elderly.It is very urgent and important that relationship between the aspects of muscle, bone and osteoporosis. Hence,the Osteoporosis Committee of China Gerontological Society set up the muscle,bone and osteoporosis group,and experts write the "muscle, bone and osteoporosis expert consensus", which will provide the guideline about the clinical diagnosis, treatment of osteoporosis and scientific research. The consensus confirms: Osteoporosis is closely related to the muscle and bone. There are many common risk factors about osteoporosis and sarcopenia. Musculoskeletal metabolic biochemical index which guide about the diagnosis of metabolic musculoskeletal disease and therapeutic evaluation can reflect the musculoskeletal metabolic state. DXA is recommended to measure muscle mass and bone mineral density .Evaluation of myodynamia and balance ability determine risk of falls. Both muscle and bone have a potential drug target .Locomotory Musculoskeletal can increase the peak of bone mass, regulate signaling pathways of bone metabolism, and promote bone formation.Osteoporosis people should pay attention to individualized exercise. Traditional Chinese Medicine (TCM) holds that muscle and bone are closely related to the spleen, liver and kidney, osteoporosis mainly locates in the kidney, spleen and collateral channels.it is mainly associated with shenxu(kidney deficiency), pixu(spleen deficient) and blood stasis, emphasize equal attention about bone, tendon and muscle, static and dynamic combination. The main treatment principle is bushen, jianpi and huoxue (nourishing kidney, spleen and invigorate blood).