绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)是指绝经后妇女体内雌激素水平下降,骨形成和骨吸收失耦连,导致以骨量减少和骨组织显微结构破坏为特征的一种全身代谢性骨病,是绝经后妇女的常见病及多发病。随着我国人口老龄化,绝经后骨质疏松症以其高发病率、高致残率逐渐成为严峻的公共卫生及社会问题。临床治疗绝经后骨质疏松症的药物以西药为主,中药为辅,但西药严重的毒副作用和中药作用机制的不明确都制约着其进一步的推广。目前,随着骨代谢机制的进一步明确和相关诊疗技术的突破,临床用药有了新的进展。本文以临床药物治疗为出发点,从西药、中药两个方面入手,通过查阅国内外近期相关文献,对西药类(基础药物,抗骨吸收药物、促进骨形成药物、双重药理作用药物)和中药类(单味中药、中药提取物、复方制剂)的临床使用现状进行归纳总结,同时提出笔者对绝经后骨质疏松症药物治疗现状的思考。
Postmenopausal osteoporosis is a systemic metabolic disease characterized by reduced bone mass and microstructure destruction,and is caused by the decrease of estrogen in women after menopause and the uncoupling of bone formation and bone resorption. Postmenopausal osteoporosis is a common and frequently occurring disease in postmenopausal women. With the aging of the Chinese population,the high morbidity and disability rate associated with postmenopausal osteoporosis has become a serious public health and social problem. Clinical treatment drugs for postmenopausal osteoporosis are mainly western medicine,supplemented by Chinese medicine. However,the serious side effects of western medicine and the mechanism of traditional Chinese medicine are not clear and therefore restrict their wider application. At present,with the further development in the mechanisms of bone metabolism and the breakthrough of related diagnosis and treatment technology,clinical medicine has made new progress.Starting from clinical drug treatments,from the two aspects of western medicine and traditional Chinese medicine,through literature review of recent publications,we summarized the current situation on the clinical application of Western Medicine(basic drugs,anti-resorptive drugs,bone anabolic drugs and dual pharmacological action drugs) and traditional Chinese medicine(unit Chinese medicine,Chinese medicine extract and compound preparation),and put forward our perspectives on the current status of postmenopausal osteoporosis drug treatment.